"Lack of identification in the emergency department."

I was recently taken to St George Emergency Department by ambulance. Due to the nature of my symptoms I was managed as a spinal patient with hard collar, lying flat with limited movement.

I was given nurse-initiated pain relief of paracetamol and ibuprofen some time after my arrival, having waited in the ambulance holding bay before being admitted to the acute area. This medication proved to be insufficient and despite several requests to nursing staff, they were unable to get further analgesia charted for me for over an hour. When they did succeed, it was half an endone tablet (?2.5mg) that was also not effective. Further attempts by the nursing staff to have additional analgesia charted seemed unsuccessful.

At one point I was feeling very nauseous due to the pain and an emergency log roll was performed by several staff to allow me to vomit safely. Immediately following this, a male staff member removed my collar whilst asking me to move my head. He then advised that I no longer needed the collar. At no point did he identify himself by name or role.

After several hours, having waited for effective pain relief without success and having no idea of what my treatment plan was, I advised nursing staff that I would go home. I was very uncomfortable, tired, becoming hungry and felt I could better manage my symptoms at home. The Nurse Manager was very kind and pleasant and whilst expressing her preference for me to stay, provided me with comprehensive instructions on actions to take if my condition worsened. At no point during my approx 4.5hr stay in ED was I aware of having seen a doctor.

After arriving home I received a telephone call from a Staff Specialist who identified himself as the staff member who advised the hard collar could be removed. He expressed disappointment that I had 'wandered off' and advised that I should have stayed. He informed me that he had  intended to order a CT scan and admit me to the observation unit. At no time during my stay in the ED was I told of this. Indeed, when I left I was not aware of any treatment plan and I suspect the nursing staff were also not aware as they made no mention of it. 

I would like to highlight that at no point during my stay in ED was a comprehensive medical history or examination conducted on me by a doctor, at no point did anyone identify themselves as a doctor to me and I was not informed of any treatment plan. I was also not consulted as to appropriate pain relief by any medical staff. 

Following the telephone call from the Staff Specialist I was very concerned that he had labelled me an absconder, having used the phrase 'wandered off' on several occasions and his general arrogant attitude during the conversation. I then telephoned the Nurse Manager and discussed my concerns with her. She reassured me that my medical records contained nothing derogatory and provided me with a telephone number if I wished to take my concerns further. Again she was professional, kind and courteous.

I tried calling the number several times the following day, each time receiving a message advising the ? CPIU was not available. I eventually left my name and number advising I wished to give feedback regarding my stay in ED.