"Negative experience"

About: Monash Medical Centre / Emergency Department

(as the patient),

In late 2018 I had reason to attend the A & E Department of Monash Clayton. I was made to wait over 30 minutes at the front desk while receptionists ignored the growing queue of sick and angry people who they deemed were able to wait another 30 minutes after their important calls and discussions. During this time, no patients were addressed by the receptionists or any triage nurses.

 When the staff finally addressed the waiting patients, the first patient berated the receptionist, as did the following 2 patients. I was amazed at the rudeness, the lack of consideration and might I say lack of professionalism by the staff. I am glad that the receptionists are so skilled at determining who can wait and for how long before being attended to at the front desk. These were skills I was not aware they had without referral and further investigation... or at least a conversation.

When I was eventually evaluated and triaged, it was determined that I had a blocked urethra from blood entering the bladder from the ureters. One of my ureters had been injured in a procedure I had undergone at the private clinic earlier in the day. As a 63 kg and 5 ft. 2 in. patient, I was given a 22 gauge catheter, as opposed to a 16 gauge catheter as deemed by many practitioners at the facility as being more suitable.

If I had received the right sized catheter, it might have prevented the unbelievable amount of pain and discomfort I was in throughout my time at Monash. Every nurse and radiologist described how big this catheter & balloon was. I was given many Endone, Panadeine Forte and Paracetamol (which did not touch the pain), whilst being told by staff that the catheter that was in place was not used anymore and was too big as well as the balloon being too big and the nurses were hesitant to do anything with it.

Consistently, the response to my discomfort was to be provided more analgesics, rather than to have the incorrect catheter removed and replaced with a more suitable catheter.

My specialist was also consulted during this process and his instructions were not followed.

While I was an inpatient, I underwent a radiological procedure in the early hours of the morning. Due to an error by the staff (that they admitted to me at the time) they were not sure if the images would be suitable to identify if there were any further underlying issues.

I sent questions to Monash Hospital including:

1. How did all registrars, nurses, radiologists, and attending medical practitioners see that the catheter and balloon were too large, yet the one who put in the catheter thought it was an appropriate size for the purpose... even the radiologists were amazed.

2. Why was this catheter described by several staff as one that is not used anymore and why is it not used anymore?

3. If a wrong instrument, type or size of instrument was used, or a better catheter could have been used, then does no one following the initial consultant have the ability to make changes? I saw the OBGYN registrar twice only - on the first night when I presented to A & E.

Could no other doctor or nurse have taken into account the distress this catheter was causing, and replaced it with a more suitable one?

4. Was adding on more and more opioid drugs that caused significant vomiting, constipation, drowsiness and little, if any pain relief the best solution?

When the catheter was finally removed, I was told I had to fill up my bladder and void 3 times before I could leave and to use the buzzer to call the nurse. I had already used the buzzer prior to this and waited over 20 minutes for the nurse to respond. Another nurse saw me and helped me as I vomited and was incontinent in the doorway and after over 20 minutes from the initial buzzer pushing, that nurse finally attended.

I was let out of the hospital after 4 days with 3 incontinence pads, an outpatient urology referral and Tramadol, Ibuprofen and Paracetamol and some nice words about how things should improve... give it time and good luck.

This was a horrifying experience of long waits, inattentive nurses (apart from one), old and large catheter being used, nurses who knew there was no appropriate analgesia, and a patient released from hospital in pain with incontinence and well wishes with the question of: was this handled in the best way and could this have been avoided?

When Monash was given an opportunity to respond to my questions, the only issue they addressed was the catheter size, which they denied was inappropriate (despite multiple employees of their institution stating that it was too large).They did not address inadequate care, multiple instances of being left unattended and the inability of clinicians to change a poor decision made by one of their colleagues.