Thursday, 26 November 2009

Tackling The Mental Health Minefield Part 1- The A&E Fiasco

Things had been going downhill for a few weeks; I was feeling lower than I think that I had ever done before, even in the first days after my husband's death. I wasn't sleeping; I wasn't eating; and I rally couldn't see any reason to carry on living. For the first time in many years I was having suicidal thoughts. Fortunately, I had enough of my brain functioning properly to know that I need help, so I made an appointment to see my GP.

His immediate response on seeing the state that I was in was one of shock. He had hoped on my previous visit that I was doing quite well after my miserable month of anniversaries and the cancer scare with the lesion on my nose. This was a Madsadgirl that he had never seen before; a Madsadgirl who looked as though she hadn't slept for a month, who walked with a shuffling gait, who has tremulous hands and who could hardly speak because she couldn't stop crying.

The obvious question followed: what could have happened for me to be in the state that I was in? The answer was simple: nothing! I had descended into the pits of hell with no helping hand, and I couldn't find my way out. Life held no future that I considered worthwhile and the result was that I felt that I just wanted to die. The thing that saved me was that I didn't have the courage to actually carry out the act.

My GP decided that I needed specialist help and a stay in hospital. He wrote the referral letter there and then, printed it off with a selection of other documents that he felt were relevant, and I was soon on my way to hospital. I reported to the A&E reception and sat in the waiting area for a few minutes before hearing my named called out to be seen by the Triage Sister, who was lovely and very sympathetic. She made a quick phone call to the on-duty psychiatric nurse and then took me through to a room specially dedicated to psychiatric emergencies in the 'majors' department of A&E. She asked me if I would like something to drink and fetched me a cup of tea. That was the last sustenance that I was to receive for more than nine hours.

After about half an hour the on-duty psychiatric nurse arrived and proceeded to take a history, which was not altogether necessary as my GP had provided most of the information necessary with the referral letter because he had felt that the fewer questions that I had to answer, the better. It should have been apparent to anyone with a modicum of knowledge to determine that I was seriously unwell and that immediate hospitalization was necessary. But the nurse's suggestion was that I went home and that the Home Treatment Team would be in touch with me in a few days. "You wouldn't like it in hospital" she said. I was somewhat perplexed because whether I would like it or not, hospital was exactly where my GP had determined I should be.

I should explain that our local Mental Health Trust has seven hospitals and which one you are admitted to is determined by where you live and/or your age and the reason that you are being admitted. There is some logic to this approach because it means that all the follow-on support can be arranged easily. The intelligence of the psychiatric nurse must therefore be called into question as she spent the next four hours trying to get me admitted to the wrong hospital!

During this period she left me in the room in the 'majors' department never bothering to see how I was or whether I needed anything. She eventually returned and told me that I could not be admitted to the 'M' hospital as I lived in the wrong part of London, something that was obvious had she bothered to read any of the paperwork that my GP had supplied, and that she should have finished work an hour earlier and that her colleague who had now come on duty was taking over my case. All of this was said in a tone of voice that implied that it was my fault that she had been trying to admit me to the wrong hospital and that I had personally was responsible for her being late in leaving for the day.

The newly arrived psychiatric nurse managed to secure me a bed in the correct hospital within half an hour, came down to see me to let me know and to tell me that he was now trying to arrange for an ambulance to transfer me. Three hours later, the ambulance arrived and I was on my way. Had I taken myself by bus I could have been in the hospital about half an hour after the bed had been secured.

I have to say that the two gentlemen who were manning the patient transport ambulance were very kind, helped me into the vehicle and out again when we arrived at our destination, and chatted to me during the whole journey. After having been left on my own so much of the day not knowing what was happening, it was extremely heartening to have such wonderful care from two people whose only task was to convey me from one hospital to another. On arrival at our destination, one of them accompanied me to the admitting ward and then wished me well as he left me at the ward entrance with the nurse who was to carry out the initial admittance procedure.

It had only taken 10 hours since leaving the GP's surgery to get me to this point.

To be continued...


Hannah said...

sounds very familiar to me, I've had my fair share of good & bad experiences with mental health service providers, I've just had to come to the conclusion that they are all human too & perhaps the level of service you receive is largely dependent on what day you catch them!
Hann x

steph said...

I can well imagine how lonely and confusing that 10 hours must have been for you.

The question is...

did you just hit unlucky or are all psychiatric emergencies treated with a similar lack of urgency?

alhi said...

I wonder when you say that nothing caused it, was it actually the cumulation of the month of anniversaries and then the cancerous lesion. Followed by relief that it was all over but then nothing left to focus on and no reason to believe that the next day, the next week or the next month would be any better.

Anonymous said...

Glad to find you are 'recovering' and posting. I apologise for my dearth of commmnts lately. I have been keeping up with reading but have had much less time to comment.
I just wanted to point out that rather than you not having the courage to end it all, you infact had the courage to carry on and ask for help.
We're all very glad of that.
Take care and be kind to yourself

Achelois said...

Have not had the opportunity to catch up on blogs latterly but came straight here today when able. I am so sorry that you had to endure the situation described above. I agree with Kate's comment above. You were brave.

Take good good care of yourself.

Anonymous said...

The Psychiatric Nurse was / is incompetent! I promise I never will be... I am far too organised!