"Praise for the Yorkshire Ambulance Service, but distressing experience at York Hospital"
About: York Teaching Hospital NHS Foundation Trust York Teaching Hospital NHS Foundation Trust York YO31 8HE Yorkshire Ambulance Service NHS Trust Yorkshire Ambulance Service NHS Trust Wakefield WF2 0XQ
Posted by Tyke (as ),
Regarding this incident in Augut, I would like to say that I did not request medical intervention for the chest pains I had been experiencing since 12th Aug, but out of concern for my distress, my mother requested assistance.
To answer the question I have to state that I suffer from severe clinical depression, anxiety and panic attacks. Also, I was going through a nervous breakdown. When the ambulance staff (from Goole) wished to take me to hospital, I begged them to take me to Hull, not York, to which they replied, reasonably, that it was against the rules.
The reason for my not wanting to go to York was because I had made a complaint against a member of the hospital staff concerning an incident that occurred in May 2011, when I felt I was humiliated and my fundamental right to consult the Out of Hours GP denied by the triage nurse – it being a Saturday morning and my having no access to my own doctor. I was suffering from a particularly nasty tooth infection and abscess (upper jaw, below the nose) and had been prescribed antibiotics by the dentist that Wednesday. It seems that I had developed some immunity to those particular antibiotics, so by the early hours of Saturday morning I became concerned, particularly about the amount of over-the-counter painkillers I had taken and the low strength of the antibiotics. Accordingly, I telephoned the OOH GP at York A&E and they were concerned enough to ask me to visit them.
On arrival at A&E, the section which is Orthopaedics during the day, the triage nurse for OOH was understandably concerned about possible liver damage and asked me to go through A&E for a blood test. In the meantime, I was put on a Parvolex drip (15mins), just in case my liver was affected. Then I was transferred to the Short Stay Ward and put on a four hour drip. The next stage would have been a sixteen hour drip. I then requested to know the result of the blood test, according to new laws introduced into the NHS Constitution in 2010, aimed at ensuring that patients are consulted throughout their treatment and their dignity respected. A doctor informed me that there was no exceptionally high count for Paracetomol in the result, but advised me to carry on with the Parvolex. Such an expectation seemed to me unreasonable; expecting a sufferer of depression and anxiety, who had not slept properly for two nights because of pain, to unnecessarily accept a sixteen hour drip. When I insisted on discharging myself, as is my legal right, the doctor advised me to see a GP about the abscess: exactly why I had visited the hospital in the first place.
On my return to A&E (Orthopaedics), I found the triage nurse on the desk with the receptionist. My request to finally consult the OOH GP was denied. I was informed that in their opinion I had forfeited my right to access the GP because I had discharged myself from the SSW. The uniformed nurse on the adjacent A&E desk looked surprised but did not intervene. I would have thought that one out of three people would have felt as I did that what was happening was wrong, unethical and illegal, but then I am naïve, it seems. Had I not been exhausted and distressed, I would have asked to see someone in authority and challenged the legality of their refusal, as it was I just went outside and broke down.
For two days I had to suffer torturously. On the Monday I got an emergency appointment with a dentist and a prescription of different antibiotics at a higher dosage soon provided some relief from the suffering. Once I had recovered a little from the trauma, I started to wonder how I could have been subjected to what I feel was callous neglect in a supposedly advanced society. Before this, if someone had told me that such an incident was possible, I would have said ‘no way, not in Great Britain.’ I do know, as an objective fact, that I would never treat another human being in such a fashion. Then I started having a nervous breakdown as I tried to come to terms with what had happened: how could someone suffering from mental health issues have their fragile state of mind shattered by an organisation that a politician recently described as ‘wonderfully altruistic’; that puts up posters encouraging consideration to people with such illness and is supposed to comply with the Mental Health and Disability Discrimination Act?
When I telephoned York Hospital in an attempt to get some explanation for what had happened, I was referred to Harrogate, which deals with the OOH. I thought I had been referred to someone who would help reassure me that I was just as equal in law as everybody else who had visited the OOH GP that day. Although I had not threatened legal action, merely questioned the legality of the incident, it turned out that I had been referred to the Risk Assessment Department – which I feel was an unbelievably callous act! Nevertheless, I was assured that the matter would be thoroughly investigated.
In answer to my concerns, I received a letter dated June. Only one paragraph in the three page letter was relevant to my concerns:
"You have stated that you returned to the Out of Hours Service to obtain further medication for your tooth but you were advised that you could not see a GP or have further medication. I have been advised that there is no record of you returning to the Out of Hours Service and there is no documentation to suggest that you requested further intervention."
What had began with in my opinion a bad judgement by a junior member of the hospital staff had been condoned by the administration, and then I began to realise that I felt I had been incredibly naïve about NHS integrity. At the request of my MP a genuine investigation was supposed to be instigated. The Risk Assessment Department then apologised to the MP (which felt like avoiding apologising to me).
What other organisation in the world would deem it appropriate to deny me a fundamental human right and cause me two days of unnecessary suffering with the following explanation?
"Firstly, I am sorry that [the patient] felt that the nurse he contacted in the first instance (triage nurse) at the Out of Hours Service thought his toothache was petty, it was not her intention to convey this message and she would like to pass on her apologies if she appeared dismissive as it was certainly not her intention…"
"When he requested to see a GP and we were not 'able or willing' to help him, we let him down and I am very sorry for that."
As for events that led to my visit and transportation by the ambulance staff, as stated, I began suffering chest pains in August, which were diagnosed as caused by stress related to the trauma I had experienced. His diagnosis turned out to be correct, but as I was going through a breakdown, and the pains continued to get worse, I could not stop worrying about it. Accordingly, I visited A&E at Leeds Royal Infirmary on a few days later, but as I was a nervous wreck and suffered panic attacks, I did not manage to see a doctor. I went to Leeds because anxiety prevented me from going to York Hospital. Since mid May, I have managed to visit York Hospital once, for a chest X-ray, but the doctor arranged for me to go in the evening with a relative accompanying, and go straight in for the X-ray. I have tried to return since but I became a nervous wreck and failed. This is nothing to do with awkwardness, rather, I have developed a psychological block related to the trauma of what happened to me and cannot overcome it.
On the following day, I begged my mother not to ring for an ambulance as I could not go back to York Hospital, but she ignored me as she was so upset and concerned for my suffering. I can honestly say that the ambulance crew – with the exception of a young doctor at St James, Leeds – are the only people in the NHS who have shown me the slightest consideration, kindness and respect since that day in May. That was so important for my state of mind and I would like to thank them most sincerely. I did explain, to the gentleman who rode in the back with me, my anxiety about returning to York. As we approached the hospital I started hyperventilating and panicking, but he reassured me that I would be treated the same as everybody else and to concentrate on getting better.
Once the ambulance staff handed me over to the hospital staff, I was seen by a nurse within ten minutes and taken into a cubicle. During the five minutes of our interview, the nurse never once asked about how I was feeling but I feel chastised me for going to Leeds for what they considered a second opinion. The stress was too much, and I felt it was obvious that I would not get objective treatment which I believe was due to having complained, so I walked out. I felt that everything was turned around to make me, the victim, look like the villain.
I would like to sincerely apologise to your ambulance crew for ending up wasting their time, which was certainly not my intention. I was in great distress at the time and, as stated, suffering a nervous breakdown. In the last few weeks I have calmed down a lot with the help of medication and returned to a state of shock regarding my experience. Due to the psychological trauma still haunting me and the fact that the ambulance staff can only take me to York, I will not be able to use your service again, but will have to take a train to Leeds or Hull instead. I am literally terrified of that hospital and suffer nightmares because of the experience.