Would you speak with the GP practice manager?

[lorelaineblu]

My 11-month-old daughter has been unwell for a month. She had severe UTI and was treated in hospital for a week whilst we were abroad. Once we came back to the UK, she developed gastrointestinal symptoms and then tested positive for COVID. She seemed to recover from COVID, but then she developed severe conjunctivitis, which I had to clear every hour as she could barely open her eyes. She had fever again and her cough became so bad that she coughed up blood on a few occasions. I went to the GP yesterday, and a paediatric nurse briefly saw her, saying she was fine and that I just had to continue cleaning her eyes with hot water and salt every hour. I insisted I wanted something more such as drops as we could not go on clearing eyes like this, she was getting dry eyes and proper scabs under them. It seems that in UK no one wants to prescribe anything at all which is really weird to me as surely some drops would not damage her, in my country the paediatrician used to give them to us and we’re all alive and functioning well. Anyhow, I told her about the rash on her back and face, but she didn’t even check it, she was just playing with my child whilst taking her saturation saying how cute she was and forgot to check her back and body. She seemed keen to fob us off and sounded quite patronising in telling me kids get sick in winter, quelle surprise. Whilst nearly at the door I asked her to take her temperature, and she confirmed that she had 37.9. She said it was fine, quickly telling me that fever is just a number as long as they drink, and that I could send the child to nursery if I wanted to, as they can’t tell me to hold her back with conjunctivitis. As I have other children and I care about other people’s kids, I thought surely I wasn’t going to send my child to nursery with that eye infection as she was literally covered in yellow discharge. Last night, my daughter started coughing badly and coughed up red fresh blood again, so I decided to go to A&E as it didn’t look right. Her eyes were red and raw. They had to run a few blood tests and found vitamin D deficiency and high infection markers, and they wanted to rule out a few nasty illnesses. She was so poorly she could barely look at me. They confirmed that, on top of coronavirus, she has slapped cheeks (5th disease), and that the conjunctivitis needed some ointment, as only hot water was making her skin sore. I am now very annoyed that every time I go to the GP practice I come back with nothing. The lady also made me feel stupid, as if I was too worried. I am also thinking about that stupid statement about fever, as my daughter had up to 41 degrees in December when she had UTI and she was drinking and eating. Despite that, she had to be admitted to hospital for a week, as otherwise it would have turned into a kidney infection. I am just so annoyed at this paediatric nurse, as she was bloody patronising and didn’t check my child thoroughly. A&E discharged me, saying to keep her at home and keep an eye, and if the fever was spiking again to bring her back. They'll call
me today to give me further answers on the blood tests they’ve run, which required more time. Would you just have a call with the practice manager to discuss the situation?

I would put all your concerns in writing, as concisely as you can, and send them to the practice manager. Make each issue (e.g. disregarding fever, telling you to just use water to clean DD's eyes, missed slapped cheek, patronising manner) a separate item in the list. Ask for a response within a certain time e.g. seven days.

It's not about blame (you could say that) but the nurse needs to be told about her errors so she doesn’t repeat them.

i hope your DD recovers soon.

So it was decided to be viral, and thus antibiotic drops would have been pointless? The bit that sounds worrying is the coughing up blood. What did the nurse say about that?

Practice manager? I would be speaking to my lawyer. These people are killing people, dont let them get away with it

Did you tell the nurse about the coughing up blood?

How long has she had conjuctivitis?

Did you ask her to look at the rash?

For what purpose. To pay them
to write a letter which the OP can do themself.

Agree with others, write down the whole list and order of things that happened and yes discuss and present this to the practice manager for review.

Future reference u can buy drops for conjunctivitis at a pharmacy if u want to xx

Yes I did mention the blood, that’s why I booked an appointment for the same day and also told her about the rash but she was so rushed that I could not fit a word in. It was all it’s fine it’s winter, they sound like smokers these babies during winter. Conjunctivitis was going on for 5 days. Her eyes were so red that she could barely open them but they said it’s viral and it will go.

The coughing up blood is concerning but she has been examined by doctors at A and E and been discharged.
Conjunctivitis is usually viral so eye drops wouldn't have helped and slapped cheek syndrome is viral too.
I would speak to the practice manager about how the cough should have been looked at by a GP, but other than that it's just been unlucky that your child has had a run of childhood illnesses that has made them feel rotten, but there isn't much you can do to treat them other than home care, paracetamol, fluids, rest.

You mention that you are from another country - I've worked for parents of many nationalities as a nanny and I have noticed that there is a huge difference between what different cultures expect from primary healthcare. I worked for one family and the child had a bad cold - green snotty nose and feeling pretty sorry for himself. It was the sort of thing where you would give them a dose of Calpol, plenty of fluids and sofa/TV time. The parents insisted that the child went to see a paediatrician rather than a GP (as that was the norm in their country) we had a half hour appointment and came out with a carrier bag of medication, including antibiotics, which went on to give him diarrhoea and nappy rash, which was probably worse for him than the original cold. It still took a week or so for the cold to clear up, same as it would have done with no medical treatment.
I'm not saying one approach is better than the other, but some cultures think they are doing the best by throwing every medical test and medicine at the patient, whereas others have a more of a watch-and-see and treat at home approach. The UK is definitely the latter.

I agree every culture is different. I would not have given antibiotics unless prescribed. My point is, why concerns have to be dismissed so quickly without making sure that a proper differential diagnosis is done, which helps in ruling out other illnesses before saying it’s fine. That’s what I was taught at university. It’s the patronising and superficial attitude of ‘you’re a parent so you’re naturally anxious’ I am not comfortable with when it comes to fresh blood in the cough together with a rash. I think it’s only fair to expect from doctor a slightly different attitude. As a parent, I felt it was important to check whether there was not something nastier going on. Moreover the wait and see approach might save resources in the short term but it generates more cost down the line as people have to deal with complications that might be prevented with the above mentioned differential diagnosis.

Everything was viral though. Just bad luck. No medication could have solved these issues.

what exactly do you hope to achieve