Experiences of patients with acute abdominal pain in the ED or acute surgical ward – A qualitative comparative study

The Danish health care system is currently establishing emergency departments (EDs) with an observation unit nationwide. The aim of the study was to investigate patients with acute abdominal pain and their experiences upon arrival and stay in an acute surgical ward (ASW) versus an ED with an observation unit. A phenomenological-hermeneutic comparative field study with participant observation and interviews was performed. The analysis showed five themes: Waiting, being placed on the edge, taking or not taking initiative, being the object of attention and being taken seriously. The conclusion was that the ED included a multidisciplinary team with nurses, who mainly had interactions with the patients before surgical assessment. In all, it resulted in fragmentation of care and a patient experience of repetition. In ASW, focus was on assessment by a senior physician, only, and the nurses’ interaction with the patients took place after surgical assessment. In all, patients experienced long waiting times. The study shows a need to define the roles of the professionals in units receiving patients with acute abdominal pain in order to fulfil the medical as well as the experienced needs of the acute patient.