"Who is running patient flow?"

I recently went to visit my brother at St Vincent's Public Hospital, as he was having an emergency appendectomy. But he didn't get into surgery until 9 pm so I decided to go to ED to see if they could let me see him in recovery at 10 pm at night.  They very kindly did but advised I could only stay for 15 mins and be quiet as there were lots of patients in recovery trying to sleep. 

The hospital was extremely busy that night and there were not many beds anywhere so all the post-op patients were tightly next to each other.  I could only talk to my brother if I bent over and looked around his fluids pole.  When I stood up to leave a felt a little light headed but continued out of the ward. I asked a nurse how to get out and he said he had to let me out as it was all locked up being after hours. I walked another 10 metres and still feeling dizzy, said to him that I felt dizzy.  He asked me if I was OK and then I passed out, face-planting the floor.  When I woke up, a code blue was called and everyone was around to help me.  They checked my sugar levels before checking me into ED (which were fine).  I have had a Mitral Valve Prolapse since birth.  I always have to tell the doctors this as if I don't and they listen to my heart they will think I am having a heart attack. The problem is, the moment you tell them, it all becomes about my heart.  I understand that it is rare (only 2% of the population have this), but I know my body pretty well and I know that my heart did not cause my passing out. 

However, St Vincent's ED was fantastic.  I was under the care of a doctor  who was wonderful.  Everything he said would happen happened exactly when he said it would happen.  He has such a lovely bedside manner as well as good time management!  I had 5 x ECG's, 2 x blood works, 1 x chest x-ray, a bag of fluids with and of course, blood pressure and heart monitoring all night.  He did advise me that he wasn't prepared to discharge me until I had seen a cardiologist and had an Echo test and that probably wouldn't happen until the morning, but I would be out at lunch time.  And just as he said, a cardiologist came round in the morning, saw me and advised that they would be arranging my Echo later in the morning. 

At 9.15 am I was moved from ED to a bed in a ward where I was under the care of the cardiologist.  The cardiologist came round and advised that he was trying to arrange the Echo, but St Vincent's was on a 'low staff' day so it may take a little time.  At 12.15 pm when I had been sitting there for hours with nothing happening, I found a nurse and advised I was waiting for an Echo (10 min test) and was happy to do this as an outpatient, as all my other tests had come back fine and I was holding up a bed that the hospital desperately needed.  She then arranged for a warden to take me down to Echo - when we got there no-one was there. I was taken back up to the ward and sat for another 3 hours. 

By this time, my brother - who actually had an operation and was sick - had been discharged and came up and sat with me on my bed, as I was his driver to get home, as he was unable to drive for 24 hours after having a general anaesthetic. I again offered to be discharged and I would come back tomorrow for an Echo, as I was keen to get him home and I am now wasting taxpayers money on a bed and 3 meals that I really didn't need.  This then resulted in the Echo technician coming to me and doing the Echo in my room.  He was lovely, efficient and professional.  The results of this test were also fine.

I was now ready to be discharged.  Another 2 hours passed and I was still waiting on my discharge papers.  I had had the cannula removed, I was dressed, all the cardiac tabs had been removed.  They brought me in dinner - another wasted meal that the taxpayer is paying for - which I refused. 

I found the cardiologist who advised that he had read the Echo report and was happy, but wanted the junior doctor to also review it.  He said it would be a maximum 45 minutes.  I waited for this period of time - it was now 6pm - and my brother was in pain. Even though he was a patient - because he had been discharged, they wouldn't give him Panadol. so I need to get him home, with some pain relief, fed and rested.  After the 45 minutes I just asked the nurse if I could have my discharge papers and she said it wasn't ready and I said I don't care -just give me the draft copy as this is getting ridiculous.  I took the draft copy and discharged myself.

I just couldn't believe how well ED worked, my brother said the operating theatres were brilliant too but once we hit the ward - it all fell apart.  Not sure who is running patient flow, but here is a problem in the wards.