"Accompanying a friend with a severe wrist fracture to the Emergency Department"

About: Bristol Royal Infirmary / Accident and emergency Bristol Royal Infirmary / Trauma and orthopaedics

(as a friend),

We arrived at 11:30pm on a Saturday night and followed the signs around the building works to the waiting room. We were surprised it was not more busy. The room felt like a bus station at night: quiet, dull decor, no one seemed particularly unwell. There were a few 20-40 year olds who appeared to have injured themselves at parties, taking photos of head wounds, ripped trousers and laughing.

We registered our friend who had a swollen, displaced wrist fracture that was immediately obvious to me, the triage nurse and radiographer. She was in severe pain and was only given co-codamol (paracetamol and low dose codeine). Having a medical background, I asked about stronger medication, but was told it was not possible.

The next two hours were very distressing. We had to sit next to our friend who was in agony. My wife was thirsty and the water fountain did not work. No one offered us a drink or showed us where we could get one. I felt like we should be grateful for being there and await our turn.

I asked several times for pain relief and for a review, particularly as the XRay had confirmed the fracture. At 01:20, I finally asked the charge nurse to help us. As soon as we were taken to minors and met the excellent locum SHO, everything changed. The environment was nicer, pain relief was given rapidly and we all relaxed. Communication was clear and honest. The SHO was charming, efficient and re-assuring.

The orthopaedic team elected to admit our friend, rather than pull the fracture in the Emergency Department. In fact they returned to the ED at 11am the next morning to pull it there. My friend reports that she was “put to sleep in casualty” to pull the arm. “Then waited all day to be allowed home”.

I am grateful to all who helped us. It would, however, have been simple to listen and give adequate pain relief on arrival. That would have transformed our experience.

Beyond the basics, an improved environment, more information and more efficient service would have helped.

Thank you again.

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