I’ve had some good comments from the Morphine post, it’s very interesting to hear about the different dosages and protocols that various ambulance organisations use.

This post is one that I’ve been thinking about writing for at least a year, but I’ve always been a bit shy of writing it because it touches on possible racism.  Just remember, I hate everyone, not just one type of person.

Sickle Cell disease is a horrible illness, it results in massive pain, and due to the blood cells ‘clumping’ it can cause stroke, blindness, kidney failure, heart attacks and numerous other complications.  The pain these patients feel is unbelievable.

The thing is, most of these patients are black.

Here is the problem that I have.  There are a number of sufferers who are banned from certain emergency departments, there have been legal orders that say a patient should not got to a specific A&E when they get a crisis.  It’s normally because the patient has caused trouble while waiting to be treated, I was an A&E nurse in North London for long enough to realise that some Sickle Cell Disease patients aren’t saints, but…

In my personal experience, Sickle Cell Disease patients are the only patients who get banned from departments.  Drunks can be much more violent, yet they never seem to get banned.  ‘Frequent flyers’, patients who attend every day, use up more time and resources than those with Sickle Cell Disease, yet they never seem to get banned.  I’ve also personally witnessed nurses being hit, yet the patient still receives treatment, and isn’t banned.

Why I understand that Sickle Cell Disease patients can be demanding, they are in a huge amount of pain.  Some of them are indeed opioid addicts, but my thought on the matter is that it isn’t hurting me to give them painkillers, and that the stresses of withdrawal can cause a sickling crisis.  But it does seem that Sickle Cell Patients are being discriminated against.

This affects the ambulance service in the following way – we might pick up a patient 200 yards from the local hospital, he has chest pain, and is in a lot of general all-over pain.  If he is banned from that local hospital, we might have to travel miles to get him to a hospital that will accept him.  If he has a heart attack or stroke on the back of the ambulance, is it our fault for bypassing a nearby hospital?

These patients often have a ‘treatment protocol’ at their hospital – this states the type of pain relief that they get, and who should be contacted to continue their treatment.  These patients are often concerned that if they are not taken to their specialist centre (always miles away…) then the hospital that we do take them to won’t have their treatment protocol.

Also, will we be called more because we are now carrying morphine, and will maybe give it to patients, when their personalised treatment protocol states that they shouldn’t have morphine at all?

 In my opinion, Sickle Cell Disease patients are treated poorly in A&E departments, and I don’t think that it can be just that they are ‘demanding’ for their pain relief, or that they are personally ‘annoying’.  While a lot of these patients can be annoying, I think it’s only because they are treated poorly to start with.

Disclaimer: I used to work in an A&E department with a huge patient population of Sickle Cell Disease patients.

And don’t forget, it’s World Aids Day today.