"Appendectomy"

I presented to the Emergency Department with severe abdominal pains. Once through to a bed in emergency, it took close to 2 hours before someone attended to me. In fact, it was a doctor who arrived first, who began questioning the nurse as to why it had been nearly 2 hours without any bloods taken or fluids given. I was soon admitted for a surgical consult with suspected appendicitis and told that the surgical team would order either a CT or ultrasound.

During the night, I was visited by a surgeon who was not convinced that I had appendicitis and was told she would review me in the morning. When she revisited in the morning, it was decided to go ahead with the surgery without any imaging. Later that day, a different surgeon completed the surgery.

It was not until the next morning that a third surgeon visited me and very quickly ran through the outcome of the surgery; the appendix was normal, there was a noted ovarian cyst, but no reason for the pain I was in, post op appointment in 4 weeks – it was uninformative and rushed. In my opinion,  I was clearly just a number. Within 40 mins of this, I was dressed, bags packed, handed paperwork and sitting in a chair in the hallway waiting to be picked up. I felt I could not have been rushed out of the room quick enough. Paperwork was rushed through and quickly signed, clearly noting over the counter pain relief and I was told it would be best to take some Panadol when I got home as I was due for some pain relief. As I was packing my last things, the nurse and the student nurse were there throwing away rubbish and ushering me out of the room.

Upon sitting in the hallway, I became visibly upset. Confused as to why I had had a surgery that perhaps wasn’t needed that I now need to recover from. On numerous occasions I had told staff that my husband was 2 days post knee reconstruction and we had a toddler, 2 obstacles that will make recovering much more challenging – especially without the ability to lift my child. The nurse who discharged me, noticed how upset I was and listened to me explain that I felt I had had a potentially unnecessary surgery that I now have to recover from in challenging circumstances and I’m leaving hospital with no indication as to why I was in pain in the first place.

All of this aside, the documentation I was given included:

- Patient Information for an Appendectomy and an Emergency Diagnostic Laparoscopy, which upon reading, I believe should have been given prior to the surgery not on discharge.

- Discharge notes, which are incomplete – both Reason for Admission and Your Diagnosis are blank.

- A pamphlet on taking pain relief medication safely, despite being told to just have some Panadol when I got home.

When I visited my GP later that week, she was able to provide me with a more detailed or at least completed discharge summary. Which clearly states under Plan 3: Discharge with simple analgesia, PRN (when necessary) Endone – patient left before script could be provided.

Meanwhile, I believe I was rushed out of that hospital room to sit in the hallway and told to take Panadol. There was no talk of a script for Endone, I did not leave before it was provided, it wasn’t provided before I was rushed out.

From all of this, I feel it is important that staff at this hospital consider the following:

- Provide patients with Patient Information sheets about surgeries prior to, so that if possible it can be read and patients can then ask questions they may have.

- Explain to patients why imaging is not needed/used for certain medical situations, despite the ED doctor indicating I would be getting imaging to confirm the diagnosis.

- Ensure that when the surgical team discuss the outcome of a surgery that they take the time to make the patient feel like more than a number, clearly explain the results and take the time to discuss the next steps, especially considering there appeared to be no reason for the pain I was in.

- Ensure all documentation is ready upon a discharge, providing a patient with a blank discharge report is not acceptable.

- Ensure any scripts that are needed are provided before discharge, as finding out later I could have been taking more than Panadol is again, not acceptable.

- If scripts have been missed or not given in time, call the patient so that they can choose to come back in and get it.

- Discharge is not just a checklist, patients are not just a number, don’t rush them out and have them sit in a hallway crying, feeling confused and with incomplete documentation.

On a positive note, the care given by some of the nursing staff was exceptional, particularly one nurse, who was attentive, thorough, professional and kind.