What does it really mean to be disabled and have an accident?

Does mainstream medicine really understand the impact on our ability to mobilise? Let me recount from my own experiences.

In 2022 as a result of a poorly constructed council footpath I fell from my mobility scooter and landed on the road. By luck this accident occurred outside a repatriation hospital, and I was quickly attended by staff (nurses) from the hospital, an ambulance was called, and I was taken to the local public hospital.

I was diagnosed with a broken finger and bruised ribs.

Imagine now as an able-bodied person you are suddenly in pain on your left side from bruised ribs and and now sporting a splint on your hand. It’s painful but you are still able to walk around, go to the toilet and do you normal day-to-day living. The pain impacts your life but you are still able to move.

Now imagine you do not have the use of your legs. To move you need to use your arms to push, pull and lift your body around. But your ribs are so painful that doing this at this time is excruciating and impacts on the healing of the injury by constantly having to disturb those injured ribs and finger by using them to move around.

You beg the hospital for help … but a nurse scoffs that you are actually in hospital with a broken finger. Your frustration is such that you whip the sheet from the bed back and proceed to lift up your legs with your unaffected arm and flop them around to prove you are in fact ‘disabled’ and in need of help.

You are discharged with no plan or no assistance on how to mobilise.

Two years later, you have another accident in the hostile built environment, on a step that is not defined with required signage or tactile markers. You have fractured your clavicle (collarbone). After seeking medical treatment, you are given a sling. So basically, taking away your arm so you cannot be mobile at all. And sent home again.

The sling is discarded in the carpark because with it on you cannot get back into the car to go home or get out at home, or basically move at all while wearing it.

These were my experiences.

One of my friends who has no leg function had surgery for carpal tunnel syndrome and was sent home. There is no way a person with a disability can simply stop using one arm and continue to function and yet she was sent home to ‘cope’. The pain for her too was unimaginable and the success of the operation compromised.

I have shown here three situations where the medical system has let people with disabilities down. There are many more. These people are discharged from hospital and with seemingly no duty of after care!

There are lots of studies, reports and information provided to patients about discharge planning from a multitude of sources, NDIS discharge planning, hospital planning and even academic publications like the CSIRO (2024) https://www.publish.csiro.au/IB/pdf/IB23088  which comprehensively highlights the real issues.

A major one is the conflicting need of people with disabilities and the desire to discharge by the hospital without real planning or consideration for the needs of the person with disability at home.

How and why does this occur in a fully functioning health system?

There seems to be a lack of knowledge at the ward level and the clinician level. There is a lack of knowledge about the level of complexity an injury or surgery has on a person with disability’s functionality. A desire to, ‘move patients on’ and free up beds at the detriment of patient care. The lack of advocacy within the health system to assist people to have a voice in their care. The lack of experience at every level of staffing in the health system including allied health working with and understanding the complexity of physical mobilisation of people who are wheelchair users.

Clinicians, it seems are simply under so much pressure that they are unable to follow the logical threads of loss of a limb function due to accident or surgery and how that will impact the person mobility. There is a real lack of expertise and it seems there is unconscious incompetence or lack of capacity to train up to do better.

How do we address this?  More training is clearly required. We need to seriously have more training for clinicians. This needs to be co-designed with people who have experienced the system and the malfunctions within, ie. the system failures.

People with disability need to be able to practically step through an education program that teaches clinicians how failed mechanisms deeply impact the lives of people with disabilities when they are being sent home in pain with no after care.  This results in longer healing times or permanent and ongoing injury because of the lack of care and clinical resources at the onset of accidents and injury.

We have to stop giving a wheelchair user a sling and slinging them out the door.

Tammy Milne is a deaf interpreter, a community activist in various fields and a person living with Arthrogrophosis Multipex Congenita.