Copy of a letter sent to RVH Patient Representative on October 16, 2015

I refuse to go back to this hospital and will drive 45-90mins to go anywhere else but here.  This is just a small (2 incidents) account of the multitude of incidents that I have been witness to or been a part of for nearly 10 years.

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Dear Patient Representative:

The time has come for me to sit down and write a letter to you.  For the past five years I have visited your Emergency department four to six times.  All of these visits were upsetting experiences but none more so that the last two visits.

I have multiple medical issues that I deal with on a daily basis.  I deal with daily pain and physical ailments that many others would not be able to tolerate.  I am not a complainer and this is the reason that I have not written to you before.  Last nights visit was the final straw.

I will start with the worst experience I have ever had at RVH’s ER and then will end with last nights debacle.

Last February 2015 I was brought to ER via ambulance in distress with chest pain.  I have a strong family history of Heart Disease and Stroke.  My care was amazing up to the point that I met Leslie, the triage RN, that night.  My mother arrived at the hospital a few minutes after me.  We got my Cardiac blood work and done and was asked to wait in Triage.

At some point after initial assessment I started having chest pains and passed out, in the wheelchair that I was sitting in, parked in the hallway.   I was told that my mother, called out to an ER clerk to watch me while she went to get the RN.   My mother, who is not a very excitable person, went up to the triage desk and told her that I needed help.

Leslie, the triage nurse, started verbally abusing my mother.  She yelled at her in front of a room full of patients and was saying things like “I will call security if you do not leave”, “If you do not stop talking you will be removed”, etc.  At this point an ER clerk had wheeled me, unresponsive, over to Leslie’s cubicle and Leslie ignored me while continuing the barrage on my mother.  My mother told her that if it meant I got to be seen by someone then by all means to call security.

At this point I became aware of what was going on, weakly I reached out and took my mother’s hand and told her “She is not listening, go find someone else, go get the paramedic that brought me in”.  I know now that this would not have helped me but I needed to be seen and I needed my mother to be able to stay with me.  Calling security would have wasted time while I possibly had a cardiac episode.

My mother is one of the calmest people I know, she has had a lifetime of hospital care while dealing with my developmentally challenged, physically impaired, behaviorally challenging brother.   She is the one person I would like to have with me in an emergency.  Not much rattles her…that is until she met Leslie.

My mother left me at Leslies triage cubicle and ran back to EMS DropOff.  While my mother was gone Leslie unlocked my chair, with me slumped over, hand dragging on the floor, and followed her.  She pushed me to the short hallway just past the ATM machine and dumped in front of the elevators saying “Let the paramedics deal with you then” in a condescending voice.  My mother found me there a few minutes later.  My pain had stopped, for the moment, but over the next hour it came on suddenly and lasted about a minute each time.

At some point my mother went to the nursing station and asked if anyone was going to coming to see me.  They told her that I had been taken out of the system and that they did not even know I was there.  It was very busy and it took another hour or more for an ECG tech to show up.

A Barrie Police Officer, who was sitting with a patient, across the hall from me, who also witnessed my dumping at the elevator, interacted with my mother over the next few hours.  She even asked if she could do something to help.  She stated she was upset by the lack of service that was obvious to her that I was not receiving.

Six hours later, a second set of Cardiac Enzymes was done.  I was finally seen by a doctor who told me to go home because it was a “panic attack”.

(I have never had a panic attack and I only have “depression” written in my chart because of one episode with one doctor at RVH who told me I was depressed after I started to cry when he told me there was nothing more he could do for my Crohns.  But for some reason this depression diagnosis keeps popping up at all my ER visits…but I digress…back to my story…)

My mother and I both stressed to him that many, many of my family have severe heart disease and that my father had had a Quad Bypass in his thirties.  My father was one of the lucky ones in his family.  All his results had come back normal.  He survived only because he collapsed, mid sentence, while talking with his cardiologist, on a CCU with all the equipment needed to keep him alive a few feet away.  He had a 90% blockage in his LAD.  All of his tests had come back normal too.  Heart concerns are utmost priority in my family!

I was brushed off, given a requisition for a Stress Test and discharged.   This came back normal.

The pain continued periodically, sometimes days apart, over the next few weeks.  I was diagnosed with A-Fib a few weeks later, after going to another hospital for assessment.

I realize that doctors can only evaluate what the results tell them.  I am not complaining about the misdiagnosis.  I am horrified at the thought that if this had been something more severe than A-Fib then what would have happened to me?  Leslies lack of people skills and compassion is appalling to me.

Yesterday, at lunch time, I was advised by my NP to go to ER to have an assessment done to rule out a possible IUD migration/misplacement.  I had an IUD inserted five weeks ago to help with a Hyperlasic Uterus.  I was registered, triaged and sent to Minor Exam quickly.  I expected a wait, I thought 4-5 hours would be the outcome but hoped for 3-4 hours maximum. 

At each interaction with staff I had to correct them by saying that the IUD was not for birth control, I also had to correct them many times saying the bleeding started eight months ago and the pain started, the day after insertion, five weeks ago.  For some reason they kept getting this mixed up/did not correct it.

Due to the pain I was unable to sit so I slowly walked the halls.  All the nurses on staff when I arrived at Minor, acknowledged me.  I asked, and was told, it was okay to do this.  I walked a rotating “C”, (from ice machine, back around past the two fire panels and then up towards the cast/optometry rooms, turned and went back to the starting point).  I ensured that I was not walking in front of the nursing station at any point because it was busy there and I am intensely aware of confidentiality.

Bloodwork was done and I was finally given a room about 1600hrs.  I did not have any form of entertainment (no phone or book), it was painful to sit or lay down and I just wanted to lean against the wall or walk.

There were four filled seats (“Patients Waiting for Imaging”) right outside my room (#7), and four more filled seats, also awaiting imaging, next to the bathroom.  A mother was walking with baby in a stroller around the unit, passing in front of the nursing station every minute or so and there all the exam rooms in front of the nursing station was full.  Of all of these patients I was probably the furthest from the nursing station.

So it was with surprise that while I was leaning against the door way, in pain, eyes closed and trying to breathe away the pain I was hearing a voice say “Excuse Me” again and again, with increasing volume.  I opened my eyes to see a nurse looking at me from the nursing station, over by where the charts hang, and when she saw me look at her she said “You need to go lay down”.  I shook my head no and said “I am not comfortable lying down” to which she responded “You can’t stand there in the doorway”.  I thought maybe due to fire regulations or safety concerns but before I could respond she continued on, I a strident voice, that “There is confidential information here and I can’t have you standing there listening, you need to go in your room and stay in there until you are seen by the doctor”.  I was severely embarrassed and a little confused because all these other patients were clearly more able to hear or see what was going on in the nursing station more than me.

I was having another pain episode so I stepped inside the room a half meter or so and leaned against the sink.  She obviously could still see my body just inside the door and came into the room to again chastise me for supposable eaves dropping.

(Funny side note…I had been a PHIPA trainer for years when working in Long Term Care and Retirement)

I made it to the corner of the room, near the sharps container, pushed the table out of the way and made room for me to have space to lean against the wall.  This nurse came in a few minutes later, to give me some pain medication, and again chastised me and told me that other patients complain about lack of privacy.  I did not respond to her, I just took the medication and water to prep for a Pelvic U/S, turned, closed my eyes and braced myself against the wall, ignoring her.  I was professional and did not want this situation to escalate.  She continued talking, in a strident voice, about my health issues and that a doctor would be in shortly.  At no point did she concern herself the there were four patients sitting right outside my room door, less than 2 metres away able to hear everything said, it did not stop her from talking, to those same patients right outside my door about tests they were going to have done, nor did she lower her voice when she was in the room next to mine talking to a patient about a miscarriage and later talking to a (unseen social worker?) about another patients lifestyle and rehab,  I heard all of this while inside my room.

Since I had been told not to leave my room and I was now is less pain, due to the medication, I decided to lie down in a knee-chest position.  I must have fallen asleep because I woke up about an hour later, bladder not full,  drank more water and waited for someone to come get me.  Another hour or so passes before the ward clerk came in to say she is calling for a volunteer to porter me to U/S.  Another hour passes while I stand and listen to the staff in the nursing station try to figure out what to do because they have lost my chart, thought I had already been to ultrasound, could not find my results, etc.  Finally, they found my chart on a different unit, sent me to ultrasound and I returned to my room.

The ultrasound technician was an absolute angel.  She was exactly what a healthcare professional should be.  She provided me with a pad, mesh panties and a new robe because the one I had on had been bled through but I had not noticed.  She was calm, courteous and put me at ease during a painful procedure.  I wish I could remember her name.

Now nearly 2100hrs, I was finally seen by Dr. Bedard, who clearly had no information for me besides that the ultrasound showed the IUD is likely in place. They could not tell with absolute certainty.

He told me it was likely just menstrual cramping or a Crohns episode and he suggested to remove it and to go on an alternative Birth Control.  I tried to explain AGAIN that this IUD was for a Hyperplasic Uterus, to help suppress uterine cancer, that biopsies were pending and that I have never had vaginal bleeding except with my thirteen miscarriages and that I have never had a “regular” menstrual period.  Actually I have had Amenorrhea my entire life.

When he told me that he did not understand “Hyperplasic Uterus” and again repeated an alternate birth control plan I decided that I would be safer going to another hospital.

I left after nearly eleven hours in ER with an inconclusive ultrasound result, a chastised psyche and a prescription for some antiinflammatories.

I know this letter is long, I know I have probably been much more wordy than I should have,  I also know that I feel so much more relieved after writing it.  I thought, five years ago, when we moved to Barrie it was a good decision to make.  We wanted to be close to a hospital as I have multiple health issues and so do my two special needs children.  Royal Victoria hospital has let us down at every visit.

I did my nursing training at Royal Victoria Hospital 22 years ago.  I have seen big changes over that period and I am not sure it has been for the better.

Thanks you for your time,

Melissa __________

Registered Practical Nurse (retired)

Human Services Worker

Crisis Counsellor