I am autistic, and have mental illness for which I take medication for, which is important here.
Thursday morning I called an ambulance as I was experiencing severe chest pains. Chest pains are not unusual for me – I’ve already been having various tests on my heart and lungs as I’ve been having trouble with them the past few months.
I was also extremely weak, nauseas, couldn’t draw full breath, and was having hot/cold sweats.
I was taken to hospital and left in the waiting room as apparently the hospital was busy. I was not given any pain relief. I waited for around 45 minutes until a nurse called my name.
I was then placed into a cubicle and a doctor came to ask me questions. I explained what was happening and suggested my symptoms could be caused by Serotonin Syndrome – an illness that occurs when one or more drugs react negatively to each other. Two drugs I’m currently taking react to another drug I’m also taking, so my suggestion was valid. It was dismissed straight away.
This is where it gets bad. As mentioned, I’m autistic, which would have been in my file. I’d also mentioned this to the doctor, who didn’t seem to find this important. I was given a painkiller – one I’ve never had before. Shortly after I was taken for a chest x ray. Arriving back to the cubicle, the pain meds kicked in suddenly. My entire body was limp, like I was a rag doll. I slumped to the floor in a sitting position. A nurse came in and told me I had to get up off the floor immediately. She said I was being silly and ridiculous and that she had more important things to do than to deal with me. I was frustrated, trying to explain my legs didn’t work but my mouth wouldn’t form the words. I then slumped to the floor, on my back. I was conscious but my body was useless.
About four other people came in to see what was happening, and I became very overwhelmed and started hyperventilating. After watching for a minute or two, they all finally realised I wasn’t faking it and started to help. After using a ‘hover bed’ to lift me back onto my bed, my limbs stayed limp for another 45 minutes or so. Then the pain meds started to wear off and the chest pain started to build.
A doctor came and told me that I had a lung infection, but wasn’t sure that was the cause of my symptoms. Nothing showed up on my scans and that I could go home and manage the pain, and take antibiotics. I felt like not enough had been done to properly investigate my symptoms and refused to go home, begging for an overnight stay to see if I improved overnight. The doctor told me I could stay but I’d be sent to the waiting room. I knew the purpose was to make me feel so uncomfortable I’d leave. I felt bullied into leaving so I did.
I think my treatment by those doctors and nurses was appalling and want to file a complaint. WIBTA if I did?
NTA but understand that nothing may be done about your complaint.
What is the complaint exactly? You didn’t have a life threatening illness and the ER did what it should have done by discharging you
i wouldn’t no. There doesn’t seem to be any substantial mistreatment here. I realize you may not like that they suggested you may be faking it, but there are many maliningers and people with conversion disorders in the hospita, unfortunately. Sounds like your reaction to the pain meds displayed itself as a conversion disorder. There are no pain meds that just make your limbs go weak for 45 minutes. Perhaps a wrong medication might’ve been administered though.
NTA. Looking at your concerns:
\- Not being given analgesia on arrival – you should have had something on transport, and then when you were assessed by the nurses at triage they should have offered you something if you didn’t already have some of your own at home/on transfer. So that could be looked in to, but you do need to be clear what you did have already.
\- Your collapse was definitely not managed properly – you should have been considered as having collapsed, not being a hypochondriac, until further notice. So that was incredibly unempathetic care and did not suggest a person-centred approach. And it doesn’t matter how annoyed healthcare staff get with people, comments like “I have better things to do” are not acceptable. So this definitely has weight.
\- Serotonin Syndrome suggestion: the problem with anyone coming in with their own suggestions is that it won’t necessarily be evidence-based and while it won’t be dismissed out of hand, it isn’t *the* most likely presentation with what you’ve described, especially with your cardiac investigations. Especially if you have been on those medications for a while. So it would be considered but just not top of the pile. Complaining about this will not really achieve anything.
\- You had a provisional diagnosis that fit with the clinical picture, were given the right treatment, and it sounds like you had no clinical need to be admitted at that point. So being discharged was appropriate, unless you can evidence that actually you clinically needed admission at that point and/or the team were neglectful in their diagnosis and treatment. Without being able to show that, there is no complaint here.
This is a great explanation!
OP you absolutely went to the hospital for the right reasons. But it’s important to remember the ER’s goal is to treat to stabilize, not necessarily treat for diagnosis- long term. Your serotonin syndrome questions should be for your providing doc, not the er doc.
Other than you should’ve technically been offered pain relief, sounds like you were managed appropriately.
are you in the US or another country?
For the US you got pretty good treatment, you were seen same day, you saw doctors, you got scans, you got pain relief. I have had family members stuck on a stretcher in the hallway for days for legit emergencies with IVs and heart issues.
Your autism isn’t an excuse to demand a higher level of medical attention or additional services. I would suggest you figure out a better way to handle it such as bringing someone with you or seeking a therapist to help you navigate life’s challenges. They literally have people bleeding to death in the ER.
Do you have a good PCP who can coordinate your care? If you are having medication complications they should be managing it not an ER.
Agree agree agree. YWBTAH if you’re filing in the US for going to the hospital with non life threatening issues of which you knew the cause, and then demanded more attention bc of being autistic… in the EMERGENCY room? No. This wasn’t an emergency and you seem to need a good primary care doctor with an understanding office team.
Apart from not being given analgesia and slightly late to react to you being on the floor which is valid for complaint everything else was treated as per your symptoms.
Having a chest infection that can be dealt with antibiotics at home doesn’t warranty an overnight stay.
Being autistic is hard but remember you went to the ER. There are many people more likely sicker than you and they should be the priority not yourself. You need to talk with either your psychiatrist or person who oversees your autism and medication in how to handle situations and coping methods. You can’t expect ER staff already in a very stressful and busy department to deal with both your medical emergency and autism – they frankly don’t have the time or resources to deal with your needs or accommodate you in other circumstances which can be done but not an ER setting
Has your primary doctor whose investigating your heart/lungs told you to call an ambulance if you get these normal for you chest pains?
If not then you shouldn’t have called an ambulance as these chest pains seem not to be caused by a serious heart condition.
I get chest pains all the time. I know they are caused by heartburn and indigestion.
If I had different chest pains from those I normally experience then I would call for a consult. And when I did, I did call for a consult and found they were from gallstones (referred pains into my chest).
I understand you are autistic. But the ER is for life threatening emergencies. You didnt have a life threatening emergency and there was nothing to suggest that you were (given the chest pains you experienced were the same ones you have repeatedly experienced).
Doctors in the ER whilst seeing to you, were prevented from seeing to patients, attending due to life threatening emergencies. So your choice to call for chest pains (which were not life threatening as they were the same as the chest pains you have been experiencing) put other patients at risk. This will be why their bedside manner was less concerned and compassionate than you would have liked.
They treated you. So theres nothing for them to answer to.
I’m sorry you went through this. It must’ve been scary and painful.
Can I suggest that next time you go to Urgent Care? That would have been better suited for your symptoms. Urgent Care would have been able to give you the monitoring and symptom management that you were looking for at the time.
Emergency rooms are for life-threatening conditions so a patient with mostly just pain symptoms, no matter how severe, is not a priority.
On the other hand, urgent care has the time to prioritize serious concerns that aren’t life threatening. For example, I had a severe migraine one day. I went to urgent care because for a $15 copay, you better believe I was willing to go sit in a waiting room if it meant getting any kind of relief at all. When I arrived and checked in, the staff immediately took me to a patient room where I could lay down and they shut off the lights so the brightness wouldn’t bother me. They brought me a cold compress for my head and water to drink. Once the doctor was able to see me, he gave me fluids and electrolytes and some other things via iv, as well as an anti-nausea patch and a shot of something else that also helped a lot. Then they just told me to lay there for however long I needed until I felt well enough to drive myself home. After about 30 more minutes I was able to leave feeling 70% better than when I came in. Totally worth it and I didn’t end up with a giant bill like at the ER.
My point is that it’s common for people to misconstrue the purpose of an ER and often go there instead of Urgent Care. The purpose is in the names. The ER is for *emergencies* meaning life-threatening conditions or your actively losing significant amounts of blood. Urgent Care is for *urgent* conditions like anything causing acute severe pain (broken bones, for example) or something that requires immediate attention that can’t wait the 1-16 weeks it would take to get in to see your normal doctor (migraine, bacterial infection, etc).
ERs are legally not allowed to turn anyone away. They’re not allowed to tell you to go to Urgent Care instead. That means that they will see you, but if your condition isn’t life-threatening then you will be bottom barrel priority. On the flip side, Urgent Care will always tell you to go to the ER if your condition is serious enough that you need that type of care.
Again, it’s a common misconception. YWBTA if you filed a complaint, though it’s not a big deal if you do. Literally they’ll just ignore it.
Your treatment wasn’t bad. You got timely appropriate care in your time of need based on your presenting symptoms weighed against the other people in the ER. Wait 45 minutes before Dr. Consult. Chest X-ray, presumptive diagnosis and treatment.
Your “reaction” to the pain meds was beyond atypical, possibly a psych response. And while the nurse could’ve had a more compassionate response they (er nurses) deal with a lot of fakers and mental cases. When they determined you weren’t either, they proceeded to give you appropriate assistance and kept you under observation until you were considered stabilized. That’s the function of an ER.
So, I have just spent two weeks in the hospital, and I am very familiar with emergency departments (life is hard right now)
What happens is that they triage you on arrival. If you are walking wounded or non urgent, then you get to sit in the waiting room and wait with everyone else. Usually, you can’t have pain meds until you have been seen by a doctor.
You said you came in with chest pain. I’m assuming they did an ecg or a blood test to rule out any heart issues.
It sounds like the nurse was rude and unprofessional. I would think about making a complaint here. There’s no need for that.
But asking to be held overnight? I think you’re being unreasonable. They only admit you to the ward if you are very unwell and they need to keep an eye on you.
They tested you and established that there was nothing life threatening/ very serious going on.
Believe me, hospital is not a place you want to be if you can help it. I’m so glad to be out and building up my strength.
The best resource for you would be your GP. And I would also ask you to consider the possibility that the chest pain could be anxiety. You would be surprised how painful that can be.
If you are worried, get an ecg or use a smart watch with ECG capability.
And establish whether you have a low tolerance for pain meds (opioids). I have an extremely low tolerance for morphine. It was not fun finding that out.
The fact that you weren’t given any pain relief whilst in the waiting room isn’t a surprise, as you needed to be triaged by a nurse and someone qualified needed to prescribe painkillers I.e. the doctor you saw. Paramedics could’ve given you painkillers in the ambulance but that’s not a complaint for the hospital. Unfortunately waits are sometimes long in ERs because the most unwell patients are seen first. If you’re seen very quickly, it’s not a good sign.
Being autistic is rarely important in a medical emergency, unless you were non-speaking or have a full time carer who would be with you to speak on your behalf. Did you not want painkillers? Were they pills that you swallowed?
I would think your main complaint was that you may have had some kind of seizure whilst you became limp for 45 minutes, I don’t think that’s something that can happen due to an allergy to pain killers or anything or why it would suddenly end. But they could’ve handled that better.
But you can’t just demand that they keep you in overnight when you’re medically stable. It’s not a hotel.