To follow on Vic's thread for recent experiences, I just have to get this off my chest...
My mum and dad are in their 80's and live 6 miles from the nearest town in the middle of the fens - their house is 1 mile from the next nearest neigbour down a single track lane.
My mum is 4 years into lukeamia - with the chemo having been stopped when she could not tollerate it (about a year ago) and steroids now stopped also. She has blood transfusions. She also has alzheimers.
Dad could not cope the other week - as she had stopped eating and was very weak - so he rang the GP, who arranged for the ambulance to come and take her to the local hospital. They arrived at 5pm and took mum away and he followed in the car. The MAU staff did nothing, and decided it was a good idea to discharge her into dad's care at 2am (because that was what she wanted) Dad had to take her to the car in a hospital wheelchair, get her into his car, drive 18 miles over unlit country roads, somehow get her from the car into the house (a trip of 20 yards with no wheelchair).
Unsurprisngly the ambulance was called again by 1:00 the next day. She has been in hospital now 7 days.
In total dad had gone 36 hours without food or sleep during this episode - I frankly could not believe anyone would dischage someone in this state into this situation. I have since heard on good authority that patients are often discharged to go home to empty hosuses in the middle of the night.
Sorry to share this - as i know we can all 'have a go' but I would not believe this if it had not happened to my family
Philip
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From: Accident and Emergency Academic List on behalf of Vic
Sent: Fri 3/23/2007 18:42
To: [log in to unmask]
Subject: Recent experiences: Hospitals and the curates egg
To open a new thread. George, my life partner, developed unstable angina 2 weeks ago after only ten days of angina whilst exercising. After waking three times in 2 hours with chest pain needing GTN I got him admitted to the Royal Preston. He had been in there seven years ago when he got cellulites from a cat scratch, and was dreading the dirty wards, hopeless staff and dreadful food. We were pleasantly surprised, the same ward was acceptably clean, the staff were generally kind, considerate and competent and the food was bland but edible. He made the following observations:
Health care assistants serving food with no presentation skills, and no-one helping patients to sit up, move bedside tables etc to get ready to eat. Why were roast potatoes a healthy heart option some days and not others?
Ward cleaners who mop the floor twice a day, but never in two weeks moved the waste bins to mop under them, or mopped behind the open doors.
Personal entertainment units that advertised Internet that the engineers acknowledged didn't work and phones that called out at 10p per minute (calls in were 50p per minute - but that hidden in the small print)
Toilet on the ward that had a faulty ball cock and overflowing cistern for two weeks, and corrosion on a leaking pipe that was never cleaned.
Junior doctors who seemed afraid to touch patients. Doctors who didn't read what was already in the notes. Being recorded as allergic to NSAI's when he is intolerant to them. Nurses who didn't realise firm pressure over the site of the Fragmin injection for six minutes reduced the bruising dramatically.
A physiotherapist who thought helping a patient provide a sputum sample involved asking them to cough after they had walked the length of the ward. My mother was a physio, she could have got a lung biopsy coughed up, let alone a sputum sample!
A delay of two weeks (all in hospital) before the angioplasty (OK, not long, but how much is a hospital bed each day, and how much an angioplasty?)
He was transferred to Blackpool for the angioplasty. Brand new unit, but how does that explain the food being much better, with made, not packet soup, and food that was infected with flavour?
One patient had angina in the night and was given a GTN spray by a nurse - who never then came back to check up on him.
The details of his MRSA status hadn't been transferred over, so he was barrier nursed. He had his own sphyg cuff for his potentially MRSA laden biceps but shared the pulse oximeter probe with everyone else on the finger he picks his nose with.
After the angioplasty he spent the night on a ward that seemed to be staffed only by a health care assistant who didn't know how to adjust the pneumatic cuff he had on his radial artery when it was too loose to stop the oozing. In the morning he was discharged with a single sheet of instructions and a "Go and see your Doctor". He doesn't know what sort of stent was inserted or much else for that matter. Oh, and the barrier nursing was forgotten, even though there were still no results from Preston.
I'm not complaining, I think overall the service delivered was superb. He had a 90% occlusion of the proximal LAD and now he is walking about again. Its just that I feel the service is rough at the edges even when it's good. Alcohol hand rubs and disposable sphyg cuffs are pointless if the same pulse ox probe goes on everyone.
Perhaps we all need to see what the patients see, but do we ever have the time to sit down and listen to them tell us? Patient questionnaires and complaint forms will never pick up these details, perhaps that's why hospital administrators use them, "Only ask the question that gives you an answer you want to hear". It applies to me as a GP as much as it does in hospital I suspect....
Vic Calland
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