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"DKA treatment and ER nurses' comments"

About: Prince of Wales Hospital / Emergency Department

(as the patient),

Was rushed to Prince of Wales Hospital Emergency Department recently. 

Upon arrival from Ambulance, I was taken straight into ER where I was cared for by a nurse who was supportive, took charge, and in my opinion, had quite an educated understanding of Diabetic Keto Acidosis. I was quite sick with dry reaching, a very painful headache, and extreme nausea. I am a type 1 diabetic of almost 30 years and have a standing HBa1c of 7 - although that is not a perfect HBa1c it is quite impressive given my stressful job and day-to-day life - needless to say, I am extremely well informed competent Type 1 Diabetic with a wealth of knowledge, experience and good health track record considering the years I have lived day to day with the disease.

I was given anti-nausea medication, was set up with fluids ASAP, and even provided with an anti psych medication to relax me as I am in fact experiencing DKA which I was fully aware of. I was also surrounded by nursing staff who I felt each had their own opinions about my stabilisation and plan of care moving forward now that I was admitted to emergency.

The first nurse who was doing what I believe to the best of her ability to make me feel comfortable shift was finishing up.

Then a new set of nurses came onto shift. I overheard this group of nurses discussing the DKA condition and was even lucky enough to overhear one of them explain to other nurses who have never experienced a case of DKA in their career say basically it is when a T1D (Type 1 Diabetic) hasn't had insulin in their bloodstream for a number of hours and their blood starts turning acidic and it cooks them real good - I appreciate the shop talk but I felt that language, especially when the patient is sitting meters away is a bit rude and in poor taste. 

Later in ER I also had the pleasure of experiencing another nurse say to me that they know I have to live my life but if I keep drinking like I do every Saturday night at weddings I am just going to end up in here sick again. They then asked, is it really worth it?

If any of the nurses who were working that particular shift on the weekend recently I would like to clarify a couple of things for you just so you can learn as a medical professional when you decide to give patients your own advice.

DKA is not something I would ever risk going out on a night on the piss. the insulin pump that I have been on has had not 1 but 2 manufacturing issues of which I had sorted with the insulin pump company. The alcohol I had consumed the night before was in no way the cause of the DKA incident. The insulin pump battery is faulty even with the supposedly new replacement insulin pump I had received. Also, my sibling was also a Type 1 Diabetic and committed suicide by inducing a DKA ten years ago this year so I really really would appreciate the Nurses in POW Emergency Room on that fine weekend morning to keep their opinions to themselves about a disease they, in my opinion, have little to no understanding of. 

I am not asking the nurses to go and become an Endocrine specialist, I am not even asking them to pat me on the head and tell me everything is going to be fine. I am asking them to not treat me or my medical case like it's an inconvenience just because I attended a wedding the night before and they assumed that I drank too much therefore inducing my own DKA.

Just FYI also I have another sibling who is a nurse and I don't go around giving people my medical opinion because I am not a nurse. Just as I'd expect a nurse not to give me an opinion about my Type 1 Diabetes Management because, in my opinion, you are in fact not a type 1 diabetic. And if one of those nurses is a type 1 diabetic I stand corrected, but also given my fairly healthy and issue-free medical history I'd advise you to keep your opinions to yourself, had you taken the time to even look at my patient history.

I'm not even going to touch on the fact that under these nurses' care my Ketones levels were rising to an even more alarming level over a number of hours.

I feel if you want to be a nurse, I believe exercise caution, treat patients with common decency and don't assume anyone lifestyle living with the disease is careless. Dig a little deeper and you just might find that I don't want to wind up with DKA as much as I feel you don't want to treat it.

For the Nurses and Doctors who did treat me in the ER environment that day who did treat me with respect and did skim over my nearly flawless medical history, I appreciate your help and treatment. Keep being amazing and compassionate and do not let toxic colleagues spoil your positive and caring attitude. I believe you guys are the ones who are in the right line of work and we as patients praise the good work you do every day.


Response from Barbara Daly, ESCM Co-Director of Nursing, Prince of Wales Hospital, Prince of Wales Hospital 3 weeks ago
Barbara Daly
ESCM Co-Director of Nursing, Prince of Wales Hospital,
Prince of Wales Hospital
Submitted on 24/03/2021 at 15:25
Published on Care Opinion at 16:27

Dear T1Diabeticw/HBa1cof7,

Thank - you for taking the time to write to us to raise your concerns regarding the disrespectful care you were given by the Nurses within our Emergency Department. In reading your feedback we are very distressed to hear your feedback regarding the poor attitude of the nurses involved in your care and the lack of dignity and respect in the delivery of your much-needed treatment whilst in the Emergency Department. All registered nurses are required to practice in accordance with the Nursing & Midwifery Board of professional standards and the NSW Health Code of Conduct and CORE values. In reviewing your feedback it is clear that your care was lacking in respect and empathy and we offer you our most sincere apologies for this most distressing experience.

We take your concerns very seriously and would like to investigate this matter to fully understand why you had such an unacceptable standard of care from the nurses in the Emergency Department. Could you please send your contact details to the General Manager's email address Consumer Feedback (

We sincerely hope that you have recovered from your illness and your health is improved. We are very grateful to you for taking the time to write to us and share this concerning care story. We hope to hear from you so that we can investigate this matter in more details and understand the failings that occurred in your care.

Kind regards


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