Stress Testing The NHS (Episode One).
Ms Raccoon has been your reporter-at-large for the past week, selflessly stress testing the NHS emergency procedures. It has not been a happy experience. I throughly dislike using a blog for a ‘poor me’ misery-memoir, but there is a reason for this post – the second instalment of the post is a formal letter of complaint to the chief executive of the hospital I landed up at. I want it here as a matter of public record. Feel free to just ignore, and return tomorrow for the normal Raccoon fare.
14 days ago, I was fit enough to drive myself to and from Cardiff and attend a conference for the weekend. 7 days ago, I was fit enough to sit in front of this computer and compose two posts – one for Monday, one for Tuesday. Terminally ill – Pah! I had just signed up to crew on the Lord Nelson, one of the Tall Ships currently circling Britain.
However, at 4pm last Saturday, I was hit by a wave of overwhelming pain. It was instantly recognisable. My shiny new colon had gone into spasm. Mr G searched through umpteen removal company boxes to find the remains of the excellent medicine I had been prescribed in France to prevent the situation deteriorating. Ouch! We had but two tablets left. But what was it called in England, and was it a prescription-only drug here?
We tried the GP surgery. Not available on a Saturday. We tried the Palliative care team. Not available on a Saturday. We tried (and failed) to find a number for the District nurse appointed to me that I had so cockily decided I didn’t need. By this time, the pain was making me be sick. ‘Call an ambulance’ friends said. ‘Don’t be ridiculous’, I said. ‘It’s not life or death, I just need this drug’. ‘Call 111’ someone suggested. So we did. ‘111’ has a check list of questions. They don’t have any answers. They informed Mr G that they were ‘sending someone’ and if they didn’t arrive within 20 minutes he was to dial ‘999’.
The check list of questions had apparently decreed that what I needed was not an answer to my question, but two fully trained paramedics and a well equipped ambulance with a snazzy blue light on top to alert the village that there was excitement afoot. Fair enough, I am aware of the multitude of other things that my symptoms could have suggested, and the inherent dangers in them, and I can understand the caution – but there was no way to ‘buck the system’ and tell someone competent to listen that this had happened several times before and ‘x’ was a simple and effective cure that worked for me.
The paramedics, bless ‘em, understood that it was the pain making me sick, and that was something they could deal with; a cannula was set up to deliver morphine – actually, the second cannula. The first one refused to work. They did insist that since they had given me morphine, I had to be checked out by the hospital – and I did still need the anti-spasm drug. We set off on the long journey across the marshes to a hospital on the East coast.
I didn’t expect to be seen promptly. It was Saturday night, this hospital was slap in the middle of what has been called the benefit capital of England. I didn’t expect it would be half past three in the morning before I was seen either, but there you go. Unfortunately, until you are seen, you are not allowed so much as a drop of water – you might need surgery – but you are allowed morphine every four hours. By the time I was seen and x-rays had been checked, I was throughly dehydrated, had not eaten or drank fluid for 12 hours – but not in pain; indeed I was smiling dreamily and suitably placid (for a Raccoon). I could go home! Even better, it was agreed that the drug I had requested was the right one to avert this situation in future. and I was given a supply. Hyoscine-N-Butylbromide it’s called in England. It will live in front of my computer from now on!
7am, Sunday and we had made the journey back across the marshes. Mr G did make me a cup of tea, but I was fast asleep after one gulp. I didn’t wake until the afternoon – more tea and some toast! A disastrous move. The pain came in waves like labour pains – somewhere between quads and triplets. I was sick repeatedly. Mr G called 111 again. The ‘cure’ was no good to me now, I couldn’t keep it down.
This time, three paramedics arrived, with an even fancier ambulance. They were brilliant. I might have run out of ‘arm’ venues, but they found a hand that hadn’t already been attacked – I was beginning to resemble a voodoo doll – and more morphine! I stopped snarling and turned back into the easy-going, complacent yet charmingly polite, creature you know me to be. Everybody peered into the sick bowl, and agreed that they couldn’t be sure whether it was blood or not. ‘Coffee grounds’ is the technical term I understand. It does make it sound less revolting. All were agreed, however, that I needed to see a Doctor – and that meant A & E again. I flatly refused to return to my Saturday night experience and asked whether I could be taken to the Norfolk and Norwich Hospital – I live halfway between the two. They agreed and off we set across the marshes again.
What happened next will be recounted in the form of an open letter to Ms Anna Dugdale, Chief Executive of the Norwich and Norfolk Hospital at 4.00pm.
Stay tuned to this channel…
Anna Raccoon
- AdrianS
June 14, 2015 at 10:14 am -
Sorry to hear your going through another bad period. Hospitals are much fun and you come out feeling like a pin cushions
Cheers
Ade - Moor Larkin
June 14, 2015 at 10:25 am -
I recall a character from “To Kill A Mocking Bird” that stayed with me more than the characters I was supposed to engage with, was the laudanum-swigging person with the inoperable cancer. I used to think to myself, “God, how awful that in the old days that was all they could do”.
http://www.tcm.com/mediaroom/video/303885/Shootist-The-Movie-Clip-Doc-Hostetler.html
Good to see you shooting from the hip. - The Blocked Dwarf
June 14, 2015 at 10:25 am -
Hyoscine-N-Butylbromide
and can be bought in every supermarket here and most major garages. “Buscopan”-as you no doubt now know.
- The Blocked Dwarf
June 14, 2015 at 10:33 am -
“A & E again. I flatly refused to return to my Saturday night experience and asked whether I could be taken to the Norfolk and Norwich Hospital “
I think, in a previous email to you, I refered to the N&N A&E as ‘The Departure Lounge’ and it sounds like you may now have discovered why…
Only recently they, the A&E, left someone displaying all the symptoms of a major stroke, sitting there for hours whilst his panicking family watched as their dear old Dad’s brain slowly ‘burned’ (remember all those F.A.S.T Burning head Ads?). Finally his Son-in-Law had to resort to words not found in scripture and a tone more commonly used during armed bank robberies to get him seen. - Michael
June 14, 2015 at 11:23 am -
Before he died of a massive brain hemorrhage, my dad saw his doctor a few times with recurring severe neck pains and was told (kid you not) “you’re too tall”. He said that, having been 6’1″ for the past 40 years he didn’t think this was likely to be the cause.
My wife struggles to breathe after doing something as easy as brushing her hair or standing up. She’s been told it’s everything from low iron, vitamin D, panic attacks and (believe it or not) the fact that she doesn’t wiggle her toes before standing up. It’s taken over two years of going back to the GP before they have decided to have a look at her heart.
Staying tuned for the next installment, but not holding out much hope of being regaled with tales of courtesy and thorough professionalism.
- Hadleigh Fan
June 14, 2015 at 11:51 am -
My Heart goes out to you Anna.
When I was in academia I was on a field course with a French exchange student. I forget now what was wrong with her, but she was panicked about being given drugs to which she was allergic – more important than treatment for what she had (flu possibly or a bad cold more probably). I remember sitting at her bedside, which today would see me on the dole queue. It was pre the ready availability of the internet or we could have looked things up.
- Lysistrata Eleftheria
June 14, 2015 at 12:35 pm -
Very sorry to hear about your latest pain episode, Anna. Not sure I’m ‘looking forward’ as such to reading what happened next…but I am keenly interested. For now, may you be as well as you possibly can be. Lx
- Magwitch
June 14, 2015 at 1:03 pm -
Sorry to hear you’ve not had the best of experiences Anna.
Good to see the 111 system working well as always – ( the usual joke is that they call an ambulance before they even know what’s wrong) -they are the bane of the ambulance service.
There are some interesting points here (seeing as I work as a paramedic for the same Trust that covers your patch)
You’ll never get 2 paramedics on an ambulance, one of them will be either a trainee/student para or an emergency care assistant. The reason you got 3 the second time, I’m betting, was because Control sent you a solo in a car first.We don’t ‘have’ to give you morphine by the way. In fact the analgesia of choice is currently I.V. paracetamol. Sadly, having given you morphine, our protocols state that we must convey to hospital; not because you need a check up but because one of the side effects of morphine is that it can stop you breathing. (that’s why we carry the antidote – naloxone, or narcan as it’s usually called) As a bonus it also works well for heroine overdoses but that’s NOT why we carry it despite what all the newbies think.
Hopefully there won’t be another ambulance visit but, if so, you could gently remind them that we can give morphine intramuscularly; it takes longer but saves all that faffing about looking for a vein.As for the N&N, although you haven’t published part 2 yet I bet you waited hours & hours & hours & ……..zzzzzzzzzzzz just to be seen.
It’s one of the worst performing hospitals in the country for ambulance hand-overs.I await part 2 with interest.
- Joe Public
June 14, 2015 at 1:19 pm -
I too am sorry to learn of your recurring medical problem.
I’m not sure whether The Health Service has a mission statement. If it has, maybe “caring & curing customers” is below “minimising litigation payouts”. The latter exacerbated by certain members of the legal profession.
Having contacted 111, I speculate it was probably more than your advisor’s job risk, to do anything other than what his/her screen dictated.
- The Blocked Dwarf
June 14, 2015 at 1:24 pm -
@LaRaccoon, Just got an email from another commentator here.
“http://www.dailymail.co.uk/news/article-3123036/Rolf-Harris-s-vile-jail-song-shock-letter-cell-shamed-star-reveals-country-rock-lyrics-damn-sex-victims-greedy-wenches-brags-cushy-prison-life.html
Tell AR”
- Michael J. McFadden
June 14, 2015 at 4:52 pm -
Anna, as always, thank you for sharing your life with us. I hope it gives other people the courage to fight for what they need when faced with being at the mercy of hospital bureaucracy. I think that of all the times in one’s life when one is most dependent on family and friends, it’s when they’re in the hospital: it’s VERY hard to “fight for yourself” with the people you’re so dependent on for your care there… you don’t want to get them angry at you or alienate them. But if you have a supporter who can speak FOR you it makes an enormous world of difference.
I was in the hospital about 15 years ago for a major internal dissection of my right subclavian artery. I’d been walking around for four days with no pulse in my right arm and finally went to see my doc (I hadn’t made very clear that it might be an emergency when I’d called on Thursday, so they gave me a Monday appt!) The poor prep nurse almost had a heart attack when I specifically had her take my right arm BP! LOL! She chokingly asked how I was feeling, and I said “Hmm…. ok… Sorta dead….” at which point she RAN out of the room and 30 secs later my doc comes in, glares at me, and says “What did you do to my nurse?” I said, I just asked her to take my blood pressure and held out my arm. He sat down wrapped the cuff, felt for my pulse, and his eyes opened wide and he said, “How are you DOING that???” LOL!
In any event I had a big op done in my neck area and it swelled up like a cantiloupe during the two following days from post-op liquid buildup. THEN… the swelling went away, but I began having difficulty breathing. A visiting friend who was trying to get me some attention and was sitting with me when he was told visiting hours had ended. He refused to leave until things were fixed. They sent a security guard. The guard said, “You have to leave. What relation are you to the patient?” My buddy glared at him and said “I’m his LAWYER and I’m not going ANYWHERE!” LOL! Guard went away and within 20 minutes they wheeled a portable XRay unit it and discovered that one of my lungs seemed compressed. Well, my breathing had started to get better, so they scheduled me for a re-exam the next morning and my friend went home. Next morning I totter to the bathroom and discover that where I used to have a carrot and two grapes I now had a carrot above a grapefruit!
Evidently the post-op fluid was just draining down through my body, had compressed the lungs the previous evening, and then made a temporary home for itself in the convenient little sack I carry around down there. It all resolved itself nicely, but having my friend there the night before made ALL the difference in the world for the state of terror I was sliding into!
There’s a good reason to restrict visiting hours: patients often feel a need to “put on a game face” and “entertain” their visitors while exhausting themselves. But having one competent, loving, caregiving friend just to read or nap in the chair at your side and occasionally adjust your pillow can be worth a whole hospital and a half full of doctors and nurses.
I wish you the best m’lady. May you continue to confound their time schedule!
Michael
- Carol42
June 14, 2015 at 5:01 pm -
Sorry to hear you had such a horrible experience Anna and hope all is well now. I had a very similar experience nine years ago, terrible labour like pains and extremes of being hot and cold. Called my own Dr. Fortunately it was a weekday so he called an ambulance, blue light to Hinchingbrooke where I was given morphine, first time ever! No food or water as they suspected a bowel obstruction but by then I was too mellow to care. I was admitted and thankfully it turned out to be a massive bladder infection that was treated with intravenous antibiotics. It is frightening that so much is left to chance and where you are taken. The only good thing I have found with Cancer is that, at least in my case, if anything is wrong they really check it out. You have done wonderfully well Anna and I hope you stay well and happy for a long time yet.
Carol - Roijtek
June 15, 2015 at 9:35 am -
Re the Rolf Harris article, the ellipsis in “basically I am doing what I like…” really makes me wonder if the next word isn’t “doing”, which kind of completely changes the meaning.
- corevalue
June 16, 2015 at 1:27 pm -
I so wish I could get on with morphine. Just makes me sick, with vertigo and appalling constipation.
I haven’t had milady’s trouble with hospital admissions, but on my last emergency visit, I was given blood-thinners to self-inject, a month’s supply. The oncology people (separate bunch based in a different hospital) then told me to take it for three months. The trouble arose because none of the three organisations involved (GP, oncology, emergency ward) would take responsibility for prescribing the extra supplies.
{ 22 comments… read them below or add one }