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June 2015
Feeling ignored in the emergency department
Jun 30, 2015 3:44 PM

This unpacks my first experience at a children's hospital in northern Ontario with my 18 month old daughter. Sadly, a family vacation turned into a tragic experience. We flew to Cuba over a weekend in late March of 2015. On Saturday evening, we went to the beach at our resort in Varadero, Cuba. What was going to be a pleasant relaxing moment turned into a tragic event. Just as we sat on the beach chairs, my 18 month old daughter caught her right hand middle finger in the chair. She completely cut the top part of her middle finger off, down to where the nail ends. Her finger bone was slightly exposed. My wife and I panicked.

My wife grabbed the separated piece, in hopes that it could be attached again. We called the security guard who right away called the ambulance. For the next 6 hours we were on the roads of Varadero. First to one clinic, where they could not treat the wound, then to the main hospital, where the wound was cleaned and she was given a temporary dressing. We got home at midnight. We had to hold her arm up straight the whole night and my wife and I took turns to rest. I looked for the first flight back to Ottawa. We flew from Varadero late afternoon the next day and arrived in Toronto late in the evening.

After a five hour layover in Toronto, we took our late night flight to Ottawa and we arrived around midnight. We went home and grabbed what we required and ran to the children's hospital. (I was afraid that there could be some infection and we, at the time, had faith in our health system.) We were at the emergency entrance around 2 AM on Monday morning. We went to emergency, explained our situation, and this is what happened next… I explained the whole episode to the person at the first triage who everyone is supposed to see first upon entering the emergency department. I also told him that the doctors in Cuba gave her antibiotics and that she has to take a dose every 8 hours. To my shock he started laughing and replies, “every 8 hours doesn’t mean every 8 hours, you just have to split the 3 dosages throughout the day - once in the morning and second in afternoon and then at night time.”

I was thinking, okay, I understand, but where is the humour in this? This person knows that my daughter’s fingertip (1 cm piece had been cut off) is in my hand and I am in extreme pain, and this is how he comforts me and my wife? After that, there was no triage done at all. We waited with my exhausted daughter for the next 5 hours. It was terrible. My baby was in so much pain and I could do nothing but wait. At this point we had been up for almost 40 hours. I went twice to the registration staff and told them exactly what had happened, but no urgency was shown. Around 6:30 in the morning we went to the inside visitor room. Here, after an hour wait, a junior resident came. We told her what had happened and she left to get scissors, she then started cutting my daughter's bandage. At this point my wife told her that the wound is fully dried now, and maybe she should moisten it to remove the bandage easily, she continued still. She then realized that it was very dry and took us near the sink in the waiting room to moisten it with tap water. She was struggling to unwrap the wound. I asked her why she was not treating my daughter in a proper room with the required equipment. At this time my daughter is crying her lungs out as she is full of fear.

After asking her twice, she took us to another room which was also not properly equipped. She brought a helper and started opening the bandage. After she opened the bandage the wound started to bleed out again. They then told me that they have to go locate the proper dressing material for her finger - my daughter is still crying with pain. I was shocked that they didn't have the equipment ready before opening her bandage. This was so excruciating for us. We felt that the treatment in Cuba had been better than our experience here so far.

The nurses and doctors left the room and here we are, me, my wife and my daughter, waiting helplessly. The blood from my daughter’s finger is now dropping on my wife’s clothes and floor. Her hand is drenched in blood. I exit the room furiously looking for some help. I ask one of the nurses at the counter about the staff's whereabout, the ones who were helping me daughter, and she gave me a robotic response: “they will be there soon.” I return to the room and grab some more tissue to clean the blood. After a few minutes three student nurses arrive with a senior nurse. The students - at least they looked like students in virtue of the instruction they were receiving - were required to do a simple dressing of my daughter’s fingers, though they don’t seem to know how to proceed... the blood is still flowing out. One nurse stated, “oh, there wasn’t this much blood when we left earlier.”

My goodness! I did not know what to tell her. Three of them clean the wound and start wrapping it with fresh dressing. Lo and behold after a minute my wife notices that they are not covering her injured finger properly, and repeatedly tells them this. When they realize they have to open the whole thing and do it again! There is also a senior nurse behind them who is actually teaching them how to do the wrapping. He is showing them by demonstrating it on one of the nurses. I am thinking, if you are qualified, just help my daughter! Why train the staff at this urgent moment? During this the senior doctor came to have a look and the only thing I hear him say is “seems like the nail is gone completely!”

That is all I hear, after which he gives some instructions to the junior doctor and leaves. Thank you doctor, for the comforting lines. They do a temporary dressing telling me that the plastic surgeon team will come have a look later in the day. It is around 9 in the morning now. We then wait for someone to show up and tell us when the team will be coming. After another half an hour of waiting, the same junior doctor arrives and tells us that we can go home and we'll get called in a day or two regarding the plastic surgeon. I explained that they did a temporary dressing and we shouldn't leave like this. Also, how will my daughter sleep? If the wound gets a little bump it will hurt her immensely. I asked her if they can cover her hand more to absorb any impact and she offered me extra dressing material to take home and wrap myself.

We had no more strength to argue or even utter a single word. We had been up for many hours (I was up for more than 50 hours). We went home, wrapped her finger with some more dressing and tried to get some rest. We got a call on Tuesday evening for our appointment on Wednesday morning with the plastic surgeon. When seeing her, she inquired about who did the dressing (this is the dressing the nurses did on my daughter’s finger, the extra one we did, we took it off earlier, as it was only for her sleep time). She actually inquired three times to who did the dressing. I told her this was the staff in emergency.

My faith in the health system of Ontario has been damaged severely. I hope something is done to restore my faith. I have seldom wrote an email to express my dismay but this one I could not ignore.

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