"Great ED care, but inadequate care in ward"

About: Geraldton Hospital Hollywood Private Hospital

(as the patient),

I felt great after a surgery at Hollywood Private Hospital, but a week after my return home I felt so sick I went to Geraldton Regional Hospital (GRH) Emergency Department. I was diagnosed with pneumonia and a couple of blood clots and transferred to the ward within 5 hours. The treatment and care I received in the ED was thorough, thoughtful and I was given adequate explanation about my treatment. I'd also like to thank the security officer who brought me a sandwich for lunch. I had not eaten for 24 hours and was ready to snatch the tray from another patient who wasn't eating their food.

However, I’d like to outline my thoughts and concerns.

1. I understand the triage system, but why can't you just explain the likely wait? I couldn't breathe and was very distressed and had no idea whether I should just go away and die or keep waiting.

2. There were mistakes in the admission record. My temperature was 39 degrees but the discharge notes called this 'mild'. I'm not confident that my condition was accurately assessed and recorded.

3. There was a notice on my door - masks were required on entry to my room. Nursing and cleaning staff wore masks but the doctors I saw didn't. I guess being so close to God they don't spread nasty pneumonia bugs.

4. The meals on the menu are not healthy choices. A breakfast devoid of protein and loaded with carbs, salt and sugar is not okay. There was a lot of Class A and A2 carcinogens available and no salads. Was that packet soup?

5. Nursing staff gave me a drug on an empty stomach and it was agonising. The drug info clearly states that it is to be taken with food. I hadn't eaten for over 24 hours.

6. The pain in my stomach was excruciating. I pressed the call bell and it took 30 minutes for someone to come. The nurse told me this was the sub-acute ward so everyone needed care. True - but if you don't check how do you know the level of danger to a patient? Just letting the bells ring and ring is not okay, especially for the old people in pain on that ward. Cruel and unnecessary.

7. Who were the team of strange people who marched into my room and started talking to me? One of them was very rude to the others, patronising and demeaning them in front of me. None of them wore masks or introduced themselves. Then they gave me bad news and stared at me - except one person who hugged me when I cried.

8. Thanks to that medical student - your bedside manner was relevant and healing - you'll be a great doctor. Thank you also to a resident (I think) who came back with a screen and explained my condition and treatment options.

9. I was discharged with antibiotics that failed to treat my condition because no-one ordered the sputum culture. Another contribution to antibiotic resistant bugs in hospitals?

To summarise, the level of care in the ED is mostly high standard. Care on the ward was not adequate and my condition deteriorated after discharge. Patient engagement needs attention. Staff engagement too. Give the menu a healthy overhaul.

Responses

Response from Michele Young, Coordinator Executive Services, Executive Services, WACHS - Midwest

picture of Michele Young

Dear Madam Manners

Thank you for sharing your comprehensive feedback outlining your concerns regarding your experience while at the Geraldton Hospital. I was concerned to read about the aspects of your care that you described and I am very sorry that you have experienced our service in this way, your experience does not meet our commitment to providing high quality patient centred care.

WA Country Health Service (WACHS) Midwest participates in the “Hello my name is” campaign which was started by a UK doctor Kate Granger to encourage and remind healthcare staff about the importance of introductions in healthcare. Introductions are about making a human connection between one human being who is suffering and vulnerable, and another who is there to help. This is the start of a therapeutic relationship which can instantly build trust in difficult circumstances, so it was very disappointing to hear of your experience relating to the team that did not introduce themselves. I have passed your feedback on to the Regional Medical Director to discuss with her team. It was reassuring however to hear your positive comments regarding the bedside manner of the group of staff that showed compassion and empathy.

WACHS Midwest has a duty of care to ensure inpatients have access to safe, appropriate and adequate food and fluids and menus should enable all patients to meet their recommended dietary intake targets. Menus are designed in line with the Nutrition Standards for Adult Inpatients in WA hospitals that was developed to guide menu design in all WA Public Hospitals and to allow adult patients to meet their nutritional requirements during their hospital stay. Geraldton Hospital conduct regular audits of meal trays and undertake regular patient satisfaction surveys using this information to update the menu. I have passed your feedback on to the dietetics team.

We are unable to investigate your specific concerns without additional details, so we would be grateful if you could contact us directly to discuss the issues you have raised. The contact details for Derek Fraser Geraldton Hospital Operations Manager are 9956 2369 or Derek.Fraser@health.wa.gov.au or alternately you can contact me on 9956 8695 or michele.young@health.wa.gov.au. Your call would be very welcome and can still be addressed anonymously if you wish. We will of course respect your decision should you choose not to make contact and if this is the case we will have general discussions with staff about your experience and how we may improve.

I was pleased to hear that the care you received in the Geraldton Hospital Emergency Department was thorough, thoughtful and of a high standard, staff will appreciate your feedback and I will take great pleasure in passing this on to the team.

WACHS Midwest values feedback like yours as it allows us to reflect on our service and improve in a manner that meets the needs of the community. Thank you again for taking the time and effort to share your story with us. I do hope you are fully recovered and I look forward to hearing from you soon.

Kind regards

Michele

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