There are so many things that put me off going to A&E when it might be in my best interests and I was wondering if anyone felt the same or has any tips for coping with the hell that is A&E when you're feeling mentally unwell.
What I first hate is having to tell the receptionist why i'm there and trying to speak as quietly as I can so other people hopefully can't hear. Then the wait can be really long and I often feel anxious and agitated. I don't like to listen to music or read while i'm waiting because I probably wouldn't hear my name being called. I don't have the option of having someone come with me.
Then it's hard to tell so many different people what i'm going through over and over again and feeling like i'm being judged and often pre-judged by some things it says in my notes. Sometimes I write things down because I find that an easier way to explain things, but because no one can get into my head I usually end up feeling unheard because I struggle a lot with communication when things are very hard. It's like I shut down.
After the trial of A&E i'm usually sent home to nothing or to an appointment with the crisis team the following day and it's hard for me to find ways to cope in the meantime. Sometimes I have been so unwell and confused that I had no idea how to get home and was out in the cold for a very long time before I realised I had to phone a taxi. Looking back on this it might be helpful for me to write a step by step plan of how to get home and what I need to do. It's difficult for me to feel like i'm in a crisis but go to A&E, be assessed, and basically be told to just go home and stay distracted. I feel abandoned, brushed off, and usually still in the same place as I was before I went to A&E.
As well as this thread being about how to get through A&E I also wanted to ask for some motivators to go there in the first place because of how distressing it can be and how other unsafe alternatives can be powerfully drawing me to them. A&E is usually my last resort but I sometimes go there when I feel the best thing for me would be to be admitted to hospital and getting assessed at A&E is the only way for that to be considered. Crisis teams, helplines, and my treatment team are usually beyond being able to help me at this point.
Thanks in advance.
I put it down on paper and then the ghost does not ache so much.
Don't try to calm the storm, calm yourself, the storm will pass.
I actually agree with you . I always found going to A&E hard as the hardest bit I found was actually telling the receptionist what had happened, I used to speak so quietly even the receptionist couldn't hear me! I would have liked to have gone with a friend but they were always busy so I couldn't. I too became very anxious when waiting, I would have my legs and hands shaking like mad and to make it worse so people would look over at me as i was there shaking. The best thing I would say is to ask if you can wait in another room, I was offered that choice before. And I would use A&E as a last resort if you can :)Like you said, try other things within the community first :)
xx
What are the reasons you normally need A&E? If it's self harm or being suicidal you really do need to be there and there isn't much you can do with that part unfortunatly.
Could you take an ipod or a book? Listening to my ipod helps calm me down a bit and distract me from all the noise. If you have access to a bed then lying down helps too but they might not give you that. If you can avoiding busy times like Friday and Saturday night would speed things a lot. You could take a notebook and write some stuff down whilst you are waiting. You could also write some stuff down before you go about what is going on for you and just hand it to the doctor so you don't really have to go through history and everything over and over?
Just brainstorming here, but I do really understand how horrible A&E trips are. *hugs*
I hate A&E trips too, and often find them totally useless... when you go due to feeling unsafe they just seem to stick you ina room to "calm down" and then send you away, and when you go due to SI/OD they patch you up and make you see a psych who as soon as you say the words "i'm fine I won't do it again" to sends you away. And then you have at least a days wait for the crisis team, who also often seem really unhelpful after a while you do start to just give up on the whole process and fall into methods of coping that require little to no external input - and generally are self-destructive in nature
I have started trying to write down a note of why i am going, and another list of issues for the doctor/psych in an attempt to make the communication side easier. Though even then we often have difficulties...
I also often end up standing outside and just nipping back in every few minuets to make sure my name's not been called. But oviously this has the issue of you potentially missing your name...
what sort of things usually cal your anxiety levels? Are any of them doable withint he waiting room?
I went to A&E due to feeling really suicidal on Thursday night, it took me ages to build up to it, I felt so scared when I rang the taxi and had a panic attack waiting for it to come.
The receptionist was quite loud and gobby and kept asking if i'd taken something and when I said "No, I'm just feeling really unsafe" she looked somewhat confused.
I was sent to sit in a tiny side room with no windows and 2 plastic chairs, it stunk, smelt like someone had just been sick in there minutes before, it was boiling hot and the floor was sticky, I was told by a rude nurse to stay in there and don't come out, the doctor will see me soon (6 hours later) and feeling very stressed, tired and claustrophobic the doctor came and asked me my life history which I have told doctors a 1000 times, didnt ask much about how I was feeling know, more interested in when I was a kid, then said he was happy for me to go home and the crisis team would ring me in a few hours to arrange to visit me. Guess what, it's now Monday and i've heard nothing from them :(
Push will get a person almost anywhere except through a door marked “pull".
i hate to say this but the experiences you describe are not unique to mental illness if that helps at all. i work in an ER and one night i got a 911 call from the waiting room. i hate the ER and my entire team knows that i will not go in for any reason if i am still conscious. if you are not dying, the wait will be 6-8 hours on a good night. you will run into those who get angry that you are there seeking care when so many people who are "really hurt" need help. you will run into rude receptionists who often are not very well trained and ancillary staff (hey i love my nurses but still they can be so inappropriate at times) who need more training.
i find it best when going to ER or A&E over there to be very upfront and direct about why i am there. how can you expect to get good treatment if you act like you are ashamed or be very indirect about why you are there? talking softly is a no go because it is a very loud place to begin with. it is so hard but i find that people often see how i would react to why i was there and treat me accordingly.
if i cut myself, i present and say " I cut myself and I need to be treated." Be ready for the inevitable questions. how long ago? with what? it may seem like the person is being nosey but those are important questions. time frame is very important in whether or not you get stitches. how you cut yourself is very important in knowing whether or not you need a tetanus vaccine. i often find the broken record technique works well. if i run into someone who keeps asking questions that are not relevant (to him or her)like why would you do that? i just keep repeating i cut myself. ask for what you need too. it never hurts to ask. if the waiting room is overflowing and too noisy, ask if there is a quieter place you can wait. there may not be but it never hurts to ask.
If i overdosed, i tell them i took too many of x-medications. if i am there because i am not feeling safe, i say that also but for most of the staff you will have to blunt. i am suicidal. if i am at home, i am going to hurt myself so i am here and i need help. i find that "i'm not feeling safe" just does not work because it is confusing. from yourself? from someone else?
the lack of follow up and care out there is appalling and unfortunately a fact of healthcare on both sides of the pond. do not agree to something that is not going to work. if going home to talk to the crisis team tomorrow is not going to work for you, say that. if you know what you need, say that. most doctors in the A&E or ER often do not know how to help plus at any given time we are waiting for 3 or 4 people to return calls, labs to come back, scans, etc. and i often have 8 on a slow night to up to 25 patients at a time on a busy night. personally i appreciate the patient who comes in and says I am suicidal. I need to be admitted or I am x and this is what i need.
don't know if this helps at all but feel free to ask questions. it is in all of our bests interests as docs and patients to work together to get needs met.
The above post was very useful; I've been to a&e many many times and I also find its best to be up front and 'blunt' about what your problem is. If you have self harmed, say how bad, how long ago, what with etc, same with ODing. I've never been there due to feeling unsafe, I've only been when I've actually done something but I know they appreciate you being quite forward and blunt so I assume they would be the same if you felt unsafe.
Lindsay i am sorry you are feeling so bad, but i read your LJ and it looked like people wanted to help you but you were avoiding it all, why is that? Do you not find the crisis team or your workers helpful? I understand the worry about going to A+E cos its emabarrassing talking the receptionist about what you are there for especially in front of others.. I never had a bad incident in A+E so i don't have much advice, but wanted to give you a hug and please go to the A+E if you are feeling very unsafe cos i don't want you to die..
Have you tried using the form on the main site?: http://www.recoveryourlife.com/index...93_articleid=3
I've not used it yet but having found writing thinks down helpful with doctors, think I may use it in the future
You can just hand the form to the receptionist and it gets over the first barrier and allows you to be descriptive without being embarassed
you coukld even do two one for receptionist with essentials details and one in more detail to give to people treating you.
after triage or at reception you can ask to go somewhere quiet if that makes you feel more comfortable. I take my soft toy duck as i find him comforting and if dont want to be seen in public with a duck will sit stroking him while he is in my pocket. So yeah touch related things to keep your hands busy help me ducky, worry beads, doodling,
and if you are just fiddling you are less likely not to hear.
The above post was very useful; I've been to a&e many many times and I also find its best to be up front and 'blunt' about what your problem is. If you have self harmed, say how bad, how long ago, what with etc, same with ODing. I've never been there due to feeling unsafe, I've only been when I've actually done something but I know they appreciate you being quite forward and blunt so I assume they would be the same if you felt unsafe.
i know i would. i'd much rather someone tell me he/she is so suicidal that he/she cannot keep safe rather than sending someone home and finding out the person was a successful suicide the next day. one of the whole reasons i went into ER or A&E was to prove that one can be a good doctor and still treat people with mental health issues appropriately. i see/saw way too many people who cut getting stitches without anesthesia or people die needlessly because they overdosed and are a "frequent flier" in the ER. During my training as a med student i saw a patient die because she came in on a weekly basis saying she overdosed and every other time she got her stomach pumped. that one night my attending refused and told me to "Get her out of my ER." i refused and so he went in and kicked her out. that was the one night she had overdosed and she died 3 days later.
i would much rather see your face every single night of the week than have that happen again.
Where I live there are smaller hospitals that only have minor injury units, and I usually find you can get seen there much much quicker and the atmosphere is a lot calmer and quieter. It might be worth researching, obviously no good for just a crisis, but for self harm it's unseful.
Let the Force be with you
I'm not short, I'm space efficient
after a while you do start to just give up on the whole process and fall into methods of coping that require little to no external input - and generally are self-destructive in nature
