Shell shocked after a and e visit

[Onethreefiveseven]

I am looking for advice on what to do next as I feel like I'm not coping

I started developing very severe neck pain yesterday. I am not inexperienced with pain, I've been through significant, life-threatening medical events. This was far worse pain than breaking a bone, for example, or an infected surgical wound. I've also had migraines and this was much worse. The closest comparison was when I went into hyperstimulation during a pregnancy induction and felt like my abdomen was in a vice. This time I felt like my skull was about to crack. It was so extremely painful and very frightening, I also had blurred vision on my left side. The pain was so intense I can't describe it.

I was sent to a and e by 111, got there at 8, told 3-4 hours wait. I sat in waiting room on a hard chair groaning and crying. By the time I was triaged the wait had become 5-6 hours and then by 11pm 8-9 hours. I spoke to a receptionist who made it clear that I wouldn't be seeing anyone until the morning. No pain relief until then. So I asked my partner to pick me up and we called 111 again desperately trying to get pain meds. Spent the night waiting for callbacks and begging for help down the phone. Sobbing and at times screaming from the pain. I finally got some codeine this morning, after 14 hours of indescribable pain.

This morning the pain is more under control and I thought I would feel relieved but instead I feel odd, psychologically, in a bad way. Kind of dead eyed and like I want to cry but can't. Hopeless. The fact that I interacted with so many people and no one helped. No one even really seemed to believe me how bad the pain was. I'm not writing this to blame them. Maybe they were doing what was necessary, prioritising other patients. It was still horrific though.

I will make a drs appointment for my physical health but I want to know what to do, today, to try to minimise the psychological effects. I've barely slept and I can't figure out what to do. Has anyone else been through a prolonged period of very intense pain and/or been denied pain relief, and found a way to cope with the emotional aftermath. Maybe just writing this down will help, I don't know.

People are dying in a and E because they are waiting hours to be seen. The OP stated that she waited several hours. It's not like go to a and E wait 4 hours and all will be well like 5 or 10.years ago. The whole system is a disaster and people are waiting 3 days to be seen in many cases.

I'm so sorry OP That is horrific and the mere fact that you were in obvious agony should have got you triaged and given pain relief before investigating the cause
For example you could have had a subarachnoid haemorrhage which is between the brain and the skull which should be ruled out
One particularly insensitive reply upthread is unnecessary and most have similar stories to tell
My DS's friend was in a seemingly minor car crash and had to wait in agony for pain relief After 9 hours she was given... 2 paracetamol.
Eventually it was discovered she had broken a vertebrae in her neck and her collarbone
Ok they're busy, but where is the compassion and human kindness?

Not necessarily.

19,000 people waited over 3 days in a and E in the last 12 months

14,000 people died due to waiting too long in a and E in 2023. Presumably most of these were triaged and thought to be safe to wait.

I don't think people realise what a scary state things are in

I totally agree. We should all be screaming from the rooftops and not taking this shit both staff and patients.

However whilst the system is in the state it's in you're far less safe if you make unwise decisions. That was the point of my post. The OP needed to stay in ED and be fully assessed as medically trained people on here have said.

I am truly sorry for the patient I really am but it is what it is. We all have to help each other not blame each other

Time is finite. Staff only have two hands each. Bed spaces are limited (although corridors are sadly also needed).
So no matter what is wrong with you, if the resources in terms of time, staffing and space are already in use, they can't be used by new patients arriving in the ED. The only exception would be a major trauma, but in those cases a crash/trauma/resus call would go out and staff called in from other departments/services to assist.

The problem is not prioritisation necessarily, but insufficient staff numbers and bed spaces. This is what the next government must fix.

And yes, people are actually dying in the ED due to lack of staff and bed spaces, plus lack of ambulance and long delays getting patients out of ambulances into hospital.

That's not the case in every hospital though. I went to A and E last year with heart problems and was triaged after 10 minutes, had blood pressure checked, ECG and bloods taken. Waited 2 hours for blood test results to come back and in the meantime was admitted to A and E majors where I was monitored on heart machine. Couldn't fault my care and the nurses were lovely making sure I had cups of tea and a sandwich. The problem is, as with everything, we only ever hear the bad side of things. The NHS saves lives every day but we don't hear that because it doesn't make a good news story.

I think they lose compassion because conditions mean they can never do a good job. It must be very demoralising. Eventually people either leave, or adjust their mindset so that giving a crap service is normal and acceptable.

A friend was a junior doctor and left because it was a choice between staying 3 hours extra every night or leaving people suffering. It isn't possible to keep the same level of caring and continue working in those conditions

i agree with this.. if the pain was so intense i would have sat there and waited it out.

in fact i did in october, i went to a&e with a suspected stroke...i was in a&e a total of 29.5 hours before they gave me a bed.. i ended up admitted and was there a total of 5 days.

I'm glad you had excellent care. I know there are hospitals and departments where things are fine. But unless the vast majority , most of the time can access excellent care it isn't good enough.

The level of care you experienced should be an expectation that everyone can have. Currently it's an exception.

Christ I hope to god you don’t have anything to do with patient care! With friends like you who needs enemies!

Yes, you’re right. My surgery is now an amalgamation of several, including a couple of village ones. However, they’ve all got the same central number to stop anyone sneaking in that way!

That sounds like workers comp.

Have you had scans of your back?

I had a back injury that resulted in several pinched nerves. I couldn’t lift my leg and it would drag behind me. Surprisingly there was zero pain initially as the pain signals were completely blocked at the time.

To cut a long story short I went to A & E and was seen immediately as they were concerned about corda equina.

If you’ve been diagnosed as having a pinched nerve then are more appropriate drugs than Tramadol. If you haven’t been diagnosed then why the hell not?!

Telling you that Tramadol is addictive is utter stupidity when you have severe pain. Especially when there are actual treatments for a pinched nerve (other than surgery).

I'm so sorry you have been through this. I just wanted to acknowledge your post. The treatment of women in pain can be unbelievably appalling.

Please continue to keep fighting for better care, and use all your wits to seek other therapies that can help. You WILL get to the other side of this and be pain free again. I'm so glad you have good friends. Sending strength x

'By the time I was triaged the wait had become 5-6 hours and then by 11pm 8-9 hours. I spoke to a receptionist who made it clear that I wouldn't be seeing anyone until the morning'

But you were seen? Triage is being seen. If there were neurological issues or your vital signs concerning you would have been escalated at that point. How long was it from when you entered A&E until you were seen/triaged? What did the triage hcp say when you asked for analgesia?

In terms of the psychological effects this sounds very traumatic. I would speak with PALs for some support. Allow yourself time to recover and process what happened, and if you are still troubled then maybe seek some psychological support/counselling.

This is a question to Brits relying on the NHS - why are you so reluctant to go to a private hospital or to urgent care and pay privately when it’s clear you’re not an actual emergency?

People are dying because of insufficient resources and public hospital waiting rooms are being taken up by people who aren’t real emergencies.

This is a genuine question and it’s not intended to rage bait. I asked a British person this question 15 years ago and I was absolutely screamed at. I know you’re attached to the NHS but you’re dying…. Surely you’ve considered other options.

'People are dying because of insufficient resources and public hospital waiting rooms are being taken up by people who aren’t real emergencies.'

This. You've answered you're own question, hospital waiting rooms are taken up by people who aren't real emergencies. People can't just pay privately, tbh it's shit anyway you'd struggle to find a private hospital with 24hr services for example. You get nice soft furnishings privately but sadly scratch the surface and that's it, you're soon shipped out to a real hospital should your condition deteriorate.

People need to go ro GPs, UTC and leave A&E for accidents and emergencies.

This is a question to Brits relying on the NHS - why are you so reluctant to go to a private hospital or to urgent care and pay privately when it’s clear you’re not an actual emergency?

Because very few private hospitals in the UK are set up to deal with acute, undifferentiated conditions.

There can be many reasons:

1. You don't know if it's an emergency or not - whether it's something that can wait or might be fatal (e.g. stroke)
2. You don't have the money
3. There's no appointments available at the private clinic/they don't service that type of medical need - as far as I know, we only have public A&E departments and no private ones.

In any case, if you've been referred to A&E by 111 then why should you feel like you're unnecessarily taking up resources?

Lastly, we bloody pay for a national health service and should be able to use it when we are in excruciating pain like the OP was, without being guilted for it.

We don't necessarily make the best or most logical decisions when we are in massive pain either - after waiting and being ignored and in pain for 9 hours with no hope of being seen soon, I think most people would be severely tempted to go and rest in their own bed and hope that they can be seen another day. I hate that a PP berated OP for taking that decision rather than empathising with her.

Exactly! I could book a private hospital for a hip replacement or to see a gynaecologist. I can not pay to see someone privately for an urgent matter unless I travel a long way. It is why even members of the Royal family are transferred many miles to a private hospital if necessary.

@Onethreefiveseven post as you like! Majority of us understand how difficult that was for you.

I had a relatively good experience in A&E (seen to fairly quickly, given strong painkillers without asking) but an elderly relative was left in a makeshift trolley overnight with broken hip before being transferred to a ward. They said a random young man, not staff, offered them drugs and I thought perhaps they were hallucinating. Not so, when they were more lucid and calm they described it in more detail.

My 92 year old aunt has been admitted by ambulance to the purpose-built A and E hospital near us 3 x since Christmas - twice with pneumonia and once with a urine infection.

The hospital is appalling. In every way. The route to the main wards is through the waiting area so there is constant traffic through the seating area of people waiting to be seen, often in really bad pain. You are seen by nurses who don't seem to have any humanity or warmth for patients and don't care about pain and distress that patients are suffering- they are disinterested and cold with patients but screeching with laughter while they play/talk on their phones or talk to other nurses in the central staff area.

There is no attempt at all to make patients comfortable- my aunt is 92, blind has osteoporosis and scoliosis and is in constant pain, never mind the reasons she was admitted- she has been left slumped in her wheelchair groaning and crying. She was left over night in a corridor on a porter's trolley (in a line of patients on hard chairs and wheelchairs) which was agonising for her for 15 hours until they found her a bed- no IV antibiotics given during that time although they had diagnosed her as being 'very poorly with pneumonia in both lungs' and written the IV antibiotics up. No food given but she was given a cup of tea at one point. (Once in 15 hours and nothing in the 4 hours she waited before she reached that corridor).
The ward itself was filthy- she was put into a room where there were used tissues all over the floor, the table trolley across the bed was covered in phlegm filled tissues which were lying in spilled water . When they got her a sandwich they put it on the trolley tray in amongst the tissues so it was inedible.
The standard of nursing care was appalling- they dud not notice they had put her IV into an area where the skin had torn and the drugs/fluid was just being pushed under the skin surface and had collected in a large fluid and blood filled blister the size of a large orange. They took her blood pressure on that arm and did not notice it. I did and they removed the IV and put the blood-soaked dressings on the tray trolley in amongst the sodden phlegm -filled tissues and soggy sandwich. When I said I thought it was an infection control issue they put it all in a bin but the tray top was not cleaned.
She was not washed or helped to clean her teeth for 48 hours. She had an ensuite bathroom but the ward had no safe shower or perching seats to allow it to be used so she could not have a shower.

The second time she was admitted was similar but the ward was better- she was actually bathed and had her hair washed - it made her cry because the nurses were kind.

The third time she was treated as a nuisance . The nurses view was that she should not have been sent to hospItal. The GP sent a paramedic who called an ambulance and the hospital admitted her and a Dr prescribed IV antibiotics.

It is the most disgusting place. What strikes me every time is how lazy the nurses are. They do very little at all with patients. They think many jobs are beneath them and are to be done by others. If the others are not available they will watch a patient suffering or in need rather than see to them. They spend most of their time in the hub areas laughing loudly, gossiping with each other, on their phones showing other staff stuff that entertains them. Patients and relatives are a nuisance to them.

It is in the south of Northumberland and I dread any of our DC, DH, PIL, DH's grandma or me being a patient there.

I hope you get the help you need OP. The situation in the NHS is quite scary. A friend's DH recently had a heart attack but when she phoned for an ambulance was told it could be several hours before it arrived. Fortunately her DH was still conscious so he could get in the car and be driven to A and E by her. It was total chaos when they got to the hospital and while they prioritised him, there were no beds so he had to sit for hours.

For the Americans - private medicine in the UK has cherry picked the parts of medical care where it is easier to make a lot of money. A and E and emergency care is expensive to provide. You need a lot of specialists who can deal with everything from tiny babies to cardiac issues. And it simply would not make a profit in the UK. To do so an A and E needs to be attached to a decent sized hospital that already has all those specialists providing care on wards.
In the US I know there is the expansion of urgent care centres without A and E facilities. They sound more like our NHS walk in clinics where people can go with a broken bone or for stitches. So we already have this provided separately in larger population areas.
A and Es though can deal with everything up to complex trauma from stabbings, major car crushes and crushing incidents.

Our private medicine tends to provide scans so people can jump NHS queues, elective surgery for which there can be quite a wait such as hip and knee replacements, and more rarely cancer and heart conditions. Although even then I have known people advised that they will get better cancer treatment on the NHS - this varies by area and your type of cancer.

If you have severe pain, blurred vision, go to A&E and say you think you are having a stroke, not that you have neck pain.

www.nhs.uk/conditions/stroke/symptoms/