To not know where to turn for help with this?

Go to a different hospital. That picture looks pretty bad and you don't need complications.

I remember your first thread @ihowlforyou .

For other posters, that thread was filled with people telling the op she was a time waster for considering going to a&e in the first place and she got a rough time from her manager. It's all very well telling the op the law, but when you're in pain, possibly some ongoing shock and have a toxic work environment it can be very hard to stand up for yourself.

@ihowlforyou I've had an injury which involved a break of a type they don't treat and told to get on with it. Separately I've also experienced dismissive doctors who made me almost scared to seek help even when logically I know I needed it.

So when I was told I had to get on with it, I did, despite impossible pain and the limitations of that. I regret SO much not going back to a&e or pushing to be seen again. I ended up suffering for over a year.

So I'm going to add my voice to others here and tell you that you need to advocate for yourself. You're entitled to ask for a second opinion- do so.

Cry when you're in front of the doctors/nurses, like me you're probably being as stoic as you can be but doctors take distress more seriously if you actually cry, so don't hold it in.

If you're really too scared to present at a&e again, call 111 and tell them you cannot cope with the pain. Tell them the swelling is still bad and it feels unstable.

Explain how it's impacting you physically and what it is stopping you from doing, and that you can't get seen at minor injuries and your gp cannot help. Ask for help and a second opinion, a reassessment of your injury.

Don't mention your skin until you're in front of a doctor.

I understand your reluctance but it's time to make a fuss - don't be like me and be a martyr because you're afraid of being criticised by the doctors. And one snotty note on your records won't make a difference to future care - doctors rarely read back anyway.

OP, if you're in this much pain, you need to go back to A&E. Maybe the initial diagnosis was wrong, maybe a stable fracture can become unstable...either way, don't leave it, because untreated injuries can cause blood clots, as well as the actual injury itself getting worse. I don't know if you're awake now, but if you are, take some aspirin. Off to bed with you and A&E first thing tomorrow, 'kay?

You had dozens of people on your other thread tell you they had a boot for the same injury.
Just go and bloody buy one off Amazon or something. Or your local pharmacy. That way you can still weight bear like doctor said, but you're keeping the ankle immobilised for pain management and optimal healing.
Keep up your wound care for the knee, or book a GP appointment if you're worried.

FWIW the bruising looks accurate for an avulsion fracture.

Yes, so as I’ve said a few times - go to GP, get a sick note, get referred to fracture clinic if GP thinks so.

She has already (correctly) been to A&E when she had her A for Accident. And it’s not an Emergency either. I think people have lost sight of what A&E is for. There are walk in clinics which do X-rays in some places, that could be an option.

Finally, she has been to rest and elevate her foot but she can’t do that at work and apparently can’t not work. So despite two threads and lots of sensible and valid advice, she’s not helping her own recovery and I’m not really sure what else she wants. Except sympathy, and along with most others I’ve given her that but am also being pragmatic.

@ihowlforyou you need to get a second opinion and be signed off work whilst it heals.

I did something similar a few years ago. Ankle rolled, I tripped over and snapped the ligaments in my left ankle. When I landed (belly down) my right knee took the full impact and I lacerated it all the way across. The initial first aid (at the tourist attraction where it happened) was incredibly poor and my knee was infected within a few days.

I was already on a written warning from work over sickness so I went back immediately despite hardly being able to weight bare on my ankle. When my knee was obviously infected I ignored it. I kept ignoring it until I collapsed at work after a few days of being back. I was rushed to hospital with a severe infection in my lower leg and knee. I spent a week in hospital having intravenous antibiotics and treatment to sort out the infection. Luckily I recovered but it took a good six months before the ligaments in my ankle healed and I was back to normal

Hope you feel better soon

Just to reassure you a bit, I had a very bad accident a few years ago and broke my foot, ankle and leg on one side. On the other side, I didn't break anything but had far more pain and very extensive bruising in my ankle and knee. The orthopaedic surgeon told me that sometimes a break is easier and heals quicker with less pain than things like sprains and ligament damage. So it doesn't necessarily mean they've missed anything, it coudl just be that you really hurt yourself. I hope you can rest it a bit more.

Surely it's up to A&E to decide if she should be in A&E?

I remember too some of the advice she was given on the other thread - loads of people telling her not to go to A&E after her fall and get on with work!! Going by your words above, you have an issue with her dramatic etc. It's ok to be that way, but I don't think you are a doctor, I don't think you should tell someone who is clearly struggling not to go to hospital. As I said, that's up to the docs at A&E.

Dunno, possibly because it was all laid out clearly a week ago on her first thread, but she’s name changed and started a new more dramatic one because she was ignoring advice there too and didn’t like it.

Either go to GP for a sick note and stop walking on it, or accept it’s going to take a bit longer to heal.

And my post that you quoted never said she should go back to A&E.

Seeing your update about your headache, feeling cold and also the puss, don’t mess about - you could have an infection that could lead to sepsis if left untreated. Call 111 now at the very least.

I’m a nurse in fracture clinic and this is the advice I would give you
Firstly, tomorrow, go to your Gp, explain the situation and ask for a referral to fracture clinic ( we see much more minor injuries than yours!)
Or go to a minor injuries unit or back to A&E. For an avulsion fracture we would generally give a boot for a couple of weeks.
Do not walk 5000 steps a day! Yes you can mobilise minimally on it but the rest of the time you should be sat down with your ankle elevated higher than your hip ( swelling is just fluid that needs to drain away from your ankle!) and if work cannot accommodate that then you should not be there!!
If you work for the NHS you can not get disciplined for being off sick unless you’ve passed a trigger point, and if you’re manager is saying otherwise you need to involve HR!

That sounds awful, OP. I’m guessing you have reached the point of frustration where your problem solving around it is compromised, and you can’t see a path forward. If you don’t want to do anything about it at the moment, can you just go and buy a boot? See if the additional support and pressure off helps!

So what did they do when you were on your two week holiday, just before you had your fall? Did it all fail and the company go down?

Understandable, but you need to go back to A&E, tell them the pain is worse. Ask for someone to review your xray, based on worsening symptoms and increased pain.
If you are feeling hot and cold and have pus there could be an infection in your knee.
I can see you take your role at work seriously but in this case your health must come first before any workplace sickness & absence policies.
Write that as your comments on the disciplinary if they try to give you one. Good luck.

I just don’t know how to do that without making it seem like I’m challenging the nurse I saw.

You should be challenging the advice given by the nurse you saw!! That’s exactly what you should be doing!! Go back, get the treatment you need, then complain.

It’s very hard to sack people in the NHS and managers really do need patients to complain when they get poor treatment. You could call PALS and ask what to do next as an option if you don’t feel confident going in again.

It’s a shame you’re asking for advice but the advice seems to annoy you.
and you are not speaking up for yourself with the doctors but able to get angry with people on here. Save that annoyance for the doctors who are not taking you seriously. You have the right to treated with respect by the medical profession.

You have had all the advice you need op. No-one can help you if you don't help yourself.

A further xray may show more damage than initially picked up upon or caused by overuse. What about the knee?
She can't get that at a GP.

They haven't tho have they? Not 100%. And things can get worse and mistakes made...... I don't understand why you're dead against the OP going back to get some further help?

Yes, see the GP, as I advised much earlier.

At this point it is neither an accident nor an emergency. Yes it fucking hurts, yes she’s bloody miserable, yes it’d be better to stay off work… but those things aren’t going to be fixed by a trip to A&E.

You have clearly received substandard care which isn’t acceptable, but bloody hell OP this is one of the most frustrating posts I’ve ever read!

You don’t want to go to A&E, you don’t want to call in sick, what exactly do you expect anyone on mumsnet fo do?

Your choices are- stop being a bloody martyr, or carrying on moaning and not doing anything about it and likely end up permanently disabled.

This - I’m a senior NHS manager and you cannot put someone through disciplinary for being off sick with a fractured bone. Nobody in the entire organisation is so needed that they cannot go off sick with a broken / fractured ankle, the wider state of your team is frankly not your concern but a debilitating injury from an unhealed fracture could have lifelong implications on your health. Take time off, rest it properly, call 111 and ask them to refer you to minor injuries or out of hours or whatever is available in your area. You’re not wasting anyone’s time by seeking appropriate medical care.

And no mistakes have ever been made by A&E radiographers/docs? And no injuries have ever got worse through overuse each morning, walking to work? I am also concerned about her knee.. I understand it's a slow heal on the foot but I think when in pain to the point of feeling sick, the OP needs some help. Only painkillers are opioids as anti-inflams slow healing so she should be back to the GP at least and insist on some codeine.

Also, on the NHS website, it says that some people are given a boot, plaster or crutches to aid.

It’s a crack rather than a snap, so does not need to be fixed and set (which is when a cast is used). Call it a broken ankle if you want as it does sound dramatic compared to minor avulsion fracture.

She needs to be off her feet but she won’t, so it’s going to take longer to knit back together. These are the facts.