"Chest Pain"

Dear Doctor situation,

Thank you for sharing your recent hospital story. Kerang community are, as you point out very lucky to have such a fantastic hospital, recently updated. I understand that Sue and our District Nursing team have been providing care for you and also spoke through your recent inpatient admission. Sue also told me that she did chat through the details of your complaint and I am now responding in writing. It is always our preference to have a face to face conversation when we can to better understand and resolve the issues collaboratively and Sue is still available to speak with you, after you receive this response.

Patient care in hospitals is provided by a team of clinicians, and due to the Doctors all working in clinics up the street, they cannot physically also always be at the hospital. They communicate with the nurses at the hospital by phone, and they arrange their visits to the inpatients in the hospital ( who are having their care needs provided by the nurses) around the patients in the hospital and their illness, and their workload at the clinic. We have reviewed your file, and spoken to the nursing staff caring for you. I am going to explain this further, and in a lot more detail:

* Patients experiencing chest pain have a pathway of care that they need, which includes having blood tests, observations like blood pressure and temperature, and an Echocardiogram to assess the impact of the pain on the heart muscle. The nurses at our hospital can do this care without a Doctor being present, and this would have been the case while they were caring for you. The Doctor is essential in this scenario when the tests show that the heart muscle is damaged or the pain is not able to be controlled. The Doctor is also essential in the follow up care, after you leave hospital to support you in the lifestyle choices that need to be made to stop having chest pain again, or further more complicated tests to be done.

* In Kerang there are two medical clinics, who both have Doctors who see their patients when they come to the hospital, and there is a Murray District Aboriginal Services(MDAS) who has a Doctor who visits to MDAS, but not to the hospital once a week, and there are people who drive through the town, and become unwell and present to the hospital for care, and also people brought in to the hospital by the ambulance service. Of all these ways that patients come in to our hospital, we are looking especially at improving the work that we do with the MDAS and the ambulance service, to ensure that patients get the care they need as close to home as possible. Part of this work is getting your immediate care attended too, and then getting the follow up care that you need by your own doctor, who knows your history and medications and has your medical file with them for this information.

* While you were an inpatient, the Doctor did his rounds in the evening after clinic and we believe you may have already discharged yourself. Many people think that because they have gone to a hospital that they will automatically “see” a Doctor. This is not always the case. The nursing staff try to communicate clearly to the patients what the estimated time of the Doctors round may be, however this cannot always be predicted due to other patients and workloads.

* The pathway the nurses followed in this instance showed there was no heart damage and therefore no urgent review by the Doctor required. We understand that this can be quite frustrating for members of the local community.

Sue would be very happy to talk to you regarding any of the above and clarify anything. I am very sorry for any inconvenience caused to you during this interaction. We value feedback and your feedback in this circumstance will result in changed partnership arrangements with both Ambulance Victoria and MDAS, and continued advertisements for Doctors.

Kind Regards

Chloe

Please note in the third paragraph in the letter that echocardiogram should read electrocardiogram.

Please accept my apologies for any confusion.

Kind Regards

Chloe