"Lack of flow and communication"

Presented to ED @approx 5pm recently. Triaged and ED Ward Clerk then back to ED Triage Wait Room. Taken into ED by staff for assessment by ED Dr, good so far. ED Dr consulted with Surgical team, ED Dr returned to discuss option of either I could stay overnight in ED Short Stay Ward or if  pain was bearable go home and return the next day by 7:30am for booked Day Surgery procedure. I chose to go home and return.

This is the start of the breakdown of patient care and due diligence process. I asked if I go home could I have paperwork for direct admit for that next day to Day Surgery. No it's all organized present to ED by 7:30 they will have your name on the list and send you up to Day Surgery. I even asked really shouldn't I have some paperwork, no all sorted.

Returned the next day @ 7:15 and advised ED Triage Nurse that I was presenting for Day Surgery & that I was told they would have a list and everything in order for me to be taken to Day Surgery. Staff apologized and no they had nothing, no notes on my record of what went on the previous day. They offered pain relief but I declined as I was "supposed to be first on list" and that I would be under anesthetic soon so I could wait for a bit.

I then was triaged, ED Ward Clerk, back to ED Triage Wait room and wait .... The ED Triage Nurses were great, calling Day Surgery repeatedly, no answer and kept me updated. Had to stand as it was too painful to sit (anal abscess). They advised me Day Surgery didn't open till 08:00 as PH but no contact could be made until 09:30. I was called through not long after this to ED for a Surgical Consult in ED bay and advised I would be taken to Theatre to drain abscess, signed surgery paperwork and the surgical team left. ED Nurse gave me a blanket and I was able to get reasonably comfortable on bed, until a wheelchair was pushed in room by another Nurse and left, PSA arrived and asked me to sit chair and wheeled me back out to ED Ward Clerk wait area and left there, no information about what was happening.

ED nurse who assisted me at ED Triage, asked me if I was OK and kept saying why haven't you gone to Day Surgery yet? ED nurse said she would ring and find out what was happening approx 10:00, and she and another ED Nurse came out to tend to me, I had a jumper on and was cold, I had been standing since 07:15 to 10:00 except for short respite on bed in ED bay, I was sitting awkwardly on chair trying to avoid too much pain. They took BP, temp and asked if I needed anything. I said I would love a blanket and a blow up ring to sit on as my butt was very sore. No ring but they brought out a towel which I was able to roll up to sit with some relief. They told me I had been pushed back and there was one person ahead of me before I would be taken to Day Surgery.

ED Nurse came out @ 11:45 to collect me and took me to Day Surgery. I declined a wheelchair as it was less painful to walk. No bed was available. We proceeded to Day Surgery and then a bed had to be found and whilst that was being done I was prepared for surgery, clothes off, gown on and get ready for Anesthetic consult. Theatre nurse discussed what would be happening and that I would be going into theatre shortly.

Went into theatre approx 12:45 and woke up in Day Surgery Recovery approx 14:30. Tube taken out, obs taken and told procedure went well and that once was ready would moved to Maternity ward and preparation for discharge. I asked what was the recovery plan, told a Wound Care Nurse would attend my home daily to change dressing, pain relief to continue and if I had any major issues to either return to ED or my GP. 

I then was transferred to Maternity Ward, given something to eat and drink and then my husband was called to collect me. When husband arrived they checked me, I went to toilet was allowed to dress and to go home.

I was given no pain medication scripts, antibiotics or discharge paperwork. I assumed all the referrals to relevant places had been done, big mistake but due diligence failure. I was told Wound Care Nurse would call me in the morning to arrange a time to visit.

The next day, by 10:00 still no call, my wound dressing had dislodged during the night, so I called the hospital to be put through to Wound Care Nurse, told not available till Monday. After explaining I had surgery day before and told daily wound nurse care, staff member put me through to the HiTH nurse who did not have any information about me or my procedure and could I come in the following day, which I said No as wound needed cleaning and redressing. She asked if I could attend HiTH rooms by 14:30. I attended and no record of procedure on file for her to access so I had to give her a rundown of preceding 2 days. She checked wound, cleaned and redressed, told to continue on pain meds (which I hadn't been given script or information about need on discharge).

ED nursing staff; HiTH staff brilliant but the breakdown of communication of my patient journey, failure to document treatment journey puts my recovery at risk. I have over over 16yrs working in Health so knowledge is power, if I had no knowledge?