Hi Alex_B, Unfortunately the nightmare A&Es are a feature of most countries, Australia, UK etc. BUT, one toad does not make a plague. Over the 51 years of being on insulin I have seen quite a range of A&Es and what strikes me is:
Tone and demeanour of A&E staff depends on who is overall head of the Unit and who is the senior staff in charge of that shift. -
a good leader will keep his/her staff in line, ensure respectful regard for patients and that protocols for management are followed (e.g. check for urinary ketones and if positive, check blood for ketones and glucose AND then for blood acidity before considering a DKA diagnosis). And busyness or whatever is no excuse for breaching confidentiality.
You have every right to request to talk to head of Unit, or senior in charge of the shift about your concerns whilst in A&E - ( not to a poor chump who has been delegated to do 'damage control") - also delaying tactics may occur ( he/she is too busy with emergencies etc) but given the length of a shift and how much time one spends in an A&E that is not an excuse that will suffice for long. (And everyone needs a meal break or toilet break after all !!)
You have every right to request to see contemporaneously what is recorded in your health record AND to request to write in those notes - a medico-legal mantra I have heard taught to staff is "If it is not written down, it did not happen". That leaves the patient is a very disadvantaged position as far as the 'truth' is concerned. Do not let the 'we only have electronic records with access for staff only' malarky deter you. As in the point above, if a written request by you in the notes to see the Head of Unit or senior in charge is in the notes it cannot be denied or lied about that such a request was never made.
You have every right to lodge a complaint about the way you were treated - the problem is often it comes down to your word against their's, but being able to write in the notes at the time, or having a support person there to witness what happened, what was said etc helps you and may keep staff behaviour better in line. Whether you can legally record what was said on a mobile phone etc without their permission is a legal issue which may vary from country to country, State to State etc. And often in the complaint process you may be offered the opportunity to provide suggestions of how things might be improved.
You have a right to later view the clinical record of your A&E visit and any summary which may have been sent to your GP and to request an alteration to those records - whilst that may not always provide the correction you desire, a record of your protest will need to be recorded, along with what you wish corrected. That can be referred to in future if need be.
Please consider going to your GP and DSN with a list of your concerns about what happened. You need people to understand your side of the story and any GP/DSN with a sense of fairness, openness and concern for his/her patients will understand that A&E departments are not perfect and that any patient might react as you did in similar circumstances. You need your GP and DSN on side in this. Thinking you will not be supported is understandable but defeatist - you need them.
In the future you may not always be able to decline being sent to A&E - you may be unconscious or your life is in danger. Better to find ways to prevent a similar episode occurring, whether that is by having an alternative A&E to go to etc, or ironing out the problems with appropriate help, counselling etc. E.G. a letter with summary of your health conditions, your concerns with A&E behaviour addressed by your GP to head of Unit and endorsed in your clinical record may make for a better experience.
Best Wishes for a way forward !