Amy’s story – Part I
27 September 2022
For Suicide Prevention Month, Amy talks to Katie (Patient Experience Programmes Lead) about her experience as a patient and failures in her care following her suicide attempt.
Topics
Part I of II – to read the rest of Amy’s story, visit here.
*Amy’s name has been changed to protect her privacy.
Content warning: Please note, this article includes discussions of suicide and suicidal feelings. If you’ve been affected by any of the issues raised, please see the resources at the bottom of this page for available support.
A: I took myself to hospital because I took a paracetamol overdose. Because I wanted to end my life. I’d wanted to end my life for about 4 days before and I kept nudging it back a day.
To give context, I’d been feeling suicidal for the best part of 18 months.
After I had taken the tablets, I kind of decided that was not what I wanted to do in that moment. But then there was a sense of, ‘I don’t think I’ve taken enough to warrant going to hospital.’ I’m in this weird no man’s land now of ‘what do I do?’
But I had this feeling I wasn’t ill enough or I hadn’t taken enough to take myself to hospital. So part of me was thinking, I’m going to have to take some more before I can go and actually get help. Because otherwise there’s that sense of stigma – that sense of ‘oh, you’re attention seeking.’ But it wasn’t, I actually didn’t want to bother anyone. I must have spent 20 minutes googling before deciding that I actually did need to go and get help.
Katie: Is that because of your clinical background? That a lay person wouldn’t know they’d not taken enough to be taken seriously?
A: I don’t know, I think back to when we talked about having therapy and I had a similar thought. I can’t stop crying and I’m thinking of ending my life, but I’m not ill enough to have therapy because there are people out there who have worse problems than I have. So maybe it’s more a personality trait than my clinical background. There’s definitely a fear of being judged when you go to hospital and I remember being so nervous on the drive the whole way there. I wasn’t just nervous that I knew if I didn’t get help I’d die, it was that sense of having to explain to people. People are going to find out. It’s a shame thing.
Katie: So what happened when you got to A&E?
A: At A&E, I had a really good experience actually from the minute I walked in the door – other than trying to find A&E which was a nightmare. Actually that’s relevant because I’ve got a clinical background, I’ve worked at many of my local hospitals and there was no way I would ever go where I might be recognised. So I went to an unfamiliar hospital and I couldn’t find urgent care. But the minute I did speak to somebody they were just absolutely lovely, really kind. And it was really good, about 8–9 minutes from speaking to that first lady, through triage to a bed. And it wasn’t quiet, it was really busy.
There is something deeply uncomfortable about feeling like a hindrance and that’s what made me question going to A&E in the first place.”
Katie: When you say really kind, what does that look like?
A: It just felt like she took it seriously. I was immediately believed. She looked concerned. She just seemed kind and said I’m going to take you this way, come with me. And there was no sense of irritation which you sometimes get. She was just really kind. I think I probably presented quite anxious and agitated as well, which might have helped. So I went straight through and had to book in, which is the worst experience, because you have to then tell the entire waiting room why you’re in A&E which I was quite anxious about. You’re basically shouting at somebody through a glass wall about why you’re there.
It’s just such a weird system because you end up repeating yourself all the time. Why does she take this information down and put it on a piece of paper to give to the guy who then asks me exactly the same questions and doesn’t look at the piece of paper?
Particularly in this moment I was on my own, nobody knew I was there. I was feeling very emotional, obviously, to have been in that state in the first place. And some random guy is asking me to shout louder as to why I’m there.
Then you go to triage again, there was a team of people in there and they had quite a few students. They were all really lovely, but uncomfortable. They were all uncomfortable as soon as they understood why I was there. They didn’t know how to talk to me, but they weren’t weird with it like some people through my story who are quite bizarre in how they behave.
We started talking, I was very upset and started crying. And they just had sympathy and I think that’s all you can ask for. You can’t expect people to have empathy necessarily, but just be human. And they were.
When I was in a bed, I got assessed by a doctor who also had a student with them. The student led the initial kind of examination, but they asked permission for that. And I was quite happy for that to happen. And even the student had excellent communication skills. She was very clear. She asked all the right questions. She was kind. There was clearly no judgement, just concern, and the doctor that was with her was really kind as well. They were very clear in their communication of what was going to happen, what tests I was having, if this was the result what would happen.
They explained the psychiatric team would come to talk to me and the psychiatric person came and he was really lovely. So my whole experience of that first bit was good – it was quick, it was kind, I felt safe.
Katie: So where did it start to take a downward turn?
A: As soon as I left that area. Next thing I know I’m being moved to what they call a ‘pit stop’. It’s a stop the clock kind of situation in terms of targets. You wait there until there’s a bed for you. And this is when things started to go really horribly wrong.
Somebody came in, didn’t introduce herself, hooked me up to an infusion. She didn’t actually say a single word the whole time.
I already had the cannula in from the blood tests but I didn’t know what the infusion was. I knew I was meant to have an infusion, but I didn’t know whether this was it or not. She didn’t say anything. So I had no idea how long this was going to last, I was just sitting there with this thing attached to me. But the infusion was attached to the bed, not on a separate stand and this becomes quite relevant.
It must have been about 20 minutes into the infusion and I was really itching. I didn’t know what was going on. When I get really anxious I scratch my head, so I thought it was that. I just kept scratching my head and scratching my head to the point where I was pulling my hair out. I was so bizarrely uncomfortable. I didn’t know what was going on.
And then my face basically started to swell up, but I was attached to the bed so I couldn’t go get help. I was in the last bay, I hadn’t seen anyone walk past, there was no help button so I just couldn’t get anyone’s attention. My face had now started to double in size. I couldn’t stop scratching my head to the point where it’s bleeding so I ended up having to just scream for help, which felt really dramatic. But I got to the point where I thought, ‘oh my god I’ve gone through all of this and it’s going to be this drip that kills me.’
Eventually after screaming a little bit, a nurse came over and disconnected it immediately and then explained that it’s quite a common reaction to the medication. That would have been good to know in advance! By this point I was really hot, really itchy, face still swollen, anxious because I knew my family was now aware of where I was and I was having a full blown panic attack and struggling to breathe. I took myself to get some water and bumped into the nice doctor from A&E who explained it was an allergic reaction and reassured me they’d get me some antihistamine.
What stood out to me more than anything was that it was just all so dehumanising. There’s something about people not talking to you or not calling you by your name.”
My family turned up then which was stressful, but I was starting to calm down. Then a new doctor walked in, he doesn’t introduce himself, is wearing scrubs and with a student and he immediately speaks to my mum. Then he turned to me and said something really condescending like, “Oh I hear you’re having a bit of a hard time?” But with a really fake smile. It wasn’t a smile, it was like a smirk. It was really bizarre.
Then he started trying to ask me questions about everything. So my issue was immediately that I didn’t want to speak in front of my mum. There was no conversation about whether it was ok or not to discuss it in front of somebody else. And he was asking questions I’d already answered three or four times by this point.
I was struggling to breathe so it was hard to talk anyway. I explained to him that I’ve just had a reaction and a panic attack, I’m not quite calm yet and actually I don’t want to talk to you right now. And I don’t know what you need, you know everything? I’ve already had my psych assessment, you know exactly why I’m here because you’ve read my notes. So you don’t need to ask me the same questions, I don’t understand. I probably wasn’t that polite. But in the moment, it was quite tough. And I basically asked him to leave. And so he did, he left, but when he left there was almost this sense of him being like, ‘oh, you know, it’s just an hysterical woman.’
I wasn’t hysterical. But I was very agitated given everything I’d gone through in the 10 minutes prior to him walking in. I even said, “You’ve not even introduced yourself.” I’ve worked in healthcare long enough to know that – at the very basic level – that’s what you should be doing when you walk in.
I never saw him again.
I was very stressed out about the whole situation. I just wanted to go home but I knew my treatment plan was 21 hours’ worth of infusions so I had some time to kill. Next thing I know, there’s someone with a wheelchair to take me to a ward. No one explained anything to me. He was just there to take me somewhere and I do as I’m told and get into his chair, and I end up on another kind of assessment unit or ward. The nursing staff are nice, but nobody explained anything. I was being hooked up to the second part of the infusion and I had to ask them for the antihistamine because of my reaction earlier. But they didn’t seem to know about it, they just weren’t that fussed about it. They would have given it to me without the antihistamine if I hadn’t pushed it.
They were kind enough, but nobody talked to me. Nobody spoke to me, it was just sort of, ‘there, have your drip and be quiet’ basically.
Katie: What happened next?
A: I was so tired, I’d not slept for a few nights so I just wanted to sleep. But then there was another man with a wheelchair to move me again. I’d just got settled and another guy rocks up and I have no idea where I’m going – none of the staff had said I was moving again. At the next ward they were about to start the next infusion, so I asked about the antihistamine. It was 8 o’clock and I didn’t want to go to sleep and the antihistamine wear off in my sleep. But she had absolutely no interest in the conversation. She just said, “Well, if it’s prescribed, I can give it to you, otherwise we’ll have to call the doctor” – like that’s the worst thing and they should never have to do that? I just said, “Well ok, we might need to call the doctor then because I’m not having a reaction and going through all that again.”
It was prescribed so she went to get it, but she didn’t answer any of my questions or concerns and was just quite dismissive. Almost like, ‘can you just shut up now?’
There were a lot of other elderly patients around who had a lot of needs. I know it’s very challenging when you’re working, particularly when you are understaffed in that environment. But there was a sense of, ‘you’re fine, you just need to get on with it.’ Again, just introduce yourself. I couldn’t say any of the nurses’ names or actually anyone’s name beyond that first A&E experience.
In the end I did have a reaction to that last infusion, even with the antihistamine, and I think it was probably the most uncomfortable I have ever felt in my life. I took an overdose, I expect that there are going to be reactions to that, your body is processing it, so you expect some pain and discomfort, but this was next level.
So, I asked the nurse for help, but she wouldn’t or couldn’t do anything. She got a doctor eventually to come see me, who also wouldn’t give me anything, and basically just told me to suck it up. I hadn’t slept for days in the lead up to this, so I’d been through quite a lot. I just wanted to lay down and go to sleep, but I couldn’t because of this bizarre feeling of pain and discomfort. Yet in the end, I think I just fell asleep through sheer exhaustion, but not till about 4 or 5 in the morning. But then it’s lights on and back up at 6 for ward medication rounds.
Katie: When people didn’t help you, did you get a sense that was because they felt like you deserved it? Because you’d done this to yourself?
A: It’s hard to know because nobody had a conversation with me. Nobody even asked, ‘How are you doing?’ Other than what do you want to eat, nobody said, ‘How are you?’ or ‘I’m your nurse for the next few hours.’ There was just nothing. There was no conversation. And I think I put it down to the fact that people were just uncomfortable and don’t want to talk about it. I could definitely hear them discussing it amongst themselves, when they were doing handovers between nurses and they were going through their list. I’m not sure what it was, but it just felt like such a taboo conversation.
The next morning, it must have been about 10 or 11 o’clock, I’d had some breakfast, and this lady walked into my bay in scrubs. No name tag, didn’t introduce herself. Then she kind of came to the side of the bed and said, “How are you?” And she kept stroking me. I asked who she was – she said I’m one of the doctors. I’ve never had a more uncomfortable conversation in my life. I don’t know why but she kept rubbing me.
I think it was her way of trying to convey some sort of sympathy, but it was strange. It didn’t feel genuine. She just didn’t know what to say and was kind of compensating with these weird physical gestures which were just really bizarre. In the end I said, “Did you want something? Or have you got any questions?” Then she said, “Oh no, no” and just left.
Katie: What happened when you were due to be discharged?
A: Finally, when the infusion was finished I asked the nurse about discharge. She kind of laughed and said, “Oh, you know, discharge can be when it is, but it should be today.” And I was thinking, ‘well, of course it should be today!? There was never a point when it wasn’t today!?’
Then they sent the psychiatrist in again. He said he’d discharged me, but they sent him in again – neither of us knew why – so he discharged me for a second time. Then another doctor came with the discharge summary and said we were just waiting on medication. I asked what medication he could possibly be talking about because I’m not on any medication and we’d not discussed medication at any point, which he was very confused by. And it turned out that it was the antihistamine for the treatment I had already finished. They were waiting for a prescription that you could just get over the counter if you needed. I told him that I didn’t need it, but he didn’t believe me. So, I told him I was going to leave without my prescription. And he said, “Okay then fine, here’s your discharge summary, thanks very much” and off he went. And I went home.
The discharge summary is quite awful in its own right. I dug it out for this conversation because I’ve not looked at it since I was discharged. I’m not going to read the whole thing, but here’s just a couple of key things. My age is wrong, but that’s ok, they made me younger. The number of tablets I took is wrong. It says I left a letter out for my family, that’s not true. That’s not something I ever discussed with anyone.
This is the best bit for me, it says: “After the incident, she brought herself to A&E and reported she no longer needs to end her life.” Do I know that? Is it all fixed? Is everything okay now? I never had that conversation. No one ever asked about whether I was going to go home and do it again. I did bring myself in so maybe it’s unlikely, but that’s one thing I’d been very clear about. I’d never said I wouldn’t do it again. ‘No longer needs to end her life’ is quite a strange sentence. Almost like coming to hospital magically changed something in my life.
Then it says that I’ve been attending private therapy and I’ve been prescribed medication but didn’t take it regularly. That’s not true, I’ve never taken any medication. And then because I have my own therapist that I pay for, I’m discharged. No referrals back into the community or to my GP – even though I was told that was going to happen.
All in all, it was quite a peculiar experience.
Katie: What stood out to you about your experience after you’d left the hospital?
A: What stood out to me more than anything was that it was just all so dehumanising. There’s something about people not talking to you or not calling you by your name. And there’s something about nobody talking to me like a person – nobody introduced themselves.
And that wasn’t unique to me, I witnessed that across the board. I can advocate for myself in a way that many patients certainly couldn’t. But I just felt like a hindrance the whole time and I already had lots of feelings about being a burden anyway, that’s a big trigger for people suffering with depression. There is something deeply uncomfortable about feeling like a hindrance and that’s what made me question going to A&E in the first place.
Continue reading Amy’s story in Part II here.
We’re incredibly grateful to Amy for sharing her story. If you’ve been affected by any of the issues discussed, please call or visit the following for support and resources:
You can call free on 116 123, or visit www.samaritans.org to find your nearest branch.
Campaign Against Living Miserably (CALM)
Call 0800 58 58 58 – 5pm to midnight every day
Call 0800 068 41 41 – 9am to midnight every day
Text 07860 039967
Mind – Information and support for people living with mental health problems.