Public hospital system..A real eye opener

Last time I was in hospital it was for an appendix simple enough procedure you would think. 3 weeks later I left the hospital about 10 kg lighter and still have trouble today all I can say is it was bloody disgraceful. Nurses that couldn't speak English and just didn't seem to give a flying **** collapsed veins from canulars being in to long ect then of course all the antibiotics would **** on the floor bloody. A doctor who I found out later off a nurse friend is border li e incompitent Makes my blood boil thinking about it

Over the last 6 or so years, we have had a heap of hospital visits, both public & private, and the experiences have ranged from outstanding to left standing....

Couple of quick examples:

SWMBO had sepsis after an op at another hospital. Drove her to the ED and she collapsed as she walked in the door. She was scooped up, and by the time I had swiped my Medicare card for her, she had 2 IV's in place, a stack of nurses & doctors looking after her, and blood been drawn. All that took less than 10 mins from walking in the door.

I had 2 herniated vertebrae. Passed out once, and went to the same ED. They gave me morphine to calm the pain, then checked out my treatment plan, and once confirmed it, sent me on my way to have a CT guided injection. A few days later, I passed out again, and on the advice of the treating GP, went to a private ED. What a WOFTM. Swipe your credit card on the way in, to the tune of nearly $300 to be left waiting on a bed, with NO pain relief, as "we are a little busy". It took my 10 yo daughter to go to the counter and SCREAM at them to come and help her daddy. This was after 2 1/2 hours. Even then, the amount of morphine they gave me was less than was necessary. Its their money, and they dont want to spend it. I was uncomfortable from the pain until the specialist came in, and upped the dosage.


Couple of weeks ago, Miss 13 collapsed twice at home. Called the ambos, who were great as usual. Off to the public ED who were having a steady night. Mum went with her, and by the time I got there, they were in the general waiting area. Well, after 3 hours, and not having had another episode, we decided to leave without being seen.

Short answer is, the ED staff do a great job, and so do the administrators, with the tools they are given. There are many reasons, but IMHO:

Increase the Medicare levy. You get what you pay for.

The GP Super Clinics were another government WOFTM. We dont have the doctors to staff them, so why were they built in the first place???

Use more nursing & Paramedic trained staff. MANY cases, not all, not most, but many, that report to the ED do not need to see a doctor. Upskill the experienced staff already in the system, and give them the tools to diagnose, treat & dis-charge.


This country has a first class medical system. Successive governments need to recognise this, and give it the support it needs.

Ean,
Glad your daughter is Ok, but good to see people start to see what actually goe's on in an ED.
My issue is there are usually too many time wasters who just dont want to pay to go to a doctor and too many drunk and drugged idiots.
What people do have to understand is the triage system and sometimes it does not work perfectly and other times patients may not be assessed correctly as nurses, paramedics and doctors are all human, wont go into that too much but lets say I have challenged a couple of so called triage nurses on occasion who did not deem our P1 patients urgent as often some of these people do not recognize the skills of our medics, on 2 of these occasions our diagnosis was confirmed. I do have to say this does not happen often and most triage nurses usually rely on our initial assessments. There are a couple of hospitals like this and a couple of nurses in particular that we avoid if possible.
Transport does not mean much, we send people by normal car,ambulance either priority or non priority, medivac chopper (our own) or by RFDS. The transports for us could range from minor to life threatening eg we may send a person with a broken leg that is not life threatening by medivac to Port Hedland, but they will not be a priority case, but we may send someone with chest pain of presumed cardiac origin who may be a priority.
Look most ED triage nurses are fairly good at making diagnostic assessments but if you have concerns raise them in a firm but rational manner, yelling and screaming will not help. However if I am dealing with maybe an EN and I have concerns that the patient has not been assessed correctly I will push back a bit, though as said most are fairly good if they see we have concerns.
I will be up front, I actually had a doctor who was semi retired working for me as a medic who made a poor diagnosis, I took his word for his assessment to find his diagnosis was incorrect and could have put a patient in a life threatening position, fortunately all was good for the patient, just shows how easy it can happen.

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Originally Posted by Lotz-A-Landies

No but the sound of a Telstra Touchfone 2000 does! Thats the one they use as the "Bat Phone" from Ambulance Control.

Like the time "Lifesaver 1" was hovering 500 feet above the landing pad at 3.00am demanding we turn on the landing lights. All go from then for the next hour or so.

Do people realise that when they are still on an Ambulance stretcher, they haven't actually arrived in the ED. :eek:

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The last bit is a cop out, especially when ramped. Ramping should not occur in any circumstance.

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Originally Posted by Lotz-A-Landies

I'm not sure where you're coming from with this comment.

A ATS Category 1 will be seen immediately whether they arrive via ambulance, helicopter or through the front door. Similarly an ATS Cat 2 will be treated within 10 minutes irrespective of mode of arrival, however if the Hospital is on by-pass the ambulances bypass to another hospital unless Cat 1 (and sometimes even on cat 1).

If there are no beds in the ED, an ambulance arrival will wait under the care of the ambulance paramedics until a bed becomes available or the patient is sent to the waiting room. A Cat 2 arriving through the front door will get a bed usually before a Cat 2 arriving by ambulance at the same time.

Remember this is my profession an ED Clinical Manager before being transferred to administration (Clinical Governance).

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Good to have someone who KNOWS what goes on in ED.
My "issue" is with the way ED is abused...headaches, minor cuts, tummy aches etc etc, and of course verbal & physical abuse of Nurses/Paramedics, by drunken/drug affected "Ferals".
I think there should be more "refusal" to people who should obviously be going to their local GP, and I also say that maybe there should be some form of "Security" to protect staff, and that physical/verbal offenders should be charged.
But, I have no real knowledge, only what I've seen & heard, but you've "been there", so what do you think about the issues I've raised?
Cheers, Pickles.

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Originally Posted by Basil135

.......This country has a first class medical system. Successive governments need to recognise this, and give it the support it needs.

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I agree, and not only that, we need to get away from the "health system bashing" in the press. So many dedicated people must get so disheartened when they think they are doing the best job they possibly can, to be told in every tabloid that the system is failing and that it's their fault.

In the example I gave, my wife was taken to our little local hospital first, deliberately because we had heard so much bad press about the bigger one a short distance away. And as it turned out, the bigger hospital did a superb job of looking after her, and that all the doubts in our minds from the various stories in the press were completely wrong.

Dave

I think local hospitals get a rough trot in the press. The new cub reporter is trying to make a name for themselves, trying for a job as an investigative reporter on one of the national dailys. Their first and easiest targets are the big local organisations so they took for any faults they can find in the hospital or local council because they are the only "big" organisations in their district.

Don't get me wrong, there are sometimes things that need to be reported to the public, and sometimes ICAC but the articles are often hyped us from a simple misunderstanding or simple human error and worthy of mediation not headlines.

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Originally Posted by Lotz-A-Landies

Dave

I think local hospitals get a rough trot in the press. The new cub reporter is trying to make a name for themselves, trying for a job as an investigative reporter on one of the national dailys. Their first and easiest targets are the big local organisations so they took for any faults they can find in the hospital or local council because they are the only "big" organisations in their district.

Don't get me wrong, there are sometimes things that need to be reported to the public, and sometimes ICAC but the articles are often hyped us from a simple misunderstanding or simple human error and worthy of mediation not headlines.

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Diana, I couldn't agree more! Yes people make mistakes, and so long as there is an open and fair review process around that, and no suggestion of sweeping events under collective carpets, then the ammunition for the tabloids disappears.

That said though, when there are truly massive systemic abuses and failures, like those which occurred in the hospital trust in the town I left in the UK (BBC News - Stafford Hospital timeline), it really needs to be publicised.
That scandal was centred in the hospital my daughter was born in, that most of my family had been in at various points, and some friends back in the UK still work at.

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Originally Posted by Basil135

Increase the Medicare levy. You get what you pay for.

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no
taxes should pay for a base level.
if you want better, go private.
if your not happy, you should have complained. its your money.

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Originally Posted by sheerluck

Diana, I couldn't agree more! Yes people make mistakes, and so long as there is an open and fair review process around that, and no suggestion of sweeping events under collective carpets, then the ammunition for the tabloids disappears.

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The system, at least in NSW is trying.

Open Disclosure Guidelines - NSW Health

Open Disclosure - NSW Department of Health

http://www0.health.nsw.gov.au/resour...Dfactsheet.pdf