Thursday, 23 February 2012

Fun in the Acute Assessment Unit July 2011

When I arrived at hospital, I was whizzed through A & E, through lots of corridors and straight to the Acute Assessment Unit. Here I was dealt with promptly and efficiently, my story listened to sympathetically and in detail. Blood tests were taken and an X ray arranged. As my last visit to this hospital, I had to have the blood test that indicates a heart attack, which is followed by another blood test several hours later. The staff were all too pleased to be given the twenty four hour number for Papworth I have been given in the event of an emergency, and made a phone call to them straight away. I recall thinking, remember to go to the doctors first again next time, this was a totally different experience from last December at this hospital. I do not have the answers why: is it better quality staff? Is it because its during the day and a weekday? Is it because the doctor sent me and I didn't just turn up? Is it because I came in an ambulance? Or is it a combination of these things? Whatever luck was on my side today, I was very frightened, wary and anxious about my illness and the staff were doing all they could to make me feel safe again. When things go wrong with an illness, all you need is to feel safe and secure and today I was in the right place.

The staff on this unit have a lot to cope and contend with, I am in a small bay, only part of this unit, with six other patients. One patient is, from what I can gather a cancer patient, having some secondary problems and he was soon discharged home, but he had been there a while from what I overheard and been dealt with well. He looked a similar age to me or a bit older. They had me, who had just walked in with a rare heart and lung disease, none of them had never seen a PH patient before, let alone heard of the intravenous medication I had, with the Crono Pump and Hickman Line, but they appeared to be taking things in their stride.

The other four patients alongside me were thirty years plus older than me and appeared to have a variety of problems, but one problem they all had in common was severe dementia. So not only were the staff having to cope with their urgent medical conditions, they were having to deal with the dementia problem as well, which appeared very testing. They were all incontinent and were shouting out like young babies, the whole time they were on the ward. They were all hard of hearing and could not really understand what was being said to them or give coherent answers.

One lady was shouting out for her horse that she thought she had lost, in between needing the loo every five minutes and she was very distressed. Another old gentleman had brought in a carrier bag; as the nurse went through what valuables he had with him, it transpired he had hundreds of pounds in his wallet and in his pocket and a carrier bag full of cash. He had only brought in most of his life savings by the looks of it. It is frightening that old people are just so vulnerable and it was heartening to see the staff doing their best for them.

As for me, I don't really know whether I'm in the right place here or not, it is quite disturbing when you are feeling so ill to have to listen to shouting, howling and complete mayhem going on around you and I have got a rare condition that the staff are having to speak to another hospital about. Still, I know I am safer here, if my heart is about to start packing up again, at least they can try and resuscitate me or try and get a reading of what is happening by ECG and then pass me on to Papworth.

It can be argued are the elderly in the right place here? They obviously have urgent medical issues on top of all the other problems they have to face and are completely vulnerable as they haven't really any idea what is going on. Staff are having to deal with their extra demands, because of dementia, but at least they are in the right place to access the urgent medical attention they are needing.

All this is going on, complete mayhem, the staff have to talk to the elderly patients in a loud voice, not because they are shouting, they are speaking loudly, but gently to help them understand. Of course you hear every word of it, not because your nosy, but because everybody is shouting!

I lie there calmly, somewhat bemused by all this carry on, contemplating my escape from all this: if I could just catch that woman's horse that is roaming around somewhere, I could make a quick getaway with the old gent's life savings and ride off into the sunset! Then I'm not feeling that calm, the nurse is trying to take some blood cultures from my arm, but for the second time is having to drop everything because the lady next to me has wet herself again. I do feel sorry for the lady and the nurse, but I'm getting a bit bothered whether those plastic gloves the nurse is wearing are same ones that she had on when she started. I can only put my trust in people at this point.

In the end they can't find anything disturbing causing the chest pain. Discharged and home safe again. I feel grateful and lucky again. I have a caring husband, doing all he can for me; I've got my lovely girls; I've got my friends, who visit and take me out;  I've still got my wits about me and understand what is going on; I'm not on my own, vulnerable and afraid. Better still, although they cannot pinpoint what the chest pain is, other than muscular and because my heart is under strain, at least it doesn't look like I'm having a heart attack and my heart is in good rhythm still. I now have some peace of mind, after all my worrying, which is a lot to be said when you walk round and sleep with a life threatening disease twenty four hours a day.  

The plight of the elderly is not going to go away, it will only get worse as the elderly population increases. The systems we have now are not really geared to cope. From what I could see, staff were doing the best they could, giving their all and more, but it was not enough, although I don't think they could have given any more. In my ideal world, these A & Es should be staffed with carers, who can help reassure, calm and attend to some basic needs, while the nurses and doctors get the urgent medical needs either sorted or continued in the appropriate department.

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