"Complete lack of consideration"

I  was called at 4 a.m. to assist a neighbour in his late seventies, who had recently fallen from his kitchen counter onto a stone floor, while attempting to decorate his kitchen. His wife died last year, and he is now alone in a fairly large house.  He had visited Raigmore the day after the incident and he was seen within 10 minutes by a doctor, but no Xray was undertaken.

I found severe bruising in his upper leg, which had born the brunt of the fall, but he was complaining of extreme pain in his lower leg and was completely unable to straight leg raise.  He had been able to do this previously, as I had been visiting frequently to check his progress. He had been prescribed strong painkillers at Raigmore, and was taking two six hourly, as advised.

I was slightly concerned, and phoned NHS 24, who were very supportive and helpful, and phoned me back asking if I could drive the gentleman to Invergordon Community Hospital. 

This I did, where he was seen very promptly by a Nurse Practitioner somewhere before 6 a.m.  She was very helpful and pleasant and asked if I would drive him onwards to Raigmore, as she was concerned about complications. I was also concerned about Compartment Syndrome, as the gentleman emphasised that the analgesia was having no effect on his lower leg.

Staff skills

I questioned whether an Ambulance would not be more appropriate, but she felt it would expedite the trip for him as there was a paucity of ambulances in the Highlands.

 So far, so good.  She told me that she had telephoned Raigmore and that they were expecting us. I was impressed by the efficiency of the NHS.

We drove to Raigmore and arrived at 06.45. We were the only people in reception. The gentleman was taken to see the Triage Nurse immediately and wheeled out in a porter's chair. The Nurse said he would have to wait and see a doctor. We were not concerned as A&E was as quiet as the proverbial grave. We were the only people there. 

And so we waited......and waited.....and waited. 

He was unable to get comfortable in any seat and began to get agitated about waiting so long. I eventually spoke to the receptionist to ask why we were not being taken through to the bays, where at least he could lie on a  trolley, but the response was that the doctors were "very busy". At this point, it was hard to contain my disbelief. I have worked in casualty, and know what a busy A&E looks like and feels like. This A&E felt completely dead. Eventually, a couple wandered out. That was the full extent of the activity we witness as the wait went on. I mentioned to the receptionist that  Invergordon had phoned, warning them to expect us, and I understood that we would be expedited.

No we were told, "Your wait starts when you get here!" 

Half an hour passed. An hour passed. An hour and a half passed. By this time, we had spoken to the receptionist 5 TIMES. 

We were polite to the receptionist, and she to us, but communication was certainly not taking place.

Reception

We kept being told he would be seen "shortly" or "momentarily". "Momentarily" created great excitement, as we wondered how long momentarily would be, 

It turned out to be 25 MINUTES. Eventually, the doctor who had seen this gentleman the day after his fall opened the door to the bays at about 08.20, called his name, and when the doctor saw him greeted him with:"What are YOU doing back here?"

Perhaps he believed that an elderly man in severe pain would undertake an 84 mile round trip in the middle of the night for fun? I found it difficult to believe that a member of the medical profession could be so thoughtless. 

Staff attitude

However, we were, at long last, shown into A&E proper.

As I had suspected, every bay was empty. 

People were standing around chatting.

And I would love to hear the explanation for this incredible lack of consideration of a patient's distress.

But then, it may just have been a shift change but it felt like the fact that someone is in pain was unimportant.  And I would further argue that it is no excuse for inconsiderate behaviour by the staff. It was nothing short of disrespectful. 

How real are Patients Rights?