"Deferred care of infant without assessment"

I attended the Cunderdin Health Service with my infant. I was concerned about their breathing and oxygen levels and as we were driving back to Kalgoorlie I wanted to ensure it was safe to continue. 

Background: we were recently discharged from PCH where our other infant was admitted following apnoea and floppy episodes, as well as bronchiolitis. Therefore, our level of anxiety regarding the health of our babies was quite high, hence the stop. 

1. I entered the health service where I happily participated in COVID screening. The answers to the questions flagged some concern with the admin clerk (flu-like symptoms in my child) who phoned through to the nurse for advice. I was permitted to approach the triage desk where, whilst on the phone to the nurse, the clerk asked several clarifying questions across the waiting area. I am always happy to answer, but the answers were relevant to our clinical presentation and included information about confirmed viral illnesses to which the clerk seemed to have limited knowledge and struggled to relay to the nurse. I suggested discussing this with the nurse rather than having a 3-way conversation in a public area. In my opinion, this should have been a basic consideration for my privacy rather than a suggestion made by me to protect said privacy. 

2. A nurse eventually attended the triage desk where they asked why I had presented. I specified - concern about my infant's breathing pattern, I specified a tracheal tug, occasional grunting, pallor, low oxygen saturation levels and potentially dehydration due to a sunken fontanelle. I explained too, our infant's recent history and admission. I explained I just wanted someone to check them over and their oxygen levels, fully expecting to be triaged and wait as required. Whilst explaining this, a nurse also stood behind the nurse and listened to the conversation. 

3. The two nurses exited the triage room and spoke to me in the waiting area and explained that as my infant was a child they would have to call Telehealth and I would have to wait for a Telehealth doctor and that they didn’t really want to do that and suggested they be seen by a doctor who can physically examine them. I had both nurses stand in front of me and tell me they didn’t want to call Telehealth and instead referred me to a GP without once looking at or examining my child. I was then escorted next door to the GP practice where the availability of a GP was discussed (1.5-hour wait). Again, no examination of my child occurred. 

My concerns are:

1. I am a parent who presented with serious concerns for the welfare of my child and was, I feel, essentially dismissed from a public health facility with “Emergency” placards clearly displayed. 

2. At no time did anyone examine my child or attempt to examine my child. I was instead referred to a GP with a 1.5hr wait to have my concerns addressed. 

3. When I requested a simple check of my child's SP02, the answer was no because then they would need to triage my child and that all children must be referred to Telehealth.  So... triage them and refer them on. Why was this a problem? 

4. While I was anxious about my other infant's recent admission and may be overly cautious in regards to my infant and their breathing; that should not have invalidated a need for a physical assessment in my opinion. And the staff seemed to have limited knowledge of this anyway as there was no capacity to provide background/history or discuss specific concerns. 

5. I had two health professionals actively discourage me from utilising an emergency health service. 

6. I explained that it was quicker for me to drive to Merriden then wait for a GP, I was simply told okay and sorry by one of the nurses. 

I am disgusted with what I believe was an absolute lack of care or support provided. I was dismissed without examination and the excuses provided were, in my opinion, baseless and without forethought as to the outcomes of their decision making. 

I am an ED nurse. I have enough clinical knowledge to know that my child is unwell and was concerned enough to stop at an emergency health centre to have someone else assess them and their degree of respiratory effort/illness. Instead, I was embarrassed being asked personal questions across a waiting area, and felt dismissed and encouraged to utilise other health services because of an apparent unwillingness to utilise emergency Telehealth or even undertake triage assessment and a basic physical and respiratory assessment.