"Understanding Children with additional needs"

About: Russells Hall Hospital

My Daughter is a selective mute, most staff at the hospital respect this and will speak to mom or dad and try to involve the daughter with the expectation that she will not answer back. Last night at around 7pm I took my daughter to A&E as she hurt her wrist in sports the prvious night and the pain was increasing. There was a Nurse and a DR in the Paediatric assessment desk. The first thing the Dr said to us was "you've had a lot of hospital visits, why?", I then explained to them that my daughter would not talk and explained she has a high pain threshold and we never know how serious her injuries are. The doctor then looked at my daughter and asked her again "why have you been here so many times?" I repeated she is selective mute and will not talk" they wanted to know why. I told the doctor some medical background, so they continued to try and get my daughter to talk and got quite sharp with myself when I told them for about the 3rd or 4th time she will not speak to which they replied " Fine I will speak to your dad then." I explained about a wrist injury and was just about to tell the doctor her elbow also hurt when they told us to go to xray. I asked the xray staff if they could do the elbow too as the A&E DR didn't listen and they said they are getting lots of people moan about the DR in childrens area but was not allowed to xray elboy as not on the list. When we returned to A&E the same DR called us to the desk and said the xray is clear just put a cold compress and use pain killers, I tried to tell them her elbow also hurt, without even looking at my daughters elbow they told me she was not in enough pain to of done much and said we can go. I think this DR was rude and had no idea how to interact with children, especially children with special needs.

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Responses

Response from Russells Hall Hospital

Thank you for taking the time to provide feedback on your daughter’s visit to our Accident and Emergency (A&E) Department. We do aim to offer our patients the highest standards of care and we must apologise if we have fallen short of those standards on this occasion. We welcome all feedback and would like to assure you that all comments are taken seriously and acted upon as part of our on-going commitment to improving patient experience. Your comments have shown a standard of care we would not expect for our patients and we would like to apologise wholeheartedly to both you and your daughter. In our dedicated paediatric area of A&E we have paediatric trained nurses whose skills are regularly updated, including training in communicating with patients in challenging circumstances. It is, therefore, extremely disappointing to read about your negative experience. We must apologise if you felt the doctor who saw your daughter was insensitive and appeared to dismiss your comments about her level of communication and pain threshold. However, we hope you understand that we have an obligation to take particular notice of children who have an unusually high number of hospital visits and we would always try to establish the reason for this. It is considered best practice to speak to the child themselves rather than their parents. Although we appreciate that you explained the reason for your daughter’s silence, our staff must err on the side of caution and prioritise safety. There is, however, an appropriate way to go about asking these questions and there is no excuse for rudeness or a bad attitude. If patients have difficulty communicating, we have a number of specialist resources including an illustrated communication book and toolkit. These tools should have been offered to your daughter and we can only apologise that this did not happen. We have a Hospital Passport which may be a useful tool for your daughter to complete at home and bring with her if she comes into hospital in the future. The passport was designed for patients with learning disabilities but would be beneficial for any patient with additional needs. You can download a copy of the passport from our website: http://dudleygroup.nhs.uk/hospitalpassport/ Unfortunately, we are bound by regulations that state we are unable to perform X-rays not specified by the doctor requesting the scan. We must apologise that your daughter’s elbow injury was not reviewed by the doctor. We are concerned by the points you have raised and, with your permission, we would like to register this as a formal complaint so that we can carry out a thorough investigation. In order to do this, please contact our complaints team by emailing Complaints.Dept@dgh.nhs.uk or phoning 01384 321035. In the meantime, we have passed your feedback onto the matron and clinical director for A&E and they will reinforce with their staff the importance of appropriate communication.

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