"Awful experience"

Recently, I had a fall in the water at a boat ramp in Dongara. This resulted in some minor cuts and bruises, quite a decent bump on my head and also a nasty cut on my foot. My spouse took me to Dongara Hospital. When I arrived, I had to lay on the floor and elevate my foot using my towel to stop bleeding.

A nurse came in (did not introduce themselves or tell me who they were) and took my name. They had a quick look at my foot and left, then returned and took some obs. I was shivering and wet on the floor but was not offered a towel or a blanket. I asked for some pain relief as it was quite sore and I knew I would need to go to Geraldton but was told by this nurse that it will take 2-3 hours at least to be seen by ETS so I may as well just go and gave me some Nurofen and Panadol. I was lying on the dirty floor in the Emergency Department wet, and in pain, and I was very lucky that there were 2 ambulance officers there who found some things to give my foot a quick clean, bandage it, help dust the dirt from the floor off of me, and help me out to the car. The nurse was rude and dismissive in my opinion, never once offering me a more appropriate place to sit in the hour that I was in there.

On the way up to Geraldton, I was in a lot of pain. I was worried about the cut on my foot and how I was going to work while recovering and look after my children and the stress resulted in me not being able to breathe through my pain anymore. I started to cry and then lost all ability to manage the pain on my own. We arrived in Geraldton and I was sobbing, my head was sore, my foot was throbbing and I just wanted things to be ok. The waiting room was busy. I had to wait a long time to get to the Triage desk. When I did, the nurse in Triage was very friendly and compassionate. I asked again for pain relief as I hadn’t noticed any effect from the Nurofen and Panadol. The nurse requested another nurse to go and ask a Dr for something while they finished my initial assessment.

The other nurse returned with Nurofen and Panadol, which I had reported that I had already taken, and the Triage nurse had told this nurse that I had taken. So I was given nothing. The nurse said that they would try and get me in so that I could lie down and elevate my foot, and probably also because I believe I was a bit of a mess at that point.

I sat back in the waiting room which felt like a very long wait, and while I do appreciate that it is an Emergency Department and that it’s on a need's basis, I think that adequate pain relief would have meant that I was more comfortable waiting and could have perhaps been more comfortable while I was waiting. I was still quite damp at that point, and cold.

Finally, I was called in the back by a nurse practitioner who was quite friendly initially, but it was extremely clear to both my spouse and myself that they thought that I was carrying on and had clear judgements about my perception of pain. I requested pain relief again as my foot was awfully painful and so was my head. If anybody had bothered to ask me, I would have said that my pain was at a 7 and 8 if I moved. Which for me is quite significant. Instead, this was declined and I do remember a comment about my request being ‘overkill’ which I find to be a very inappropriate thing, in my opinion, to voice in front of a patient and their family.

Local anaesthetic was applied, the cut was cleaned and stitched. I did complain that I felt like there was something inside my foot multiple times. I asked if I could have prophylactic antibiotics but was assured many times that my wound was cleaned, there was nothing in it and this was unnecessary. I said I was unsure of my last tetanus injection and while I received it, I was told that the chances of me getting tetanus from this wound were very low and the injection was unnecessary. Which, while I do agree with, think is an unnecessary thing to say, given that I was naturally worried about everything at that point, and in a lot of pain.

I explained that I lived out of town and it was about 30 minutes for me to get into town to see a GP and I was approximately 1.5-2 hours from Geraldton and I was worried about infection as I was unsure what I had cut my foot on, and I felt that there was something still in my foot. I knew it was under the jetty and it was either coral growth or metal. I also complained of pain yet again and asked for a script for some stronger pain relief but this was declined.

I was unaware at the time but my spouse was given a script for antibiotics but was told I wouldn’t need them as it was highly unlikely that I would get an infection. My spouse was also given a head injury sheet. The Nurse did quickly have a look in my eyes and then reluctantly gave me one tablet (pain relief) after me begging because I knew the drive home was going to be 2 hours and I was worried about my ability to cope when the local wore off and my head was pounding as well.

I did not receive a script for pain relief despite asking multiple times. I left feeling humiliated. I felt like staff (with the exception of the one nurse who triaged me) saw me as a drug seeker and that my pain was an overreaction, yet it was real to me. I was sobbing, cold and in extreme pain. I felt that my attempt to explain that my foot didn’t feel right was ignored and it seemed I was written off as a ‘worried well’. I had stated multiple times that I knew something was in my foot still. I almost fell outside the ED as I was very unsteady on my foot and quite upset.

I went home and luckily had some leftover pain relief (Endone) from a previous surgery. I took this regularly for the next 24 hours but was not able to get the pain under 3, which I knew was a sign, things were not right as my foot was elevated and I was also taking regular Nurofen and Panadol as well. The script for antibiotics wasn’t filled because my spouse trusted that the nurse was right and I didn’t need them. I knew deep down that something just wasn’t right but in my opinion, I had been made to feel like I was overreacting the day before, and felt quite embarrassed, so I just ignored it.

The next day, I ended up presenting at another health service with a severe infection. I was admitted and given pain relief and a few days of IV antibiotics, with scripts for both after I was discharged as well. My stay and care in this health service was fantastic. I believe it was the first time in the journey that I was listened to. A few days later, I had to travel to Geraldton again to get an ultrasound as I had a blood clot in my arm as a result of the treatment I received.

I am now waiting for another ultrasound to see if there is a foreign body in the wound or another issue as I have even more complications with my foot which now has altered sensation, poor circulation to my big toe and I am unable to weight bear on the area almost a month later. I worry that this may require surgery and what impact this may have on me, my family, and my job.

I know that it is a question that we will never know the answer to, but I do wonder if this could all have been prevented if my initial concerns were listened to.