I mentioned in yesterday’s post that a few days ago my family doctor had sent me into hospital because of worsening shortness of breath. I wasn’t overly surprised when I was met with stigma in the ER. It seemed like the ER doc took one look at my list of psych meds and decided to write me off as a psych patient. He barely listened to anything I said, and kept asking what the point was of my GP sending me in. All he wanted to do was repeat the tests my GP had already done and refer me to an outpatient clinic. I was upset with being dismissed like that, and there was no need for me to be in ER to do what my doctor had already done, so I left.
Then yesterday comes along, and the stigma in the ER situation really kicked into high gear. From the time I woke up, I was extremely dizzy, to the point where even walking around my apartment was difficult. I checked my blood pressure a few times, and it was very high. My heart rate was also high. On one recheck of my blood pressure it was 170/118, which is extremely high. I still didn’t really want to go back to ER after the experience I had a couple days before, but I called the provincial Healthlink phone line and talked to a nurse, who thought I should definitely go in to ER.
I was too busy to make it to my building’s front entrance to catch a taxi, so I called an ambulance. The paramedics showed up a short time later. When they loaded me in the ambulance, they rechecked my blood pressure. It was still high, but not dangerously so. At that point I was freaking out, thinking that ER was going to brush me off as a psych patient and not take the physical stuff seriously. I was upset and started crying, and told the paramedics there was no point in me going to ER. They assured me that my physical issues were concerning and they would advocate for those to be taken seriously. After several minutes of cry-fest, I decided to go ahead and go to ER, mostly because I didn’t think I could walk back to my apartment from the ambulance.
After waiting for a while in the waiting room with paramedics, a triage nurse directed me to a chair in the triage area to wait in. I had no further contact with ER staff until 3 hours later when the psychiatric triage nurse came to talk to me. The initial triage nurse had entered into their system that my presenting complaint was depression.
I was so upset with this, and I wish I hadn’t had such a strong emotional reaction because it made me less able to stand up for myself. I asked to talk to the nurse who had triaged me, and she was defending her decision, saying I was in ER for a mix of things and she had to pick one so she had picked depression. She showed me the triage form she had completed for me based on what ambulance had said, and based on that my presenting concerns were shortness of breath, dizziness, and hypertension, and depression was part of my history. Yet when entering me into the hospital system, it was depression. I told her that had nothing to do with why I was there, but she kept insisting that yes, it was. She minimized all of my physical concerns, to the point of being really offensive. She told me that my vital signs were stable, even though it had been three hours since my vital signs were last checked. One of the things she brought up was that I didn’t make eye contact during the two seconds that she directed me to a chair, as if that right there decided things. I told her that this was typical of the stigma around mental illness, and she said she didn’t have stigma, and she has friends with mental illness. Well that takes care of that, then, doesn’t it?!
I asked to speak to a manager, but with it being a weekend there wasn’t a manager on duty, so she brought in the ER charge nurse. Of course the charge nurse backed the triage nurse, minimized my physical concerns, and was disgustingly patronizing. Any time I swore she shushed me and told me not to swear because there were senior citizens around.
At that point I was just done, so I left. No marching confidently out; I was still extremely dizzy, so my walking was slow, tentative, and wobbly. But who gives a crap about that, right? I’m JUST a psych patient, and who was I to think I could escape being met with stigma in the ER?
This hospital is part of Vancouver Coastal Health, an organization that has traumatized me before, both when I have been a patient and when I was an employee (I’m a nurse) being bullied. While they proudly claim to have processes in place for dealing with complains, I know from experience that what they actually do is brush things under the rug rather than acknowledging and dealing with them. They steadfastly refused to admit that the workplace bullying I experienced actually happened. Their modus operandi seems to be making the whole ordeal as stressful as possible for the person making the complaint. So I emailed their Patient Care Quality Office to express my concerns, but I asked them not to contact me to follow up, and instead pass on to the ER manager that some anti-stigma training is called for. I also sent in a complaint about the paramedics who transported me to hospital for telling me one thing and telling the triage nurse something entirely different. I’m also going to call out Vancouver Coastal Health on Twitter.
Unsurprisingly, this has set me back in terms of my depression. I’m prone to developing psychomotor retardation (a depressive symptom involving slowing of movement and thoughts) in response to overwhelming stressors. Combine that with ongoing dizziness and moving around is quite the challenge.
This kind of thing is not okay. There is more than enough stigma to go around without health care providers hopping on board so that patients are facing stigma in the ER and elsewhere. Just because someone has a mental illness does not mean that it’s always to primary issue or that their physical concerns are trivial.
There’s more on stigma on my stop stigma page.
My book Making Sense of Psychiatric Diagnosis breaks down the different categories of DSM-5 diagnoses, explaining the diagnostic criteria and providing first-hand stories of the various illnesses. It’s available on the MH@H Store, as well as Amazon and other online retailers.