"Patient experience of the emergency department"

I attended CAH ED a few weeks ago. On arrival the reception staff having received communication from my GP automatically prioritised my care. This was excellent and reassuring. During my 9 hour stay I had numerous investigations and interacted with different staff and departments. The following are some of the things I wish to share to support improvement of patient experience and safety and are not meant as a complaint. 

- I was cannulated and bloods taken twice in the blue area corridor in full view of others and whilst sitting elbow to elbow with other patients despite the plaster room being free. Two or three other rooms had Do Not Use signs up. 

- cannulation tray was set on the floor and items lifted from floor level. On reflection this could not possibly meet infection control measures?

- I was told I needed an x-ray. I was already seating outside x-ray door. Approx 30 mins later a nurse asked me if x-ray knew I was waiting. I replied I hope so. Nurse went into the room and on return said, they do now.  I was taken straight away. Approx 5 staff were in the x-ray room. Should the x-ray staff not be alert to patients needing to be seen? 

- I had to wait on a porter to take me to the CT Scanner. I was able to walk but the porter said if I didn't go in the porter chair I would have to stand as there were no chairs in the scanner dept. This was a waste of staff time and resources and delayed me attending 

- in the blue area the nurse shouted up the corridor (common practice) and pointed "you". All seated patients asked if the nurse meant them. Nurse continued to point and reply until everyone else had replied, and I realised it was me they were speaking to.

- staff mainly stayed in the notes room, only stepping out to shout up the corridor instructions e.g. CT scanner porter is on there way. Everyone knew everyone else's care. No confidentiality was maintained 

- Prior to discharge a Doctor told me I was being red flagged for Ultrasound Scan and the reason why. This was told to me sitting elbow to elbow with other patients. I was extremely annoyed at this behaviour which was appalling especially given again the plaster room was free. More bloods were taken but I did not know why. My care was not explained and I left the unit not knowing what was wrong with me. The upset of being spoken to in front of others  I appreciate was a further contributing factor to my confusion. I had to phone my GP the next day to unravel my diagnosis and plan of care. My GP was excellent, patient and reassuring, and communicated clearly to me. 

- In ED there was no oversight of care or anyone coordinating stages of care, moving treatment/patients along hence managing attendance levels and patient experience and safety.

- Most staff did not introduce themselves. Staff in various coloured bought scrubs, pink, green, blue etc. One person in jeans, one in track bottoms. Causes confusion as to who is who (regardless of professionalism and infection control) Staff with long painted nails. 

- appreciate it is an aging building but very poor ventilation 

- the unit was noisy because of staff calling out names and instructions that everyone could hear. Could buzzers not be purchased and staff walk to the patient to converse? 

-I was not allowed to leave the unit but yet no food or fluids were available/offered. Appreciate some people may need to fast but again this could be managed and a water station at least put in place. I'm sure there is plenty of research on dehydration and health outcomes yet within a few hours of being in the hospital patients are on the wrong path. One man asked for coffee and was told to buy it. He had no money and was advised not to leave the unit. Was told if he spoke nicely to someone they might make him a cup.

I do not believe anyone intentionally sets out to cause harm or upset. I appreciate CAH ED is a busy unit but staff did not appear to be rushing about manically providing care. Yes there are long waits but there always has been in ED. Is the ambulatory unit always staffed to ease the pressures in the main ED area?  Yes room is limited but there was free spaces. 

My fear is staff have accepted a lower standard of care as the norm and therefore it is now acceptable to treat and give diagnosis in corridors. Please do not use the excuse space is limited. This behaviour is never acceptable, and as stated rooms were free. My grave concern is staff have become desensitised. I hope that there is actions from care opinion stories and not just the sharing of a story with no meaningful actions and monitoring.