"Ectopic Pregnancy: Poor staff treatment and follow up"

About: Box Hill Hospital / Emergency Department Box Hill Hospital / Maternity Service

(as the patient),

Earlier this year I was treated at Box Hill Hospital for an Ectopic Pregnancy.

From the moment my husband and I arrived at the hospital (straight from my pregnancy dating scan where the condition was found and diagnosed), I felt we were treated less than ideally in a clearly highly emotive medical situation.

Presenting to an emergency department having just found out that your pregnancy is now no longer viable, your health is in immediate risk (tubal rupture) and the stress of not knowing what the immediate future may hold for you (future pregnancies / treatment for this condition / will surgery be required etc. ) was something neither my husband or I had emotionally prepared ourselves for.

To then be poorly treated by the staff members we saw, treated as a pin cushion with needles prodding in everywhere with no apparent explanation (and I have an extensive medical background to understand why things are done when in regards to medical treatment) and to feel brushed off by staff when I asked with tears if I would be needing emergency surgery for my condition, it just went from bad to worse.

What ended up being without a doubt the worst 15 hours of my life spent in hospital involved; no doctor consultation, no doctor physically examining me, nurses and doctors attempting to place intravenous catheters in me left, right and centre (even though I was well hydrated, not in shock and in no immediate risk of rupturing). I had 12 different needle attempts at gaining IV access all up and the more that this went on the colder I became and obviously the harder my veins become to access. At one point one of the doctors requested that I was given a blanket as it was freezing cold in the examination cubicle, and I was in nothing but the thin hospital gown, the doctor assured me that if they warmed me up a little first then they should be able to gain IV access more easily. I was never provided with a blanket and was left sitting there shivering whilst two staff members continued jabbing me at once. I was constantly referred to as - the tubal pregnancy girl, through my examination cubicle curtain by doctors and nurses alike, (this happened at least 3 times during all the staff hangovers) and whenever I did dare to ask if a doctor would see me shortly I felt I was brushed off and told that the obstetrics/gynaecology team were all extremely busy and would see me as soon as they could.

A specialist from the gynaecology team did eventually see me, 15 hours after I was admitted where they told me that I wouldn't be needing the emergency surgery that the ER team had assured me I would be having, and had also fasted me for all night. I understand that they were extremely busy however throughout this time I feel things could have been much better communicated to us and it was not at all necessary for the ER doctor to lecture me on emergency procedures and cross matching for blood transfusions, when I was not even actually having surgery for my condition.

After a lot of staff dealings, apparently completely confused over whether or not I was having surgery or what was going on, I was then approached first thing in the morning by a member of the accounts team. They entered the room whilst I was in bed crying asking me to complete paperwork to put through a claim for my stay on my private health insurance. I had not eaten or drunk anything for almost 20 hours, had not slept all night, was completely and utterly emotionally exhausted and was in quite a bit of pain post-internal ultrasound (from the ectopic pregnancy location and bleeding) and could not control my tears of complete shock and exhaustion, and they felt that then would be a good time to send in an accounts person.

This is the shortest summary of my overnight hospital stay. The ongoing blood work, methotrexate injections and maternity ward care follow ups then proved to unfortunately show no better a level of patient care. It was an ongoing saga of terrible patient care and service in an already obviously stressful and upsetting time.

I had desk staff on the maternity ward greet me 6 times on different occasions at follow up appointments asking how far along are you in your pregnancy, and where is your pregnancy folder, when attending appointments. These questions should not be routinely asked to all women just because they are on the maternity floor. If women experiencing miscarriages or ectopic pregnancies are expected to have their follow up performed on the same floor as many other heavily pregnant women, they should not be forced to answer these types of questions as it only heightens the already difficult situation and emotional state.

When I went in for one of many appointments to come and the first chemotherapy injection appointment, I informed the desk clerk of my arrival and it seemed to me they forgot to let the attending nurse know that I was there. 1 hour and 45 minutes later when I brought it to their attention that I had been waiting for a ridiculously long time, it appeared to me that they then went white and realised that they never told the nurse of my arrival. Having to wait in a waiting room for that length of time at any point in time is frustrating. Having to do it when awaiting chemotherapy treatment to terminate your very much wanted pregnancy, in a room full of heavily pregnant women is obscene.

The follow up provided by the team from there was also no better. I thought I was promised calls from doctors and nurses with my blood results each week that never happened. Again I completely understand the pressure that these staff members are under, however you do not promise someone that you will call them and then forget to do so. Do not make the promise if you cannot deliver. I was constantly chasing team members for my blood results and having to ask about follow up of where to go from here each week in regards to ongoing follow up.

At no point in time did any staff member I saw discuss counselling or follow up with a professional for what I was dealing with or going through. I understand again that everyone is busy but surely handing over a brochure of suggested people to talk to should you need it would also be such a easy step for staff members to take in helping their patients.

I was also given very different information by the staff members I dealt with in regards to my treatment. 2 doctors told me that we could try and conceive again after 3 months post the 2 methotrexate injections I was administered and then another nurse and doctor told me we should wait 6 full months. On another occasion one of the attending midwives lectured me for 10 minutes about going back on the contraceptive pill and how I had done the wrong thing, only to be told 5 minutes later by the attending doctor on the ward that I had done the right thing and needed to be using contraceptives to avoid pregnancy during this treatment time.

Although I am thankful to be on the other side of treatment now and I am glad that I had healthcare services available to me at the time, I feel that my treatment was very poor and that so many things could have been done differently to have a much better level of patient service.

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Responses

Response from Alan Lilly, Chief Executive, Eastern Health

picture of Alan Lilly

Dear PO-OCT15

Thank you for sharing your story on Patient Opinion. I’d have to say that my heart sank when I read about your experience and I also felt extremely saddened by the way you experienced our service and care in Eastern Health. I am really sorry to learn of your experience in our care at a time when you needed us most and no doubt, when you would have been feeling quite down and anxious too. Your story highlights a number of failings in the way that we delivered care to you and your husband and regardless of the nature of the environment, I know and we know that this is simply not acceptable. To add to your burden, I also understand that there appears to be much confusion and hearing different staff views does not raise your level of confidence in our services either. I get that. I am also concerned about the way that you heard yourself referred to and the impersonal nature of some of our staff interactions with you.

Through sharing stories on Patient Opinion, you will probably have also seen from other stories that we get to hear about when we do things well but we also get to learn about where we fell short of patient and family expectations. More importantly, you will also see that we have been able to change and improve our systems, our processes and our staff knowledge to prevent recurrences of poor experience. In order to learn more about your story and experience, I would welcome the opportunity for you to meet with one of our staff from our Centre for Patient Experience. To be able to talk through this further would help us in providing feedback to staff on your experience and what we can learn from it. If you would like to do this, please email tanya.hendry@easternhealth.org.au or call her on 8804 0483. Tanya is very experienced in having these discussions and I believe this would be highly beneficial for you and also for us.

I am going to be taking leave for a couple of weeks but I will be taking a very personal interest in your story and will follow-up on my return. In the meantime, please accept my sincere apologies that you experienced our services in this way and also, please be reassured that we will learn from this as well. I am just so sorry that you experience has led to this.

Kind regards, Alan Lilly

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Update posted by PO-OCT15 (the patient)

Hi Alan,

Thank you for your well thought about and considerate response. I greatly appreciate your empathy and understanding regarding what was a very difficult situation for me and my husband.

Initially I was very hurt and angry over the way I was treated at such a fragile time, however I wasn't sure how exactly to express my concerns properly or provide valid constructive criticism/feedback.

I decided it was important for me to speak up though, so that this didn't happen to other women who may be going through the same or a similar experience.

Thank you for providing me with both Tanya's email address and phone number. I will endeavour to contact her shortly to explain my situation a little more in depth and provide feedback on what aspects of my treatment could definitely be improved.

Thank you for taking the time to respond to my concerns

Response from Gayle Smith, Executive Director, Quality, Planning and Innovation, Eastern Health We are preparing to make a change

picture of Gayle Smith

Dear PO-OCT15,

I am Acting Chief Executive whilst Alan is on leave. I am just writing to say thank you for responding and we look forward to you contacting Tanya Hendry at the Centre for Patient Experience so that we can further follow up on your experience with us.

Speak soon.

With kind regards,

Gayle Smith

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