"Accepting the patient's concerns"

I recently attended Perth Royal Infirmary with a radial styloid fracture. I was given a splint and was told I would get a call two days later with a care plan, once the orthopaedic specialist had reviewed my X-rays.

I did indeed get a call from a nurse at Ninewells Orthopaedic Outpatients department who conveyed to me the specialist’s recommendations.

During this call I raised concerns that I thought the splint I had been given at A&E was too big as it was slipping down over my hand and I didn’t feel I was getting support from it. I said I would appreciate it if I could have the splint checked as my main concern was that I wanted to ensure that my injury was being properly managed to help as much as possible with the healing process.

The nurse said that if I had the strap fastened properly around my thumb then there was no way it could slide down onto my hand.

The nurse proceeded to tell me what the specialist had recommended with regard to my care plan and seemed to be disregarding my concerns about the splint. It was recommended that:

• I remove the splint at bedtime after Week 1

• I wean myself off it at week 2

• I remove it altogether after week 3

I was confused as I had been told at the hospital that I should keep it on for a minimum of 4 weeks. The nurse reassured me that these were the specialist’s recommendations and that every care plan is different. I accepted this.

On at least another two - possibly three - instances during the call I reiterated my request to have my splint checked. Eventually the nurse said if I really wanted it checked they would see if they could get me an appointment at orthopaedic outpatients at PRI.

I attended PRI the same day and I have nothing but praise for the way I was treated. The nurse immediately recognised that the splint was too big (size L) and was providing no support whatsoever. They fitted a size appropriate for me and advised me about keeping my arm raised as much as possible and told me how to exercise my fingers etc. They reiterated what I had been told in A&E about keeping splint on for 4 weeks.

Had I not persisted with the nurse at Ninewells in requesting an appointment, I would have been wearing a splint for several weeks that was at best useless and at worst detrimental to my recovery.

The following day I phoned Ninewells and told the nurse that the splint had in fact been the wrong size. With that in mind, I wanted to re-clarify how long I should keep it on for as there had been conflicting information. Again my main reason was to ensure as speedy a recovery as possible.

Again the nurse explained, as outlined in bullet points above, the procedure I should follow. I needed to have this clarified for my own peace of mind.

The nurse said they would contact the orthopaedic specialist, and they would call me back later in the afternoon.

An hour or so later, I received a call from the nurse at PRI to say that the nurse at Ninewells had contacted them to tell them I had phoned to get clarification. I was actually quite upset at this. After that call I reflected on it and actually felt quite angry.

I couldn’t help but feel that the nurse at Ninewells had perhaps been passing the buck. They didn’t seem to want to take ownership of the fact that they were wrong in not being forthcoming with an appointment for me, until I pressed the issue. I wondered if they were trying to cover up their shortcomings by putting the focus on the nurse at Perth, with whom I had a very positive experience.

I had been in communication with the nurse at Ninewells and had quite frankly lost confidence in my interactions with them. Given how I was fobbed off when I suggested (correctly) that the splint was ineffective, I was seeking reassurance that they had given me accurate information about my way forward.

At no point did I question the advice of the specialist, nor did I suggest that I did.

I also want to emphasise that I have had nothing other than a very positive experience in my interactions with the nurse at Perth. They were friendly, helpful and extremely professional.

I wonder, if the nurse at Ninewells were to reflect on their responses, would they in a similar situation, accept the patient’s concerns and immediately offer an appointment without having to be pressed for one. Common sense would tell me that it is always best to err on the side of caution.

I would like the nurse at Perth to know that I didn’t ever complain about them and thank them for their care and professionalism.