That’s a really valuable thing that you do to help out your children.

That’s a really valuable thing that you do to help out your children.

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What can I call you?

Ah, you can call me Bill.

Call you Bill? Ok, well, my name’s Natasha Reedy and I’m the examiner for this course, The Patient Experience and Partnering in Care.  So, thank you for joining me today to talk about a recent experience for you, and you’re going to share with us that experience and some advice on how nurses could improve their care.  So, before we start that, how’s your day been today? 

My day’s been up and down, but enjoyable.

Yeah, and did you do anything specifically today?

I bowled with the Golden Oldies and had equal high game, so I did alright.

Ok, excellent, alright.  And are you married?

Yes I’m married.

And have you got, do you have children that are grown up?

I have all middle aged children these days.

Alright, and any that live in your local city, or rural city?

Yes, we have 2 daughters in this city.

Ok, alright.  It’s a regional city isn’t it?  That’s good for you, and do you see them much?

Oh, when we’re needed to mind the children.

Alright, well that’s always helpful. Ok good, and are you minding any children, grandchildren, today?

Yes, we’ve had our youngest granddaughter today.  She’s on school holidays. 

Ok, well that’s really good.  That’s a really valuable thing that you do to help out your children.  That’s great.  Alright, well let’s get back onto why you’re here today.  And, I understand, is it about 6 years ago you had a couple of falls that impacted you then, and they still impact you now.  So, can you tell us what happened the day you first fell?

Well, what happened was, that I was out doing the prescribed exercise routine.  I’d gone down to the shop, walked down to the shop, and walking back I didn’t stop to blow my nose, and I tripped over a piece of concrete and I just belly flopped into the gutter which took skin off my nose and my chin, wrecked my right shoulder, and took skin off my left elbow. 

Wow, that’s some really bad injuries there.

I was motoring along at the time.

Yeah. And sorry, you didn’t experience a fracture though? 

No, there was no fracture, but there was certainly a major injury because I immediately lost use of my right arm.

Ok, alright.  That’s significant isn’t it? 

Yes it is.

So tell me then what happened?  So you’re lying half on the gutter, half on the footpath, and were you fairly close to home at this point or not?

I was about 20 metres from home.

So what happened? Was anyone around that saw the accident?

Absolutely nobody.

Nobody?

I was on my own by myself.

So how did you feel at that time? Did you go into shock?  Were you kind of like, ‘oh, what’s happened?  And I wonder how I’m going to get up off the ground’ or…

Well, that was my major thought, was how in the heck am I gonna get out of this mess.

Yeah

Because I couldn’t put any weight on any part, on any limb. So I rolled over and swivelled onto my backside and managed to get up from there.

Yeah, and do you remember when you got up did you feel pain anywhere, or did you feel dizzy, or what were your feelings at the time?

I was in absolute agony with my right shoulder.  

Ok. Intense pain?

Intense pain yes.

Ok, so you struggled home all by yourself?

Yes.  I saved the shopping.

Yes?  You saved the shopping?  So you still struggled home with a really painful right arm was it?

Yes.

That you couldn’t move, and so you had to put all your groceries on the other arm?

That’s true.

And then you got home, and was there anyone home when you got there?

Yes, my wife was there and we had visitors as well.

Ok, alright, and so what happened then?

They all wanted to rush me off to hospital, but I declined.  I decided I’d wait till the following morning to see my GP who sent me for an xray.  And I waited for results of the xray and I took them back to my GP and I was sent to a surgeon.

Ok, so just going back to that day that you had the accident.  So you had the opportunity to go to the hospital, but you declined.  Was there a reason why you wanted to wait to see your own doctor rather than go to the hospital?  Were they tending to send you to the public hospital?

Well, the down side of going to the public hospital is the time you spend there waiting to be seen.

Have you had a bad experience before at a public hospital?

I have had a bad experience at the hospital yes.

What happened there?

I had a kidney stone being passed and I waited 11 hours to get relief.

In the waiting room? Were you in the waiting area?

Waiting room – yes.

And you were in intense agony for 11 hours in the waiting room?  And so what care were the staff giving you during this time in the waiting room?

Every 3 or 4 hours I’d go and ask for more pills.

Right.  So no one was coming and checking on you?

No one was coming to talk to me at all.

Did anyone update you on why you had to wait so long and you were in intense pain?

Bout half way through the period I was told I was next in line, but meantime there was 5 or 6 ambulances arrive and they had priority.

Right, so for 11 hours you stuck it out in the waiting room in intense pain.  And the waiting room, was it full of other people?

Yes it was.

And they were watching you?  How did you feel being in such terrible pain in front of all those people and not being attended to by the staff? How’d you feel?

My feelings in that situation was very uncomfortable but I wasn’t worried about what anyone else thought.

No.  And do you remember feeling angry, do you remember getting angry about why the staff weren’t coming and telling you what was going on, why they weren’t caring for you?  Were you feeling upset and frustrated?

No, I didn’t get angry, because I knew that there was a priority system and my priority was number 4.

When you think back to the pain.  If I said to you 10/10 is the worst pain you’ve ever or would ever experience and 0 was no pain, what was that pain sitting at in the waiting area?

Well, that pain was about an 8.

An 8? Ok, and so they gave you some medication did they?

Yes they did.

Do you remember what they gave you?

Codiene.

Some codeine.  Right, and did that relieve the pain at all for you?

It dulled it for a little while, that’s about it.

It dulled it for a little while, but it came back and peaked.  And when it peaked, you had to go back to the counter and ask for it.

And ask for it.  That’s exactly right, yeah.

So that wasn’t a very good experience for yourself.

It certainly wasn’t one to encourage you to attend public hospitals.

Right.  Did you ever get to be seen?  Was it after 11 hours, or, did you leave and go…?

I did get to be seen but it was amazing.  I was called in to a waiting room and on the way in I said to the nurse ‘I need to go to the toilet’, and I passed the stone.

Right. Ok.  And then you had immediate relief?

I had immediate relief, yes.

Ok, but it took 11 hours.

11 hours to get seen to.

Ok, so that’s very disappointing.

It was yes.

So this time when you had the fall, you were not going to go and go through that same experience again.

That’s exactly right yes.

So you decided to stick it out at home where you were more comfortable rather than get ignored at the hospital, is that right?

Yes.  With pain killers, yes.

Right, ok, so you had some pain killers at home?

I did yes.

Right, ok.  So you stuck it out during the night, and in the morning, did you find that pain a lot more severe?  Were you able to move it or not?

No, I couldn’t use it.  I couldn’t use it from the moment I fell and…

So did your wife have to help you get dressed and get showered?

I had to be up and dressed and showered, and everything else, and if you’re right handed and not ambidextrous, doing things with your left hand is very unco.

And so did your wife drive you to the doctors clinic?

Yes she did.

And how does your wife feel about driving?

She was extremely nervous because we were new in town.

So new in town, and would she get a chance to drive much normally though as well or…?

She normally doesn’t want to drive, but basically after the fall, she drove for about 6 or 7 months, because I disqualified myself from driving. 

Yeah, cause you couldn’t.  And so, the impact on your wife then, did she find that high stress?

Very stressful yes.

Because she didn’t know her way around and didn’t have confidence.  So then that would have impacted on you too, you would have…

I had to be a navigator as well.

You had to be a navigator, you couldn’t take control like you would normally, you know, take control of those situations.  Ok.  So you presented yourself to the GP clinic the next day having to struggle through the morning, manage your wife, navigating while you were in pain, get to the GP clinic, and then how was the care you received there at the GP clinic?

I have no complaints about the care and the response to my situation. Absolutely none.

Ok, right.  So they assessed you?

They did yes.

And you said you got an xray.  Did you get blood tests done or anything like that?

Blood tests weren’t called for. But the xray, I waited for it and brought it straight back.  I had an open appointment to come back with the xray. 

Ok, that’s good.  Alright, and so you went to see the surgeon and what was the outcome there?

Disappointing.  Very disappointing.  He was overly honest and …

What did he say?

And, what’d he say? Well, I had a 30cm tear in the muscle that goes over the shoulder.

That’s a really huge tear, isn’t it?

It is yes.  And he said to me, he said can sew you up, repair it, he said, but repairing it would be like sewing an old rag into a new pair of jeans.

Oh.  And hearing that news would be kind of, were you shocked?  To have your body described like that?

Well, I thought, you know, am I that old, and is my flesh that…

Fragile.

… tattered?  Cause I immediately thought of these people that have hip operations and all that sort of thing who are in their 80s.  And so what was different?

That’s right.  So, did you think at that time, so he offered, did he offer you a choice of physiotherapy?

He didn’t offer me a choice, he sent me to the best one in town.  In his opinion.

Ok, alright. In his opinion? Ok, and did you think at the time, being in this regional city, would it be worthwhile, or did your GP suggest maybe, visiting another surgeon for another opinion maybe in the metropolitan city, as a, just to have a second opinion?

No.  I was quite satisfied with his diagnosis.

You were satisfied?  Right, and so you went to the best physio…

Yeah, according to him.

And so what did you think then of the physio? What was the care there?

The physio was very good.

Ok.  And what made you think that the care from the physio was ‘very good’?

Well, the physio taught me how to use my arm, with the assistance of the other arm, and with the assistance of other aids, such as sticks and you know, you get it to lift and so forth, you know, resistance exercises.

And how often did you have to do these exercises? Did you go to see, ah, was it a male physio, or female?

Female.

Female. And did you have to see her weekly, once a week, what was the regime there, or did you do it at home?

Well, according to my entitlement I had 4 visits with her.

Ok, what’s this entitlement.  Can you talk to me a bit about that?

The entitlements were through medicare and also through my private health fund, who limit a certain number of visits, but if I wanted more I had to pay full price.

So you had 4 visits. Ok, and do you remember what the cost might have been or not?

At the time each visit cost me, with the subsidy, $35. 

Ok, alright.  So then, you’re travelling along and then, I hear that you end up having another fall inside the house 4 weeks after that.  A really nasty fall.

Yeah, I had a dizzy spell and hit the deck.  I was standing up and when I spoke to my GP about it, a blood test was ordered and we found out that I was anaemic and …

Were you surprised to hear that you were anaemic?

Well, I was relieved in a sense because I’d initially gone to my GP and told him that I feel like I’m breathing *rarified* air.

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