"Inadequate handover, repetitive examinations, and no advice"

Overview 

I'm not complaining about wait times, I think that's to be expected in an ED, I respect the triage process and understand other people need more urgent care.

However, I felt it was clear no one was reading notes or doing a thorough handover, if they were, I believe they weren't respecting the previous professional's opinion, leading to what I felt was a huge waste of time for everyone involved and seemingly attributing to delayed services for other patients. In my opinion, these are unnecessary systemic issues that exacerbate the wait times.  

Situation 

I was experiencing consistent rectal bleeding, had been to the GP who did an examination, couldn't see any signs of haemorrhoids and referred me to a specialist. My specialist appointment isn't for a few weeks, the bleeding got worse, I was starting to feel lethargic, I couldn't find any useful information online to help me identify how serious my situation was or what I should do, so I presented to the hospital.

Experience in ED 

- Took a bit over an hour to be triaged, that process was easy and straight forward.

- After waiting about 2-3 hours, a nurse took my bloods and vitals

- About 90 minutes after that I was reviewed by a doctor who asked for more details about my situation, medical history, allergies, colour of the blood coming out, if it's in the stool or just coming out with it etc. (this was fine it seemed routine)

- They gave me a lecture about haemorrhoids; I told them I know what they are and my GP had already done an inspection and not seen any signs of them.

- The doctor asked to do rectal examination, looked at my anus, pulled the skin around it, pushed on it, and inserted a finger to see if I had any pain or they could feel something.

- I went back into the waiting room while this doctor consulted someone else. 

Note - everything up until this point was totally fine

- Two hours later I'm told I'll be reviewed by the surgical team and taken to a bed. 

- This doctor (who I'm pretty sure was a surgeon) asks me all the same questions I'd previously answered including allergies, family history, colour of the blood coming out, if it's in the stool or just coming out with it etc

- They gave me another lecture about haemorrhoids and asks to do another rectal examination. 

- At this point I felt quite annoyed the first examination apparently wasn't sufficient but figured if this doctor is a surgeon maybe they will see something the previous doctor didn't. 

- This doctor seemed concerned because the bleed must have been coming from deeper in the bowel, said I'd be admitted to the ward, I should start fasting so they could do further investigations in the morning. 

- I'm taken to the ward, and a nurse (I assume doing my formal admission) asks me all the questions I've already answered, e.g. why I'm there, family history, medications I'm taking, allergies, etc. 

- First thing in the morning a new nurse and doctor wake me up, the doctor doesn't say anything and ends up walking away, while the nurse gives me an even longer lecture on haemorrhoids (they were the only person I found to be rude and seemed to have already made their mind up about me/my condition)

- By this point I am getting really annoyed and upset because I thought the previous doctor had established there were no visible signs of haemorrhoids and it needed investigation to be sure where the blood was coming from. 

- I explained to the nurse that I'm educated in bowel health because my parent is a nurse and we have a family history of people dying young from colon cancer or needing cancerous polyps removed. 

- The nurse asked to do another rectal examination looking at my anus, pulling at it, pushing on it (they didn't insert a finger this time, but they weren't being gentle)

- They then advised me they'd discharge me, put me on the list to be contacted for a colonoscopy and admitted as an outpatient. Which is fine, but considering the previous doctor wanted it investigated I wasn't sure why this nurse was so apparently entitled to disregard that advice. 

Outcome - after nearly 20 hours in the hospital 

- They said I am category 1 for a colonoscopy and someone would contact me (which is good). But I don't know who is contacting me or when, and I'm not sure who to follow up if I don't hear anything. 

- 3 different people did the same rectal examination no explanation as to why it had to be done again. This seemed unnecessarily invasive, and considering something is wrong with that area of my body, consistently putting fingers in there without needing to seemed somewhat negligent in my opinion. 

- All three doctors lectured me about haemorrhoids - I was already quite educated on the subject upon arrival but was happy to listen to the doctor the first time, everything else post that discussion felt like gaslighting, a waste of time (for me, them and the people waiting), and it made me feel I had to prove yet again there was no evidence of haemorrhoids in order for someone to help me get more answers.

- I was asked the same questions by 5 different people, about my situation, health, lifestyle, medical history, the colour of the blood, if it was in the stool etc. This included - triage, the initial doctor, the second doctor, the first nurse on the ward, and the nurse who saw me in the morning.

- Upon discharge, I was given a consent form about the colonoscopy but received no advice about how to manage it in the meantime, nothing about a recommended stool softener, foods to avoid, what I should do if the bleeding gets worse, things I need to keep an eye out for, and how to monitor it, absolutely nothing.