To have discharged myself from A&E?

[AandEnightmare]

As the username suggests…

I attended A&E with numbness is my hand, pins and needles in both arms and legs, blurred vision and extreme stuff neck pain.

Stroke nurse was happy it wasn’t a stroke but wanted an MRI as did A&E consultant.

Both concerned about MS and tragically I then urinated myself in the A&E waiting room where I was left on a wooden chair for 8 hours.

i asked for a change of clothes, just a hospital gown and was told until I was seen by a neurologist who agreed to book me in; this wasn’t possible.

I have long covid and extreme fatigue and pain at the best of times and I was in tears in the waiting room crippled in pain and exhaustion and was just told repeatedly that only a neurologist could determine if an MRI was needed as an emergency or as an outpatient and on the time of leaving, after 7 hours, I was number 13 on the list so expected to be seen by this evening.

I will ring my GP as soon as open but I’ve never had such a terrible experience in a hospital in my life!

i feel shocked

I don't understand why they couldn't have given you a gown and some underwear. You don't need to be an inpatient for that to happen.

In our trust, the only time you'd have an MRI from A&E (where I work, I should add) is if they suspect Cauda Equina Syndrome.

Our patients are left on chairs for much longer than you were, unfortunately, because we're massively over subscribed and there is physically no where to put people. It isn't unusual to have to wait 12hrs to see a clinician.

We wouldn't, however, dream of leaving anyone in soiled clothing for any length of time. You should have been provided with a gown and wipes to clean yourself up, and assistance if required.

As for the MRI: last December I developed symptoms in-keeping with MS. I didn't have an MRI until January because it just isn't considered an emergency. I then had to wait several weeks for results. 12 months later, I am still awaiting a lumbar puncture. It's frustrating but ultimately my symptoms aren't immediately life-threatening.

@adomizo of course it's not how it should be, but it is how it is and until people vote for a government that will solve it, this is how it is and what you need to expect. We either solve it by massively increasing NHS funding, increase pay for all staff and reduce workload so that we stop haemorrhaging staff, and also have massive investment in community health education so that people take better care of themselves and know better how to judge when A&E isn't the right place to go (including having easier access to GP and other community health resources), all funded by massive tax increases. Then we can all have the A&E service that a first-world country ought to have.

Or we go the other way and switch to a two-tier system with privately funded fully-staffed health care for the rich (which will cost the rich more in additional insurance premiums and co-pays than the extra tax for option 1 would) with a state-funded last-resort option for the poor which will still be underfunded but hopefully under less pressure if all who can afford it are elsewhere.

Personally I would prefer option 1 but I am not going to live my life on the assumption that we have option 1 available to us and can rock up at A&E expecting that level of care.

Give her gown? You know the simplist of solutions that requires no cost, no staff, no effort. Two gowns. One on each way and sit back on the chair. Would you let your dog lay in their own piss? So why is OK for a human. The more everyone minimises and normalises the harder you make it for nhs staff. This is the née normal now. The self setting bar. Everyone is OK with it so how can staff actually complain they are overstretched while simultaneously saying it's OK? If its OK for a able bodied person who seems quite unwell to walk to a desk to ask for a gown to sit for hours dripping in her wee to be ignored then surely it's equally OK for a pensioner to lay in bed like that all day. As you are over stretched and this is the new standard. So when you have 50 people being treated in your corridor it's OK as what do you expect people to do?

Push back and say its not right might be a tiny step forward.

As I have said. I don't know why she wasn't. The OP told the receptionist. I don't know why it wasn't escalated. This might have been when OP left

Take the women to a toilet and change her. Just do something . You shouldn’t be working where you are then should you . Leaving a patient in urinated clothes you are the nhs problem .

Why do you work in care ?

I am so sorry this has happened to you.

When you are feeling a bit better please lodge a complaint with PALs and contact your MP.

The OP told the receptionist, not the nurses, how were they supposed to know?

@widowtwankywashroom

There is no excuse for that level of degradation of a human being. Don't try to justify it or you are perpetuating the problem.

I am not justifying it
I hate the way patients are left for hours on end
But if the PT wets themselves in the w/room and the nurses aren't aware, what do you expect then to do?

Last time we were in A&E we were triaged and told we'd need an ECG and some blood tests, ECG was done quickly but then we sat for hours. We asked several times about the blood tests and got told to sit and wait. After 8 hours we were called through and the doctor turned to look at the blood test results and we pointed out that they hadn't yet been done, bloods were finally taken and we were told it be another 2-3 hours for the results.

Honestly the lack of organisation is farcical

Hospital admin - there is a constant struggle between available resources, personnel, and patient need in every acute setting. However, from the point of view of patient comfort and safety (which admin are trained to consider), leaving you sitting for hours like that after an episode of incontinence was definitely not ideal. There definitely should have been the option for a gown to change into and a blanket if nothing else. I'd be asking PALS to raise this as a matter of concern. Get a soon appointment with your GP for referral for the other issues. (The admin staff WILL be criticising you for the self-discharge, sorry, but the medical staff won't, they know how bad it is, I promise.)

I agree about the urinating without realising it is very concerning you must go back to the hospital.

Wales had been labour forever our NHS is in a worse state than ever before

Did the op ask for a gown and they said no?

If not a gown change into what?

I expect you to find two minutes to give someone soaked in urine a fresh robe regardless of the rules.

We arrest people for treating animals like that.

OP you need to talk to PALS.

So sorry this happened to you. Absolutely complain via pals. Was there anyone who could have brought you a bag in ? I'm not sure you will get any easier or quicker route via your gp though, it does sound like an urgent-care/ a and e referral.

So many NHS armchair critics who have no idea of the reality of working in ED.

I worked on a ward, where staff would frequently get sent to ED to work due to staff shortages. I hated it and whenever I was told I was being moved I would be filled with anxiety.

It's not as simple as saying 'just do it' and as hard as it is to imagine sometimes there is simply no time and no free staff to deal with the personal care of patients - because you have life-threatening issues to deal with which take priority.

Sitting in urine is humiliating and should not happen, but will not kill someone. Someone who has come in with breathing problems, desaturating, but combative and pulling off their oxygen mask when left unattended is and nurses have to prioritize based on clinical need.

Please, if you think you can do better go and train as a nurse and show us all how it should be done.

I've had to hang around hospital a lot recently with elderly parents, and I noticed quite a bit of people of all ages waiting for incontinence issues to be dealt with.

I queried this with a doctor, who explained that urine is in effect sterile when it leaves the body (if no UTI of course) and as such, although smelly/uncomfortable, in the short term poses no real risk to anyone, hence when they are busy or short staffed it just gets left.

Personally I think thats a rather cold scientific respose and doesn't take the psycological or comfort needs of the patient into account.

In terms of discharging yourself, I have two friends with MS, it's a very, very slow disease, not an accident or an emergency, I would expect it to be diagnosed by GP and hospital appointments, so you can go that route sounds sensible as they ruled out stroke, only benefit you would have got waiting in A&E is that, though painful waiting, you would have had the MRI that night rather than being in a waiting pattern.

I love the way people who don't work in the NHS or in A&E all have so many ideas about how it could work far more effectively if we just did such and such, why don't you all come and work here then ????
Tell us how it could all be done so much easier

Sorry to hear your awful experience @AandEnightmare

I would have done the same thing, gone home. I have a lot of respect for the NHS and most of the people who work there. My husband works in the NHS so we totally support it. BUT I would be scared to rely on its services these days. I’m honestly thinking about taking out private healthcare insurance though I used to not believe in it. I appreciate it’s not the answer and especially in an emergency situation but the NHS is on its knees.

I took my 5 year old to A&E about 6 months ago on the advice of 111 due to a 15 hour episode of persistent vomiting, lethargy and reduced urination.

I got to the Paediatric A&E at about 10pm and the waiting room was totally full. There were at least 25 infants/toddlers/children waiting to be seen and it was chaos. There were no chairs available so parents were sat on the floor with their sick child in their arms. One woman was even sitting on the floor outside the entry because there was nowhere else for her to wait.

We got triaged very quickly and my son had a low blood sugar so he was started on a dioralyte fluid challenge and we were called back into triage an hour later to have it re-checked and thankfully it had risen to more normal levels and he’d passed a little bit of urine by this point too.

The Sister told me there was an 8 hour wait to be seen and that if she were me she would just take my son home. She said all the doctors would do is give him the quick once over and send him home with a stash load of dioralyte.

She gave me a box of dioralyte from a cupboard in the triage room and said that it was my choice whether to stay or not but if not then to continue with the dioralyte at home.

I went back to the waiting room to see it was even more full and understandably I had lost my seat. It was now gone midnight and I was having to stand up whilst trying to balance my heavy 5 year old in one arm, my handbag in the other whilst trying to measure out and give dioralyte every 10 minutes. My son was exhausted and I was exhausted.

I knew I wouldn’t be able to maintain this for 8 hours and so I left.

My son was absolutely fine and by the next day it was as though he’d never been ill.

It was a horrific experience and I couldn’t believe the way the system was working.

The Sister who dealt with us was lovely and very apologetic and understanding and I’m sure she and the other nurses felt so disappointed that this was the only quality of service they were able to offer.

I’m sorry you went through something so awful OP and I agree that PALS is a good option. I hope you get to the bottom of things soon and it doesn’t turn out to be anything to worry about.

I love it when people say don't vote tory and have the impression under labour everything is going to be so much better that the money tree will appear, that departments will be fully staffed, it isn't going to happen no matter who is in bloody charge

I am so sorry OP that is terrible.

I think you need to go back though as others have said.

Please do complain when you feel strong enough.

The hospitals and NHS in Wales are as a whole in a way worse condition than in England.

Labour are not the golden ticket people think they are.

The state of the NHS is awful, I left the NHS 7 years ago and went into private healthcare due to this. When I worked in ED, I'd often have a very poorly patient in one bay and need to walk through a bunch of other relatively stable patients to get to the meds cupboard. I'd have to put my head down and quickly walk past all the shouts of 'nurse!' to get my critically I'll patient what they need and run back. It was like something out of a war zone. I imagine it is much worse now.

I'm sorry you went through that OP, it's terrible. It's not safe and it's not fair.

100% this.

I truly feel for OP and it is a true testament to the state of the NHS currently. In an ideal world, or even just in a normal world, absolutely you would hope that there patient comfort is key and that there would be enough staff to keep everyone comfortable while waiting. BUT the reality is, as this poster has said, there are much more urgent and critical issues to deal with constantly. The hospital, especially in A&E, are there to deal with the medical issues at hand and to treat the EMERGENCY. This does mean that patient comfort while waiting is the sacrifice, and while everybody is quick to complain about that, I can’t imagine anyone would choose to argue that given the choice between patient comfort & a patient emergency, patient comfort should come first. It’s a sad state of affairs, but that is where we are at.

I can sympathise having had a trip to A&E recently for a family member with pneumonia. We were sat in the waiting room for 10 hours before finally being seen, even when we were seen it was on a bed in a corridor, she needed to be admitted but we were just told there is literally no beds free on the wards- it’s uncomfortable, it’s not ideal, and it’s clear that for issues of comfort while waiting you have to look after yourself/have family look after you. The A&E staff will treat you medically, but you/your family are responsible for your comfort.