"Lack of clinical curiosity, timely care and adjustments"

I recently attended Minor Injuries with my daughter. She is learning disabled and autistic and had sustained quite a bad burn to her leg.

The burn covered a large area and had blistered badly. I decided to quickly head to Minor Injuries to get her an assessment and appropriate care. 

When we arrived, reception staff informed me that we could be waiting anywhere between an hour and an hour and a half to be seen. They said that it may be quicker to phone NHS24 as they might be able to get my daughter an appointment to be seen sooner. 

I advised reception that my daughter is disabled and autistic which they advised was passed on to the senior nurse, however the suggested waiting time did not change. My daughter was in pain and crying in the waiting room, whilst people passed us who were hobbling but able to walk unaided and otherwise smiling and laughing. 

I called NHS24 who were very helpful. The nurse I spoke to was flabbergasted when I described that I was being asked to call them, from the waiting room of minor injuries, in the hope my daughter would be seen sooner by minor injuries. 

They managed to get her an appointment that was 1 hour after we arrived. I'm not certain that my being on the phone to them for 20 minutes made any difference at all since it was no sooner than the initially stated waiting time. It also took time away from me being able to comfort her appropriately, but I was worried and trying my best to ensure she was seen ASAP. 

We spent about 5 minutes with the senior nurse, who wasn't told about my daughter's disability so I have no idea what the receptionist passed on and to whom as there was no other nurse there than the senior nurse. The senior nurse also didn't ask any questions about how to approach or support my daughter in light of her disabilities and needs, which is essential to her care. 

After a quick nursing assessment, we were then passed to a healthcare assistant to dress her wounds and advised to keep dressing the wounds at home, then to see our GP nurse urgently on Monday. I presume this is to monitor for infection, but this wasn't stated. I am a nurse, but wound care isn't my area of expertise and I would have liked some more information about what to expect over the coming days and weeks. 

When we saw the HCA, they also didn't seem to know about my daughter's disability and looked confused when I spoke about how to approach my daughter. The nature of her disability and autism means that she doesn't like to be touched by people she doesn't know and when she is overwhelmed and in pain it's helpful to keep noises low and voices quiet or it can tip over into a meltdown making care/treatment impossible. The HCA listened, looked a little perplexed and said nothing. Then carried on as though I hadn't said anything. The result was a lot of distress for my daughter while her wound was being dressed. 

The HCA did allow me to help and didn't stop my daughter from touching the bandages and trying to do some of it herself which was helpful and gave her some control over the pain and the overwhelm she was experiencing. If they hadn't, I'm not sure we would have managed to get it done. It was a very distressing experience, some of which is just the nature of the pain and my daughter's needs but some of it I feel was preventable if the staff had been educated in learning disability care or even if they had just been more curious about my daughter's needs and taken more time to work with her. 

The bandages the HCA used were not great also and fell off as soon as my daughter stood up and started walking. At this point, my daughter was overwhelmed and we had to leave. I had to ask some of my nursing colleagues for advice on alternative bandages and we bought more suitable ones at the pharmacy on the way home. Thankfully these have worked well - I'm not sure why they weren't used by the HCA. 

Ultimately, it was a poor experience for my daughter and the way the service is run is also quite poor in my opinion. I believe this contributed to the experience significantly. 

There was one senior nurse, several HCAs and a few AHPs that I saw. The HCAs had nurse auxiliary on their badge which suggests they are nurses. This is not true, nursing auxiliary is the correct title and from what I have observed I believe the HCAs are working beyond their skill set - particularly managing wounds and providing direct care to complex patients like my daughter. I worry, based on what I have seen, that they are being used in place of registered nurses. 

Having only one nurse also meant there was no capacity to triage properly and see people based on need/severity as this is a nursing skill. There was also very little consideration or interest in the needs of learning disabled people in my experience. 

The result is that my daughter was left for an hour, burnt and blistered and in tears. Then, when she was seen, her needs were not sufficiently considered in her care and treatment. It may seem minor but this is why learning disabled people have poorer health outcomes - a lack of clinical curiosity, timely care and adjustments. 

This is our local unit and I'm not sure I would feel confident if we ever need to bring her back there again.