"When the patient comes last..."

About: Sir Charles Gairdner Hospital

(as a friend),

Recently one evening, I was directed to attend Charlie's (Sir Charles Gairdner Hospital) ER by police after an aggravated assault on me and a friend by a drug addict. During the altercation which was caused by my attempt to stop him breaking into my car, my friend was injured by his dirty needles, and we were both physically assaulted.... This was comparatively pleasant to my experience at Charlie's ER. 

We were triaged by what seemed to be the most unhappy person in the world, and whom made me feel like I was genuinely burdening her with my health issue. We waited for an hour and half in the waiting room where the police continued interviewing us. We then waited another 2 hours before a staff member came out and said to us, we don't really know what to do, and we can't get in touch with a doctor who can tell us. After another 30 minute wait, I asked for an update from the triage nurse, informing her that we had been told they didn't know what to do and queried whether attending another ER would be a good idea. To which her response was, you can go to another hospital if you want, but you'll just go straight to the back of the queue, How long do you wanna wait?. About 15 minutes later, we were finally allowed to go in, however, this is far from where our bad experience ended.

We were placed on a bed in the entrance. My friend was lying down on the bed, whilst I was standing up next to the bed, unable to even perch. I was thankfully offered a seat by a friendly paramedic who asked me whether I wanted one as I looked so incredibly uncomfortable. I quickly accepted as I was very uncertain whether any of the staff, seemingly oblivious to our clear state of distress, would ever replicate the gesture. At this point, we witnessed an argument between a doctor and a nurse who seemed to be in charge after the doctor had requested a bed for a patient. The nurse said there were no beds, to which the doctor replied that they had just walked past a number of empty beds. The nurse just repeated that there were no beds, without any added clarification. This was extremely uncomfortable for us to watch, and didn't make me feel confident at all that there was any sort of sense of team, nor any common goal of prioritising patients.

The most engaged I saw any of the staff the entire time was when one nurse was noted to be coming back from some period of leave. Everyone was so excited to this nurse, and made such a big deal when she finally arrived and was greeted by a whole group of nurses. This occurred right near us, still distressed, and still waiting to be told what was even planned for us. During this time, which lasted about 2 hours (6 hours after we arrived), an elderly lady was wailing softly a few metres away constantly for help and to go home. No one seemed bothered and the nurses were rolling their eyes and yelling over at her - you're ok. Yes you're going home. Just wait - and dismissing her complaints. I thought she was just old and that there was no issue, so it didn't bother me at first. However, this continued for an unreasonable amount of time. I then proceeded to hear a doctor come out to speak to the lady, after which he went to a nurse and asked whether a form he had just taken out of her file was the one that was supposed to be sent to organise her ambulance to get her back to her nursing home. The nurse made an uncomfortable nervous giggle and went off with the form, presumably to rectify the mistake that the elderly lady was trying to highlight by wailing out for help.

A doctor then came out, about 6ish hours total from when we arrived, saying there wasn't much else to do and for us to go see our GP. Then doctors we encountered we're really lovely and caring, as were the paramedics. The staff providing direct care were all really lovely and caring - this included the doctors, paramedics and one nurse. The remainder of the (I think) nursing staff who were supporting the rest of the ER operations, seemed to have a complete lack of interest in our care or well-being. In my opinion, this was a truly horrible experience, and if the ordeal with the enraged drug addict wasn't taxing enough on our physical and mental well-being, the experience we had at Charlie's ER was certainly the cherry on top of that cake.

I would like to recommend some things I believe will stop this from happening again, both from my experience in leadership and people management, and my experience as a human being. I felt the culture in the ER could only be described as toxic. When I reflect on the reaction of staff to the behaviours being exhibited and the way people were treated, it was clear that this was 'the way they do things around here'. I'm not in the medical field, but I can't imagine that this is an effective environment for making people better - neither staff nor patients.

The KPI of seeing 80% of people within 4 hours, as shown in the poster in the waiting room, is quite accurately described as a 'dream', because this is all I believe it will ever be unless staff attitudes change and patients are prioritised in a meaningful way. 

Waiting Time

Waiting time


Staff skills

Staff skills


Team work

Team work


Nurses

Nurses


Reception

Reception


Staff attitude

Staff attitude


Lighting

Lighting


Responses

Response from Janet Zagari, A/Executive Director, Sir Charles Gairdner Osborne Park Health Care Group

picture of Janet Zagari

Dear EDDDAY,

Thank you for sharing your story of your experience in our Emergency Department. I am sorry to hear about your frightening encounter.

I am concerned by your story and would like to investigate this further. To do this requires additional, specific information and therefore I would ask that you contact our Patient Liaison Service on (08) 6457 2867 to enable us to look into these concerns.

What you describe of your visit is not what the hospital supports. We believe that every patient should feel cared for as well as receiving the very best in clinical care and it is important that we are able to review what happened when the patient experience is not what is should be.

I am sorry that you were not treated within the 4 hour target. The majority of patients are seen and treated or discharged in this time frame but there is still work for us to do in order to make sure that we can meet the target during our busier periods.

Again, I would ask that you contact our Patient Liaison Service and I also hope that you and your friend are recovering well.

Kind regards,

Janet Zagari.

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