Thursday, 31 October 2013

The A & E Revolving Door Protocol - UHW

The A & E Revolving Door Protocol

No guilt, no change in direction, no remorse, NO INPATIENTS

No need to guess who we are still trying to make see sense.  There is nothing logical about the NHS/Wales government’s changes, nor is there any financial justification for the murderous policies being adopted by either legal entity.  I have little enthusiasm left in me. for continuing the horror story, even after hearing the misleading promise of a 45 bed neurological ward for Llandough hospital.  Re-arranging the deck-chairs on the deck of the Titanic was of no use, neither are any such stupid outpourings from our Minister for Health and Social Services, Mark Drakeford,  Professor of gardening implements and their application.

Not even the article of 11th October about an increase to 13,147 patients waiting 36 week or more from their referral to hospital for treatment. What chance anyone elderly or with a chronic illness got of surviving until his first appointment .  My answer is “damn all”, with not a care in the world  However, I would like to relate my own personal experience of being taken to what used to be called Accident and Emergency Department at many of our local hospitals.  Now, it is said – by the great horticulturist and the First Minister of Jokers – that “we don’t need more than 4 or 5 A and E departments any more, even though we have, apparently, been making excessive demands on these facilities.
Once upon a time, the A and E department of the hospital was its’ front door. Now, for reasons of falsification of figures and costs, this entry point door has become  a revolving door, intent on sending you out faster than you were brought in – even following  a 999 call or an urgent referral from your GP. My first such emergency trip to hospital received short, sharp shrift.   I had a suspected heart attack and endured a day and a half on a trolley before being given a hospital bed.  The following morning I did not see or hear from a cardiologist, only a 16yr old ( looking  ) F1 who had been told to” discharge me” before lunchtime. My protestations were ignored, the only response being “make an appointment to your GP for a referral to a cardiologist” !  But the 999 call had been made by my GP, so what the blazes were they playing at ?

The most recent visit was as a result of an increasing pain in the surface of my left side, and the 999 call being made by a ‘concerned party’, despite my protestations. Ah well  “Better to be safe than sorry – eh  ?“ [Why is it that most people speak in platitudes, sound-bites, or Americanisms ? ]
To continue my tale, neither of the ‘first responders’ was a paramedic so, no mandatory E.C.G. Taking a mere 45 minutes to drive from Penarth to the Heath ( 7.1/2 miles max }, I waited a relatively short 20mins before being wheeled into a small corner of the new Assessment Unit – still under construction, and exposed to the open air – the ambulance man was instructed to wheel me to ‘Ambulatory Assessment” , where I waited little more than 45 mins before being taken to a ‘trolley’.

Nope ! – not the old type of uncomfortable trolley with the side-gates and no room to move – but a new trolley,  Black 2 piece, covered in shiny PVC , impossible to adjust yourself and as uncomfortable as the rack designed by Edgar Allen Poe.  A short wait and a highly efficient doctor – dressed all in black, making me feel as though in the presence of a pall-bearer – who bunged a canular into my arm, took some blood, and said “A medical doctor will see you shortly”. During that period of wondering what the difference between a doctor and a ‘medical’ doctor, I attempted a find a comfortable sitting or lying position on the rack-sorry trolley both were impossible, so I bent my knees to enable me to lie onthe flat bit whist a charming nurse (over 12y.oa ) took an ECG. Needless to say, I was still in great pain, and relieved to see a fresh-faced medical doctor ‘in civies’ who examined me and asked me every detail of my medical history ( in spite of having all the data to hand on his computer. ) This true professional then escorted me to x-ray for my chest to be examined.  After being returned to my rack-trolley, I endured a further  E.C.G, conducted by a green woman - who allowed no speech – then told me that I could take off all the stickers.

The hours past, without my being offered a cup of tea and/or a sandwich, until the time came to take my usual medication. No one answered my - “Is it alright to take my tablets now…….?”. Another hour passed with me longing for some fluid and nourishment from my tablets, at least. The bench grew more uncomfortable and I was becoming a little frustrated.  Eventually a new shift brought a charming sister who provided a welcome cup of tea AND a sandwich, promising to organise my meds and to arrange a trip home. Sated, I realised that no one had given me any results, so I began asking “Is my doctor still here….?” Again, no answers but a short 45 minutes later, a most charming, distinctly Irish consultant bussled up to me, apologising and saying that “The tests showed nothing so I have to agree with your original feeling that you are suffering from Shingles”.  During his most charming manner, he touched my skin in several places, causing me to yell out in pain, before saying “Shingles – yes” before bustling away again.
My happiness was short-lived as another import from the Emerald Isle approached, saying “Is this your bag “, rather abruptly, to which I said “Yes, what’s wrong with it ?”

“I Need this trolley” he, continued, rudely.  Fortunately, Sister Fiona intervened, telling me to send anyone else like him to her and she would sort them out. Regardless, of her kindness I collected my bag in silence and went back to the grubby chair area, to await the ambulance.
At last, 10.00pm slipped by and the St John’s ambulance men slipped, offering the friendliest smiles I had seen all day. A mere 40 minutes later I was being escorted into my flat by these wonderful men.

Not bad after eight / nine, hours of purgatory . Unsurprisingly, they didn’t have my medication, so I gingerly followed my way out as the nurse was washing the blood off the trolley !    Since then, then pain has not lessened during the following seven days, and all my GP can tell me is that I “must have perpatetic neuralgia” without giving any indication of how long this might last.   R.   W.

N.B.   One sad sight on my way into the A and E Dept. was seeing a young man in handcuffs being kept outside by a policemen. I asked the nurse if he was mentally ill and she replied " I'm afraid so". So, if we treat our so-called 'norma'l patients badly, just imagine how awful it is to be mentally ill and unable to access proper care.

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