Incredibly frustrated at substandard care and knowledge in A&E department

My Asthma has been pretty severely out of control for some time now but while the respiratory team I see on a regular basis have been amazingly supportive and patient with me I can't help but want to stomp my foot and scream at my local A&E department.

I generally do not take the decision to present myself at A&E often as I find it frustrating and equal to banging my head against a brick wall repeatedly.

I seem to always get fobbed off by doctors with little knowledge of anything but a textbook (almost junior version) of what an asthma attack is supposed to be like. For instance my chest tends to go very silent and not much air will move around in the base of my lungs, so where there is little wheezing I get told there is nothing the matter, surely O2 sats of 92/93 prove otherwise to this theory? I can go for days with no proper sleep due to my asthma and when I know I'm struggling to look after myself because I am so tired is the point at which I feel it necessary to present myself to the hospital. This evening I had to present during what is essentially my good time of the day only to be met with a doctor who did not even know how to operate a peak flow meter (not the first time this has happened) and who would not listen when I explained that my body was tired and while the nebs picked me up briefly that I was worried that I would be back in the same situation within a few hours as night time is my worst and needless to say I was right, now I have to decide whether I have enough energy to represent and go through the same discussions or hope for the best and ring the respiratory dept in the morning. It's a bit ridiculous that it should keep coming to this constantly.

Sorry by the way I realise this is a mammoth whinge!

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hi little monster

I would like to tell you that you have just described the predicatment i often find myself in. I now usually wait and ring my resp department the following morning. Infact i am currently in this situation i have been going down hill all week and been in constant communication with my resp nurse who has got me an appointment with my consultant for today as an emergency. I much prefer and they prefer i wait and are seen by people that know me and my asthma than go to a and e and waste valueable energy and breath on people who are no good with people who know there condition well.

I only go to a and e when i get an attack out of the blue now that is sudden and unexpected! I wish i could sleep, that there was another way around this problem but i guess our asthma does not class under the standard emergency asthma procedure very often and they are not trained to deal with us.

I just wanted to reply and tell you, you are not alone and that i face this predicament regularly.

Hope your respiratory department can help you today

Plumie

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having given this more thought

i would like to actually say i do not think it is A and E fault. I do not think they are there to deal with failing asthma management. They are only there to deal with out of the blue asthma attacks so to speak. I think there should be more specialist nurses and consultants that we can call upon when our asthma starts to deteriote and that they should give us more open access to the hospital when we feel we are losing control so we can leave the A and E for the real one off emergencies.

Sorry it just dawned on me we are expecting wrong of A and E and need to fight for asthma action plans, open ward beds, more consultant appointments and more specialised nurses.

A and E do a great job in the out of the blue asthma attack but not the asthma that is going out of control because this is not there area of speciality. That is the consultant and GP and specialist nurses role.

Hmm i have gone crazy with lack of sleep i think!

Plumie

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AT our AnE we now have a ward at the AnE that is for breathing problems just go through a

door and the ward has 4 beds a doctor and nurse just for breathing problems and all geared up

to give iv mag etc nebs and do bloods etc.and xrays.

My last visit about a month a go spent 5 hours there and when went the A nE had to see the normal nurse who then sent me into the breathing ward that was only for AnE people with breathing problems so you are delt with realy fast and does not take any AnE Emergancy spaces for other problems.

great if all AnE Places could do the same.

IT was only set up a few weeks back xxxxxx

edit-hope you get better treatment next time lol xxx

[Skee-skee]

Sorry to hear about your fustrations. Hope you are feeling a bit better.

Have you spoken to your respiratory team about the problems you have had in A&E? (I assume you have). Have you asked if you could have an action plan or something to show them at A&E? Have you asked about direct access (if they do it at your hospital)?

Do you take someone with you to A&E, who has more puff to talk to the doctors for you?

Most textbooks would have 'no wheezing and silent chest' in as signs of a life threatening attack. I guess that (fortunately) mostly they see less severe asthma attacks where people are wheezing and so they automatically think asthma= wheezing.

Take care

Bryony

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Thanks for all the messages, it's always nice to know that you're not suffering alone with these things. Needless to say as I thought would happen my asthma continued to get worse throughout the night and I was admitted in the early hours with sats in the low 80's, a very draining experience. Spent the night on oxygen, regular nebs and some hydrocortizone to boost my system so feel better but very tired today.

Unfortunatly I usually end up going to A&E on my own, but I don't mind this too much as quite a few of the nurses there are familiar and tend to be absolutly fantastic with my asthma. Luckily on my second visit last night I was handed swiftly over to one of the more senior medics so that I could be admitted.