Bubbles' visits to the ER (Long)

[Mishi]

A few months ago, my youngest daughter (Bubbles, 2) tripped while playing with a paintbrush. It was one of those things that happened in slow motion, I was walking towards her to take the paintbrush away when she simultaneously stuck it in her ear and fell over. So while I was calming her, I called my GP, talked to the Child Health Nurse and she told me to head to the emergency room, just in case we needed to see a specialist. After only a 45 minute wait with Bubbles cuddling and talking nicely to everyone, we saw a young lady doctor. I explained what happened, she commented on how calm Bubbles was and said it's unlikely there was any damage. A few moments later she looked in Bubbles' ear, her face paled and she said: "Oh wow, let me go get another doctor for a second opinion!"
Second doctor, walked in as Bubbles was counting and complimented her. He took a look in her ear and blurted: "Holy crap! She's really made a mess of this one, hasn't she!?"

Standard care: Keep it dry, go to our normal doctor in 2 weeks time for a check-up and then again 4 weeks later for another check-up to be sure it's healed. If she has a fever, return to ER immediately! I wish the story ended there...

Just shy of 2 weeks later, Bubbles had a fever of 39 degrees Celcius. Straight back to the ER as told (and as I later found out, as noted on her paperwork) after I gave her some ibuprofen to help with the fever and pain. ER was very quiet, and we saw the triage nurse straight away. He was a condescending older man that tried to talk mostly to my husband instead of me and told me off because she only had a fever of 37.5 Celcius. Never mind the medical advice, right?

Back to the empty waiting room, and boy did we wait! Rugz stayed with me for the first 4 hours, then left to pick up our eldest daughter and take her home. We saw loads of people coming in, leaning on their friends while clutching various body parts, moaning and making a general commotion with 15/10 pain etc. They saw the triage nurse... they sat down... they chatted loudly... they made phone calls... they were ALL seen within 10 mins, returning to their acts when they were called in. On their way out around 15-20 mintues later, they were happy, pain-free and chatting on their phones once more.

I waited for 5 hours in the waiting room, with other patients coming and going quickly. Bubbles woke up, she'd been sleeping most of that time. I know what she's like when she's sick, so when she'd started stirring I walked to the receptionist and asked for an emesis bag. I caught all of it and asked for another one while settling Bubbles with some water. After an hour of this, with her temperature climbing steadily, we were finally taken into the ER ward. Only because her vomiting was bothering the other patients! After another hour (making it 1 am in the morning) we finally saw a doctor. Her temp was 38.8 - "Oh, we'll leave that, it's okay for her temperature to be that high." It took all of 30 minutes for him to diagnose her with an infection in the ear with the punctured ear drum and organise some antibiotics, and then we were on our way.

TL;DR - I understand that ER's can be busy, it doesn't normally bother me. I'd rather see my GP if it's not too serious or if its afterhours!
Waiting 7 hours to see a doctor on a quiet day with a sick toddler after being told to return straight away if she develops a fever and seeing obvious drug seekers receiving care before us... that's just fucked up!

Edited to add: Her ear healed very quickly and she's doing very well! I decided to take her for a check-up the day before she finished her antibiotics, just to be on the safe side. Almost 4 weeks post-trauma and there was no sign of any damage.

[teh_blumchenkinder]

That could have been a lot worse! (Uh. The injury, not the visit. The second visit... daaaaamn.)
I'd report it to ... somewhere. Where would someone report such a travesty in the hospital? If a child has a fever, it's an infection, which means something that could be passed on to someone else! And vomit? Eeeeew! No one wants that, and it's a vector for disease! Jeeze! (Mishi... thank you so much for 'catching' it... maybe her sending it to the floor would get you seen! ... okay, doubt it, but still. No points, ER, no points.)
Glad the little one's healed up solid!

[Seshat]

Mishi, I somehow got you confused with fireheart and looked up the South Australian ombudsman's office.

However, their website has contact info to all Australian health complaint boards. So it was useful anyway.

[Sapphire Silk]

That could have been a lot worse! (Uh. The injury, not the visit. The second visit... daaaaamn.)
I'd report it to ... somewhere. Where would someone report such a travesty in the hospital? If a child has a fever, it's an infection, which means something that could be passed on to someone else! And vomit? Eeeeew! No one wants that, and it's a vector for disease! Jeeze! (Mishi... thank you so much for 'catching' it... maybe her sending it to the floor would get you seen! ... okay, doubt it, but still. No points, ER, no points.)
Glad the little one's healed up solid!

She should probably complain to the department manager on this one. That triage nurse needs some remediation.

Fever doesn't always indicate infection (though of course it did in this case). Sometimes fever is the normal result of normal inflammatory processes. If the temperature is under 101.0 F or 38.3, then it is either that normal response or a helpful fever that kills the pathogen.

Ear infections in children are very, very common. Most are viral and require only supportive care. I don't get worked up about them unless the infection becomes chronic or if it does not respond to anti-pyretics (fever meds), or if the kid gets dehydrated.

In this case, the triage nurse failed on two levels. First, he didn't believe Mishi's report on what the fever was to start with. Then he ignored the fact she gave ibuprofen, hence missing the fact that it was doing it's job when he took the temperature.

The ER itself failed when it made you guys wait when it wasn't busy (assuming it wasn't busy in the back). Given her history of ear trauma, I would not have assumed THIS ear infection was viral. It needed to be seen sooner, and unless those other patients had undiagnosed chest pain, respiratory problems, or abdominal pain, then they probably didn't need to be seen before others who got there first.

What probably happened was someone looked at the chart, said this is bullshit, and decided to teach a lesson by making you wait. I worked with a charge in California who was notorious for that.

I'm sorry to hear you had that experience, Mishi . . . and I am glad Bubbles is doing better.

[Mishi]

Thanks lovely ladies! I'll try to chase it up, I can't remember the nurse's name, but it should be on the records. I do want to make an anonymous report though, if that's possible (which it probably won't be without the nurse's name). I don't want it to affect any future visits, because even though that hospital has a reputation of long waits and 'bitchy'* nurses, this is the first and only time we've had a problem. He seemed like one of those blokes that enjoys people being afraid of him. I was annoyed, but polite. I don't play that game.

@Panacea: That's exactly it! If she hadn't had the injury, I wouldn't have gone. Bubbles gets semi-regular ear infections, and we've only needed to go to the doctor for them once. She had a controllable fever for 2 days and we went on the 3rd morning. He confirmed that it was an ear infection, gave me a script and told me to fill it if her fever hadn't gone by the next morning. It had, so I shredded the script. Her symptoms are just fever, drowsiness and vomiting, so I thought she'd caught a stomach bug that was going around. No ear pulling, no redness, normal balance and normal hearing. I found out that she was having them when she had her pre-vacc check-up and the doctor said "Oh, here have a look at this. She's had a recent ear infection. Cleared up nicely, but you can tell by the changed colour. Good job, it's great when parents don't come in for every little thing!"

*Whinging from an inlaw, my response: "Oh no, how horrible... The 'bitchy' nurses moved you and your baby into a private room, and refused to take her to the nursery (they promote rooming in, anyway) because you had an active Golden Staph infection? Yes, they're so mean to politely insist on disease control. Oh, they wouldn't let you visit a friend in the maternity ward because you had flu-like symptoms when H1N1 was spreading like crazy? ARE YOU FUCKING KIDDING ME???"

[teh_blumchenkinder]

Re: fever can be from inflammation: huh. learned something new! Thanks. So... can someone get a fever from an allergy? Or is it only certain types of inflammation?

[Sapphire Silk]

Re: fever can be from inflammation: huh. learned something new! Thanks. So... can someone get a fever from an allergy? Or is it only certain types of inflammation?

Usually it's caused by a stress response to an insult to the body. Vigorous physical activity can cause it. Minor trauma can cause it. It is common and expected immediately after delivering a baby or having surgery. I've never taken my temperature after an allergy attack, so I'm not sure about that one. I'd imagine yes for an acute attack, no for those who have chronic allergies. In chronic conditions, the body adjusts to the stressor and does not produce the same result.

[jedimaster91]

I have chronic allergies and when they are particularly bad, I run a low grade fever (something like 99F which really isn't even enough to be called a fever). So it's possible but varies from person to person.

[ThirdGenRetail]

Man, that reminds me of a story passed to me by my mother(Multiple times...)

Rewind to about... '88, '89. I was a wee toddler, and apparently before I was a full 2-3 years old, I'd had MANY ear infections that tended to enjoy going hand-in-hand with bronchitis(In fact, when I was 14, I was home from school two weeks with a case of it. I enjoyed my mini-vacation). It probably didn't help that I was reacting to the pollen from Carolina Pine trees, so I guess that could be called an allergic reaction? Any-who-how... My sister had been taken in for something, I forget what, and, being a single mother, I went along with. My mother mentioned to the doctor that she was sure I had an ear infection, since we were already there, and I'd already had many at that point.

Thing is, I don't tend to run fevers, even at a tender young age, and took whatever pain there might have been so well it didn't look like I was even ailed by anything. So, given that... He didn't believe her.

I can't recall if we even made it back to the waiting room after my sister's appointment(That may have been the time she broke her ankle... She was known in her youth to break odd bones. The doctor was amazed she'd broken this itty-bitty bone in a hard-to-break place), and we ended up backtracking... Because my eardrum had ruptured Needless to say... The doctor believed her!

I'll have to bug her for the full details some time and write it down right... And what the appointment was for in the first place. And now I stop derailing!

I think that nurse needs experience his own 'medicine', as it were... That was uncalled for!

[Irving Patrick Freleigh]

Ear infections in children are very, very common.

As a wee Irvling, I used to get them like they were going out of style. Not fun.

[Seshat]

It wasn't summer if I hadn't had at least one ear infection!

[AccountingDrone]

I lost a portion of hearing in my right ear ... I was in hospital with pneumonia, and complained that my ear hurt ... the nurse figured I was seeking attention [I was all of 6 years old at the time] and didn't bother getting the doc for me, until she came in 3 mornings later to find the infection had perforated my eardrum when it exploded ... and my pillow and hair were covered with blood and pus. That got some attention ...

[LadyAndreca]

My second brother had so many as a baby and toddler that he eventually had to have speech therapy because he didn't learn to make many sounds correctly.

[Pagan]

And here I've never, ever, ever had an ear infection in my whole life (so far)! I do believe I will continue along that path, tyvm.

Re: fever can be from inflammation: huh. learned something new! Thanks. So... can someone get a fever from an allergy? Or is it only certain types of inflammation?

Panacea, correct if I'm wrong with this example.

Inflammation can come from a lot of things. Next time you cut yourself really good, like the next day, feel and look at the skin around the wound. It'll be puffy and hot. Like my thumb is right now because I sliced off a chunk slicing veggies with the mandolin last night.

[Eisa]

I had loads of ear infections when I was really young--I even got tubes put in my ears.

That ER made me go WTF is wrong with that nurse?!