"Burns treatment"

Started out as a very busy day at the medical centre where I work. I'm a practice nurse and had a full day of bookings on this particular day.

In the middle of a 75y health assessment, my workmate knocks on my door and said that we just had an emergency walk in, a little child with burns to their fingers.

I said I was in the middle of something (the health assessment) and would be with them asap and advised my colleague to run the child's hand under cool running water while grabbing supplies and equipment. Stating as per PCH Burns Protocol, they would need a tub of soapy water to soak their hand in, sterile scissors and forceps, intrasite gel, Acticoat silver dressing and duoderm dressing.

The other nurse popped their head back into my room and said it was my child and stated their name. I was still unable to leave my patient in the middle of a Geriatric Depression Scale assessment, so gave instructions to soak their hand in the water and see if any blisters needed deroofing, apply the gel, apply acticoat, moistened with sterile water, apply duoderm and bandage if required.

I joined the other nurse in the room next door and saw my child's blisters possibly didn't require deroofing and also discovered we didn't have any Intrasite gel.

I phoned PCH to ask if we could use Solasite gel instead but they advised  to use Intrasite gel.

I phoned PDH and asked to speak to the ED nurse on duty. I spoke with a nurse and handed over about a young child and their name, with burns to their thumb, index finger and second finger of their Right hand. I said I had spoken with PCH burns team and as per their standard burns protocol, we had the child's hand in soapy water and wanted to apply Intrasite gel, silver dressing and duoderm however we don't stock Intrasite gel. The nurse confirmed over the phone they had Intrasite gel in stock and to send the child over for burns dressing.

At 3pm, my child was over in ED waiting room.  

At 4pm I messaged my partner to see if our child had been seen yet. My partner said that they had not. They also said our child's fingers were still burning and they did not have a basin of water to sit them in.

At 5 pm I messaged again to see how they were getting along. My partner advised they were still waiting and the nurse had no response from PCH, the phone was ringing out.

At this point in time I rang my partner and asked what they were waiting for from PCH? They said they were waiting to find out what to do with our child's burns, the nurse didn't know. My partner said the Nurse I'd spoke to hadn't handed over to the current ED nurse so they were unaware what to do. I was fuming.

I phoned them stating I had handed over to the duty nurse and gave their name, stating I'd been in touch with PCH burns team and protocol was soapy water, deroof blisters if required, apply gel, acticoat pre-moistened with sterile water, duoderm, then bandage and review in 48hrs and to send a photo to PCHburnstlehealth@health.wa.gov.au. I asked if they could show my text message to the duty nurse but I was told they weren't interested.

At 5:20pm I messaged my partner to see if they wanted to meet me back at work (Medical Centre) and I'd dress the wound myself, using Solasite gel. At least my child would have some pain relief from the gel at this point in time. My partner replied stating it was being dressed now.

I'm not commenting on the time to be seen, we understand cases are seen on a triage basis.

My frustration is with the lack of handover as well as the lack of something as simple as a basin or cup of water for my child to dip their fingers in whilst waiting to be seen.

I'm also frustrated that as a GP nurse, I'm aware of standard PCH burns protocol and am wondering why ED staff do not, based on this experience.