"Elderly Cardiac Issues"

I attended Joondalup Health Campus in the afternoon recently. As usual, I believe, for a tertiary Emergency Department it was busy.  The display in the waiting room said 5 hrs for adults. However my elderly parent was suffering from a cardiac issue. They had been in an irregular rhythm all day at approx 130bpm, feeling symptomatic with tiredness, palpitations, anxiety and chest discomfort. We waited our turn and were called up to triage. The nurse we saw appeared disinterested and didn't seem to listen to my parent. I gave some collateral information. We sat back down. 

As an older patient with a new arrhythmia, symptomatic and being a cardiac issue I believe my parent should have been a Cat 2 and at the very least been given an ECG to check what rhythm they were in and a basic set of observations. They received neither of those. My parent had had a loop recorder inserted 2 days prior to try and find what was going on with previous history of syncopal events. 

I understand as per NSQHS Standards and as a result of Aishwarya's case there should be a dedicated nurse in every Tertiary Hospital Waiting Room. I saw a wait room nurse twice in the three hours we were out in the wait room attending to two other patients. At no time was my parent looked at or checked on. I spoke to the triage nurses twice more both, I felt, being dismissive. At just over three hours I approached the triage desk and reiterated my concerns to which I recall I got, your parent has been here for 3 hours and the waiting time is 5 hours, in a seemingly very derogatory tone with the nurse rolling their eyes at me and sighing.

I am a Clinician at another busy Tertiary Metro Emergency Department. I am well aware of triage, ATS scores and treating in a timely manner. I'm aware of how busy Emergency Departments are but the fact even a basic ECG wasn't done greatly concerns me. 

The reason we went to Joondalup is my parent's loop recorder was inserted there 2 days prior and my parent's cardiologist works out of Joondalup. Plus it was 15 mins drive away. I left and took my parent to my workplace where they were looked after as per ATS scores for triaging as a Cat 2 and placed straight on cardiac monitoring. They were found to be in a new Rapid Atrial Fibrillation. They were commenced on blood thinners and a beta blocker. 

I don't believe the triage nurse took my parent seriously or, in my opinion, your nurses are not following triage ATS scores correctly. I felt the attitude from the nurses left a lot to be desired too. Perhaps more training and different processes are needed.

My parent is doing well and their heart has since settled.