"My sick child"

We attended the ED at Bunbury Regional Hospital recently. My child was very distressed and clearly in pain. My child has ongoing chronic medical conditions and a complex medical history. We saw the triage nurse initially, and placed as a priority 3, despite my child being in immense pain, and distressed, their O2 saturation was 86% on RA, no BP was recorded and I don’t recall my child's HR, and it would have been very difficult for anyone to record an accurate respiratory rate, due to the way my child was thrashing around in pain. 

When we were taken into the ED, we were put in the paediatric area of the ED. A nurse came over to talk to me and find out what was happening, no vital signs were taken at this point and the nurse seemed to be concerned for my child, the nurse went straight to a doctor and discussed with the doctor my child and the situation. The doctor came over and attempted to listen to my child’s chest, then went to talk to a more senior doctor. My child was still in immense pain, thrashing around, screaming (by this point my child had been like this for over 24 hrs). My child was not offered any kind of intervention, to relieve the symptoms (I had given my child Panadol and Nurofen at home, with nil effect). 

The nurse made a comment to me about calling my spouse because the nurse could see I couldn’t ‘cope’ with my child, this comment was not helpful! My child was behaving like this as they were in pain, my child is non-verbal and has developmental delays, so can not express how they are feeling, but as a parent I know my child was obviously in pain and clearly unwell.

Two more senior doctors came to see my child, one of the doctors made a comment that the nurse had recorded a full set of vital signs, that were all unremarkable and within the normal limits. I questioned this, as this was definitely not the case nor what I had observed. At this time only one set of observations had been taken, which was in triage. 

I find it concerning that vital signs are being recorded incorrectly or even possibly being made up. The doctor said they would address this with the nurse, and immediately after the nurse came and completed a set of vital signs, at which time my child’s O2 saturation was still below 94%. 

Later my child was prescribed a stronger analgesic, Oxycodone. I was walking around the ED with my child to try to calm them down. Two nurses came to administer the medication, my child did not have any ID band on, the nurse asked if this was (my child’s name) to which I replied yes, the nurse asked if this was my child’s date of birth, to which I replied yes, then they gave me the medication to give to my child in the middle of the ED. Again this concerns me how a scheduled 8 medication can be administered, without the correct procedure being adhered to! Several diagnostic tests were carried out and we were referred onto the paediatric team, who we are well known to. 

Later we were discharged, unfortunately re-presenting via ambulance no more than a few hours later, my child hadn’t improved and was still in immense pain. This time in the ED I was very impressed with how the head consultant took us seriously, they examined my child from head to toe, to rule out something simple (no other doctor or nurse had done this prior), the consultant called the paediatric team back straight away and they administered medication to try to calm my child and relieve the symptoms.

All the staff involved in my child’s care from then on were amazing with not only my child’s care, but they could see how much this had distressed my spouse and I and they showed care and compassion to us also. My child was admitted to the Paediatric Ward, where the nursing staff did everything possible to help my child and assist in their care. I’d like to commend the staff on the paediatric ward, Dr Adam and the nurse that cared the second time we presented to the ED. 

However, unfortunately, this seems to not always be the case in the ED and very concerning that nursing staff may have made up observations on a legal document, contravening the nursing and midwifery standards and national quality and safety standards.