"The management of my T1 diabetes "

About: Flinders Medical Centre / Emergency Department Royal Adelaide Hospital / Emergency Department Royal Adelaide Hospital / Spinal injuries

(as the patient),

I was in A&E at Flinders Medical Centre (FMC) across dinner time, following a road accident. As soon as I arrived I told the nurses and doctors, that I have T1 diabetes and would need some insulin before 8PM, or my blood sugars would go up. The nurse told me that they weren’t going to feed me. As if I was asking for food - even without food, I knew would still need insulin. The doctors I saw did not appear to be interested. This was before I had Lantus, DAFNE and a correction bolus ratio. I told them I didn’t know how much insulin to have if I wasn’t eating. The staff that were looking after me didn’t seem to take any notice. My blood glucose was up from what it was at the scene of the accident.

A few days later I was back in A&E. The next day my blood glucose came down and I was transferred to the Spinal Unit at the Royal Adelaide Hospital (RAH). The last time I was in this hospital my diabetes was not managed well, in my opinion this was because I was not in the Diabetes ward, so I knew I had to be assertive about managing my diabetes well, so I could recover faster.

The Endos came to see me soon after I’d arrived in the ward, so it seemed all was going to be OK.

That night I did not get any long-acting insulin, despite repeated requests, and asking for an endocrinologist. After a while the nurses didn’t respond to my buzzer. So disempowering and alarming.

Next morning one of the Endos came to see me, just to add insult to injury, tried to blame me for my blood glucose going up overnight. I did some assertive talking about long acting insulin and keeping diabetes stable. There was a registrar on call, who did not act and call the Endo on who was on call. So why weren’t they called????

Later one of the Endo students came to see me, a good chat about the importance of keeping diabetes stable, and how best to do that. The student was intelligent, receptive and understanding. An endo arrived who had introduced herself and said she was from Endocrinology, without telling me her position (student, registrar, doctor, professor, cleaner), but to me it seemed she was clearly senior to the student. She admitted to being the one who had withheld my long acting insulin last night. Through my contained rage I gave her a good, positive, polite, assertive talking to about the importance of keeping diabetes stable. It appeared to me that she had a lot to learn about diabetes, and a lot to learn about consulting with consumers. I was most annoyed that she’d done this without discussing it with me, without considering the predictable effect of missing the long-acting.

Two weeks after the accident, I saw my GP. He told me other people have had worse outcomes. I take that to mean they died. He was most emphatic that I write a letter of complaint to Flinders about my diabetes being ignored on the night of the accident. Emergency staff ignoring diabetes is not on. In my opinion this is an issue has to be dealt with. If my diabetes was managed in A&E on the night of the accident, I do not think I would have spent long hours in A&E, and several nights in the Spinal Unit.

The letter of complaint to Flinders Medical Centre got no action.

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Responses

Response from Patient Opinion

FMC are concerned to hear of your experience and ask that you make contact with the FMC Consumer Advisory Service on Ph: 8204 5433 or via email consumeradvisory.fmc@health.sa.gov.au. FMC aims to acknowledge consumer’s concerns within 48 hours and provide a response to the concerns within 35 working days. In August 2012, FMC responded to 100% of complaints within these timeframes. Due to the lack of information pertaining to your experience, we have been unable to identify any concerns that have been raised directly with our service and encourage you to make contact with us so we can attempt to resolve this issue as soon as possible.

Kind regards,

Jane Tamkin

Consumer Advisory Service

Flinders Medical Centre

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