"2 visits to A&E - 2 experiences"

About: University Hospital Wishaw / Emergency department

(as the patient),

Recently I attended A & E at Wishaw General. This was my second visit in 3 weeks. During my first visit on an incredibly busy day in July, from the moment I checked in I was treated with compassion, understanding and respect. The receptionists could see how much pain I was in and requested pain relief for me from the triage nurse. The triage nurse was amazingly understanding and arranged not only for pain relief but also a bed for me to lie down as the pain was worst in a sitting position. The staff were absolutely run off their feet dealing with patients but continued to check in wire me as often as these could and monitor my pain levels. When I did see a Dr I was really listened to and they arranged for more pain relief as the nurse prescribed medication wasn’t dealing with my pain levels. I was admitted and some investigations carried out. Again the staff in ward 18 were compassionate and listened to me, frequently checking in on my pain levels. the dr and team kept me in good humour throughout and arranged a specialist follow up appointment for when I returned from my holidays. 

Last nights experience could not have been more different sadly. 

I arrived after having another acute pain episode. This started at around 3pm in the afternoon and I contacted both the specialist nurse lead clinic I am due to attend and also consultants receptionist to see if I could get any quicker an appointment to be seen due to 2 such intense episodes in 3 weeks. I was unable to make contact with specialist nurse and consultants receptionist advised if it was too painful and I couldn’t manage it - to go via A and E. I am very proactive in my own care and pain management as I live with Fibromyalgia. I am not someone who looks for a pill to fix things or a quick fix - but I also know my body and it’s limitations when it comes to pain and when to ask for help if needed. 

I arrived at A and E in visible pain. Despite posters encouraging patients with high pain levels to request medication my request was not addressed by the receptionist who stated I had to wait to be triaged. When triaged the nurse advised I could be given codeine. I explained that this medication was tried last time and didn’t touch the pain however I would take it alongside stomach medication until seen by Dr. I also advised that I was finding it incredibly painful to sit upright and asked if I could have somewhere to lie down. I explained clearly that I was absolutely happy to wait to be seen but that I could not sit upright for a further possible 2 hours. I asked for somewhere that I could lie flat or on my stomach as these positions helped alleviate pain. I was told there was nothing available for me. I explained again that I was happy to go back into the waiting area but couldn’t tolerate sitting upright. I was met with a very uncompassionate response of “you are the third person tonight that has told me they can’t possibly go back out and sit in the waiting area - my hands are tied”. 

I clearly explained again that I had no problem returning to the waiting area to wait my turn to be seen but that sitting in upright position was incredibly painful. Was simply sent back to sit and wait. After a further hour and with pain not decreasing I was left with no option but to utilise the round cushions in the children’s area in A & E and lie on the floor there. 

When I did get though to A & E my experience was polar apart from 3 weeks ago. I felt I wasn’t listened to, my pain levels were not acknowledged (no scale measuring questions asked although they should not have been needed as I was visibly in pain), and I was basically to cut a long story short sent home with no pain relief and told to visit my GP to discuss and attend specialist clinic next week which was already in place. The Dr discussed chronic pain management with me and I explained that I am more than aware of chronic pain and it’s management. I also explained clearly that knowing my body very well - I am very sure that this is not a Fibromyalgia flare up and that I feel that everything is always blamed on Fibromyalgia diagnosis when there is still “me” underneath that diagnosis. I felt dismissed, upset, frustrated and disbelieved about the amount of pain I am experiencing. 

I had taken along relevant medical information which the Dr looked at only part of. I asked for all of the information I had taken to be added to my notes as a way of self advocating the position I find myself in (going round in circles in a lot of pain), but the Dr refused to take the information. So I’m back home, still in acute pain and feeling like it’s all in my imagination. I am upset, frustrated and probably above all confused as to why both visits with acute pain were treated so differently. 

Responses

Response from Andy Pender, Senior Nurse, Emergency Medicine, University Hospital Wishaw, NHS Lanarkshire

picture of Andy Pender

Dear Dazzle,

Thank you for taking the time to post your experience on the care opinion.

I am sorry that the second visit was not as positive an experience for you as the first visit and I would like to have a chance to review your concerns.

If you would please contact the patient affairs manager with some details I will ensure these concerns are reviewed. The contact details are Yvonne.ross@Lanarkshire.scot.nhs.uk or telephone 01698 366658


Best wishes

Andy

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Update posted by Dazzle (the patient)

Dear Andy

I am already in contact with Patient Services. I genuinely wish that I could say that the above was the end of my journey but it hasn’t been. I was re-admitted to ward 16 and then 18 via my GP on Friday. The nursing staff I have encountered during those inpatient stays have been an absolute credit to themselves and NHS Lanarkshire, however the systems, communication and I am sad to say the Drs I feel have completely let me down. I do not have the energy at present to detail each event - but I will as it’s incredibly important that lessons are learnt from some of the experiences I have had to encounter over the past five days. Incorrect information being relayed, relevant medical information not being given to me, mistakes with drug prescribing, Drs basically tellingly me that my symptoms are in my head because their text book says “normally” those things wouldn’t happen. And to still have to beg for relevant pain relief to be sorted almost 48 hours into an episode of acute pain is not acceptable. I have the utmost respect for the accessible free healthcare that we are very lucky to be able to access in this country but during this episode I feel like I have been in the middle of a circus with no ringleader. And it’s still ongoing

Response from Rick Edwards, Programme Manager for Person-Centred Care, Quality Directorate, NHS Lanarkshire

picture of Rick Edwards

Dear Dazzle,

I'm sorry to hear that your current health has required an admission to hospital. Thank you for taking the time to feedback about the positive and not so positive elements of your experience.

You're absolutely right of course; we have an opportunity to refelct and learn from experiences shared and it's very important that we are able to do that. Your story also illustrates how complex healthcare can be with many different specialties, teams and staff involved in providing treatment and care.

I'm glad you've taken up Andy's offer to get in touch with the Patient Affairs team; they'll be able to take more specific details so that we can reflect on your experience and discuss the issues, or investigate them in more detail with the relevant staff if appropriate.

In the meantime I hope the staff have been able to make you more comfortable and you'll hear from the Patient Affairs team as agreed.

Kind regards

Rick

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