Thursday, 17 March 2011


life feels pretty fragile today. partly i'm feeling on edge about the continuing situation with the nuclear power plant in japan, on top the massive loss of life and the number of people left homeless and struggling. also, someone i know* ended up going to the hospital today in an ambulance, because he was suffering from chest pains. he's ok, and probably got discharged this evening, but hearing about his treatment at the hospital leaves a lot to be desired.

apparently he was assured that the problem wasn't with his heart, but they wouldn't keep him overnight for observation. blood tests were done, but even though there was a possibility of kidney stones or gall stones, they refused to test for that. they basically told him that they would make sure he wasn't at risk of death, and once they had done that, he would have to leave.

is this normal? i haven't been to A&E lately, for myself or to support anyone else so i have no idea. but this seems to me to be a very high level of non-service. surely if someone is presenting with something like that, they'd be held while a full range of tests were done? i would expect that there would be some level of preventative care going on, beyond the emergency treatment.

but perhaps resources are so stretched, and the pressure for quick turnaround times for A&E patients have resulted in the minimum level of care being provided. as well as the fact that the private system stands to make gain from sick people who aren't critically ill, who don't get full or proper treatment in the public system.

i know this is one incident, and perhaps other people are having much different experiences at A&E. i sincerely hope so. i would hate to think that this is the norm.

*not a member of my family


Anonymous said...

I don't know where your friend lives, but if he is in Auckland, his treatment sounds, if anything, above average for a hospital there.

It's one of those "don't get me started" subjects for me. I stayed with my sister in Middlemore for a week before she died (prematurely)last year. It was horrifying, her treatment was inhumane, callous, incompetent, disorganised, discriminatory....

I could go on but I probably shouldn't.


stargazer said...

i'm sorry to hear that, reader and condolences on your loss. there is always the health & disabilities commissioner if you can face the thought of going through a formal complaints process.

again, i don't know whether it's underfunded and understaffed hospitals that lead to this kind of treatment or what. and race-related issues when it comes to healthcare? yeah, don't get me started either.

Amnion said...

They probably don;t have the resources to test for kidney stones or gallstones in ED. They probably view that as a community type investigation, and having ruled out cardiac chest pain moved on.

They tend to rule out the deadly and leave to GP to do the other investigations

stef said...

Having said that, when I was once referred to hospital by GP for treatment they had me in straight away.

Octavia said...

Last time I was in Auckland hospital (2 months ago), admitted via A&E, I was kept overnight but received similar shitty service (gynae ward). I was admitted due to extreme pain from an extant health problem, but everyone who was supposed to be caring for me kept forgetting to get me any pain relief. Three different staff members forgot, I was begging them to get me some but kept getting fobbed off and ignored (including while three nurses had an extended conversation about their pets) though it was late at night on a day they said was not at all busy in that ward.

It took them four and a half hours to give me any pain relief, despite being admitted with something that would rather obviously require it. One nurse half-heartedly apologised, after it was discovered that oh yeah, something ruptured which would in fact mean my pain was quite real.
Considering I already had trust and anxiety issues about health care, especially gynae care - *which* I gave them a heads up about - it was not a good experience.

And in general, considering the experiences of so many vagina and uterus having people, I would have hoped a gynae ward of all places would err on the side of respect and compassion.

Still quite angry about this. Next time (it's likely to happen again) I would rather wait the night out in pain and see the one gynae doctor I trust, than go back.

^ I'm so sorry Reader, that's horrific.

Lucy said...

The one time I've been to A&E, in Christchurch, they kept me in far longer than I actually thought the problem warranted (I'd fainted while making breakfast and my partner insisted on calling an ambulance). They certainly seemed determined to rule everything out before they let me go.

On the other hand, it was a Monday morning, so I don't think they were particularly busy - probably helped.

lutramania said...

Sounds entirely normal (though that's not intended as judgment of quality of care). Not being kept for observation once a heart attack has been ruled out is standard, unless there are obvious indicators of another immediate threat.

I've been in the same situation myself. Once serious heart problems were ruled out, I was booted out pretty quickly with referral to cardiology if problems persisted (there was heart weirdness, but no heart attack), otherwise told to see my GP in the morning. I actually had one of the nurses fight my case; the ED doc who examined me initially wanted to refer me straight to mental health before any testing because he believed any woman my age with chest pain was experiencing an anxiety attack. Let's just say that was not the issue by a long shot.

ED serves a very specific purpose and won't do much in the way of preventative care when the situation isn't urgent, that's usually handled via referral to other specialists and/or a GP. I sort of understand where they're coming from - and ED docs are certainly not famous for having any bedside manner whatsoever - but being on the receiving end of such standard treatment really sucks, even if it is standard.

MacDoctor said...

It is quite normal for the emergency department to deal only with the emergency. Neither kidney stones nor gall stones are considered emergencies and can be safely investigated in the community. This has nothing to do with staffing levels and everything to do withnwhat emergency departments are actually for, dealing with the truly urgent and life or limb threatening.

Chest pain in itself does not necessarily require an overnight admission. It very much depends on the presentation.

Anon at 11:26: You should consider at least a letter of complaint to the hospital. Our hospital services are never going to improve unless we both complain when the sevice is bad and compliment when it is good.

Cat said...

A couple of years ago I went to Wellington hospital with fairly intense stomach pain. I had to wait an hour or so to be seen, but once I was the doctor determined it was probably gallstones and I was given some intravenous morphine which dealt quite nicely with the pain. I was then discharged and told to go see my doctor asap to get treated - seemed reasonable to me, as someone else said, things like gallstones aren't life-threatening, and I didn't want to take up space/time for someone whose life was in danger..

stargazer said...

thanx everyone for your comments. octavia, really sorry to hear about your experience, it sounds quite awful.

i'll readily admit my lack of knowledge about A&E services, and it seems i didn't understand their purpose. the only thing i would say though, is that i don't understand the point of being referred back to your GP who would then refer you back to the hospital (which they would presumably do for kidney stones? or maybe not, i don't know). basically i'm thinking that once you're in hospital, they should be checking that you don't need to stay there for a serious condition that isn't critical.

again, would be happy to be corrected on that.