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"Experience with the ED for my child's care"

About: Perth Children's Hospital / Emergency Department

(as a parent/guardian),

Recently my adolescent went to the Emergency Department (ED) as they had gastro. My teenage child had been vomiting for days and although trying very hard to eat what they could, nothing had stayed down for 4 days.

It was right before the weekend and I was concerned about them. I was unable to speak to anyone from the Eating Disorders Clinic. I phoned the Emergency Room, the Nurse Coordinator. I explained that my child has had multiple unpleasant experiences and admissions via the ED. I explained that I was concerned they were dehydrated and they had not passed urine for almost 12 hours and was unable to keep anything down.

I asked what the protocol would be if I brought them into the hospital. The nurse transferred me to a doctor to speak with. The doctor did not identify themselves in any way. I felt they were rude to me and said they were unable to tell me the protocol and said to ring Health Direct (HD) if I was concerned. I explained that I knew from past experiences that HD would suggest I go to the hospital.

I told the doctor that as my child is over 16, I was nervous about turning up at Perth Children's Hospital (PCH) with my child to the ED only to be turned away. I explained the trauma involved in a possible admission and was looking for some information to help me know how to act. The doctor told me that they were unable to help me and to ring HD and hung up on me!

I was so upset and confused. I then rang the PCH switchboard and explained my issue, I asked to be put through to the nurse coordinator or after hours CNS to assist me. I was refused. The person on the telephone kept telling me to ring Health Direct. I told them that they couldn't fill me in on the hospital policy for gastro and under what circumstances my child would be rehydrated or accepted into the ED. I asked to speak to a Dr in charge and was refused to be put through. I then asked to speak to their superior.

They did this and I got to tell my story again. My concern about my child, my question over the protocol for admission/rehydration and the desire to pre-empt my child's arrival and make it as stress-free as possible. Once again, the person was unable to help and told me to ring Health Direct.

So, I did ring Health Direct and they said to go to the nearest hospital. I asked if they could access the ED and inform them that we would be coming in so as to isolate my child from other patients and ensure their admission. Only to be told they could not do that. I asked if they could access my child's information on the My Health Record to help me make decisions or make notes and again, told they couldn't. They didn't have access to it.

I was exasperated. 

I packed up my sick child and headed to the ED. On arrival, there were no face masks, or sick bags, or wheelchairs around to help us. Not good enough.

When we got to the triage desk, I politely said to the nurse that my child has an eating disorder, has gastro, and has not passed urine for over 10 hours and they are dehydrated. I have rung Health Direct. I want them taken in and treated please, and I won't take no for an answer. The nurse looked at me and said fair enough, come through.

In my opinion, so many things are wrong. I would like things changed so this does not happen to others. Allow us to speak to the professionals who know our kids, give us information and do not hang up on us parents.

My child got IVH and stayed the night. After 6 litres they felt much better and passed urine after 23 hours.

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Responses

Response from Victor Cheng, Executive Director, Operations, Child and Adolescent Health Service 4 years ago
Victor Cheng
Executive Director, Operations,
Child and Adolescent Health Service
Submitted on 20/02/2020 at 12:38 PM
Published on Care Opinion at 12:39 PM


picture of Victor Cheng

Dear Butterfly,

Thank you for sharing your story on Patient Opinion. Your feedback is important to us at Perth Children’s Hospital (PCH). Our core values are compassion, collaboration, respect, equity, accountability and excellence.

Firstly, I would like to apologise for the distress this situation has caused you and your family during this time. Unfortunately, in these particular circumstances, Emergency Department staff are generally unable to provide advice over the phone or guarantee an admission. This would be the reasoning for PCH staff informing you to present to the hospital or contact Health Direct.

Please be assured your feedback has been passed on to the Emergency Department. However, if you would like to investigate this further, I am happy for you to contact me directly via email victor.cheng@health.wa.gov.au to discuss this further and to discuss the admission policy at PCH for children over the age of 16 to avoid a situation like this happening for your family again in the future.

Kind regards,

Dr Victor Cheng

Executive Director Operations

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Update posted by Butterfly (a parent/guardian)

Thanks Dr Cheng

Yes, I would be willing to contact you and have a conversation. It does not make sense to me that:

1. the doctor could not tell me the protocol which I now know is a drip or ngt with fluids if the patient is unable to drink/eat for x time or pass urine for x time.

2. the doctor hung up on me.

3. I was unable to speak to staff on ward 4A who know me and my adolescent.

4. I was unable to speak to the consultant on 4A who knows me and my child.

5. that calling HD most often results in "go to hospital" and yet they cannot a) inform the hospital we are coming b) access our records to help guide us.

6. that the person on the PCH switchboard was not able to put me through to a nurse manager for help and support.

I am confident that I would not be the first parent to require advice/input/support after hours for a patient of PCH with a chronic illness and I will not be the last. I would like to help put steps in place to prevent this from happening in the future.

I will be in contact. Thank you for your response.

Response from Victor Cheng, Executive Director, Operations, Child and Adolescent Health Service 4 years ago
Victor Cheng
Executive Director, Operations,
Child and Adolescent Health Service
Submitted on 25/02/2020 at 4:59 PM
Published on Care Opinion at 5:11 PM


picture of Victor Cheng

Dear Butterfly,

I’ve decided to provide some additional information for other parties who might see this post as this might be of use for them as well as yourself.

I understand your frustration with regards to the lack of confirmation regarding the circumstances that would warrant admission to hospital. The reason for this is that we would not want to provide false reassurance that admission was not required as it is understood that many parents might not want to bring their child to ED if the end result was that their child had to go home. The concern would be that parents would stay at home rather than presenting resulting in a deterioration in their child’s condition.

At the present time only 20% of the children who present to the Emergency Department are admitted.

The requirement for admission needs to take into account the specific circumstances of each patient, especially if your child has a chronic condition.

If you find Health Direct to not be much assistance, another option is to seek the advice of your General Practitioner, as a general rule.

I would ask that you contact me directly to have a conversation either over the phone or if it is convenient for you in person. Please call me on 64565890 or alternatively via email on victor.cheng@health.wa.gov.au

Kind regards,

Victor Cheng

Executive Director Operations - CAHS

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