‘I don’t think they care’, was Hubby’s summation of the nurses behaviour, I just think they are thick.
Yes, we have just returned from visiting son. He has been vomiting, he is not eating and is hardly drinking. All his tubes have been removed and he is on his own, as are the other patients in his bay. In the 5 hours we were there the staff spent a total of 10 minutes in the bay, they served dinner, they did a drugs round and they conducted a temperature, blood pressure and pulse check and during those times I didn’t hear them ask one question. The man in the bed opposite son vomited everywhere, as he started being sick son rang his call buzzer, I put on gloves, grabbed some tissues and helped him out. Another visitor found a bowl, as he had filled the first and I cleaned the patient up, made sure he was comfy and then found a nurse. I gave her the full bowls, and that was that. No one came and checked on him, they obviously weren’t concerned. Meanwhile son said that he hadn’t passed urine for 7 hours, since his catheter was removed. I asked if his bladder felt full, no. Looking at his fluid balance chart I noted that it hadn’t been completed, neither had his stoma chart. Twice son was sick, deep green and 500mls each time, I know because I measured it when I took the bowls to the sluice. I told the nurses, they were not impressed and neither did they feel that it was necessary to come and check that son was okay. Hubby went out and found a doctor. She was the cover for the weekend and knew nothing about son but said that she would read his notes. DIL came in, looked at son and burst into tears, I knew how she felt. I went out to the nurses station, and waited. The doctor came up first and I outlined my concerns about the lack of communication and asked to see son’s care plan, there isn’t one. Okay then, I asked to see the nursing care plan, same outcome. A nurse scuttled past so I spoke to her, she ignored me so I followed her and suggested that it would be better that we spoke in the corridor than in front of the patients. I told her that I was concerned about son, she told me that he was fine. ‘Oh, good. When did he last PU, and how much? How much did he vomit? How is his stoma and what are the contents? Have you requested that he be prescribed new analgesia since his PCA (morphine) was discontinued? Where is his care plan and fluid balance chart. Has his wound seeped at all? Are you aware that he hadn’t yet PU’d?’ She had an answer for that one, ‘It’s not unusual not to pass urine for some time after a catheter has been removed’. ‘Really, for 7 hours? Wouldn’t you want to check if they had a full bladder? If it’s not full wouldn’t you be concerned that they may be dehydrated or that the kidneys were not functioning? ’. ‘Well he told me to remove the catheter, he told me the doctor had said it could come out’. ‘WHAT? YOU DID IT BECAUSE THE PATIENT TOLD YOU IT WAS OKAY? IT WASN’T WRITTEN IN THE NOTES?’
Suddenly the cavalry arrived, the doctor had called her registrar to attend. Hurrah. It was all systems go. Bladder scan revealed 70mls of urine, that is giving an output of 10mls per hour, the average is about 30 – 40 mls per hour, son is either dehydrated or there are problems with his kidneys. I favour dehydration as the cause, but bloods have been taken for kidney function and also to rule out infection. Fluids, with a potassium additive have been commenced and an abdominal X-Ray has been requested.
At last, we have action. I’m furious with the nurses for failing to keep the records which should have alerted them to problems. I’m amazed at the surgical teams lack of a care plan, where is the continuity and how is a stand-in doctor supposed to provide the best treatment? I feel sorry, and concerned, for anyone on that ward who does not have an advocate as we timed how long it took for a response when a call bell was rung, 40 minutes, unforgivable, inexcusable and dangerous. On Monday I shall be having a chat with Matron.
I am so glad that you were there and had the medical jargon to name them – sure for the average Joe they’d probably not have made the call for the registrar.
I hope Sunday is a better day for you all but come Monday that you get to ‘seriously kick some ass’ with this regime….
I have just come across this blog, and the really moving story of you, your son and DIL and the ‘care’ that he is getting. I’m so so sorry that you are going through this.
This story chimes in with what some of my patients tell me. What is nursing and doctoring coming to?
It wasn’t like that when I was a hospital doctor in the late 1970s: keep blogging, please – the story needs to be told.
The Jobbing Doctor.
This is appalling. I think it’s good that you’re keeping a record, I hope some good comes out of it and they have to smarten up their act.
Keep it up – hopefully your involvement will help make what appear to be essential changes.
What a disgrace this is. Honestly, I really do think our country is the third-world of medical care. Isn’t that shameful?
Harrowing reading ! I kept notes when My Husband and Mother were in hospital. (I couldn’t keep up with all the incidences of lack of care, mistakes etc.) God help the patients who do not have someone with the knowledge of good practice to root for them when they are in such a dangerous and vulnerable situation.
We nurses uses to pride ourselves in being observant, spotting problems, ensuring care,comfort and cleanliness.
How can we get the Staff back circulating on ‘The floor’ and away from ‘The desk’
Keep at it for your son. If more people did this perhaps the BUCK UP message would get through.
Your son is lucky that he has you there, and you know what you’re talking about. The other patients there probably aren’t so lucky. I hope he recovers soon and can get out of there.
mumof4 – Thank you for all your comments and good wishes. Time for replying has been limited! This morning son phoned and sounded so much better, we’ll be visiting later and hopefully my update will be as positive as he sounded.
I feel a crusade coming on, I anticipate a brick wall but I won’t know unless I try.
The Jobbing Doctor – I am appauled by much of the care. There is one ‘true’ nurse on that ward but unfortunately she has days off!
I know that uch has changed since I trained as a nurse back in the 70′s but there are some aspects of the medical and nursing process which cannot be ignored, but are. What is the point of having someone in hospital if the nursing care is scanty and there is no communicable plan?
I labelled the nurse as ‘thick’ as she genuinely did not appear to be concerned about her ignorance of the patients well-being or able to appreciate the connections between the removal of the large intestine, reduced urine production, vomiting, unproductive ileostomy and decreased fluid intake.
I have made no friends with the staff of that ward and done nothing to enhance their opinion of midwives!
This is just awful, words fail me. It probably needs a crusade to knock those brick walls down, this just cannot go unchallenged. Above all, I really hope your son recovers soon.
Disgruntled – The really sad thing is that I was so positive about everything at the start of this saga.
Punctuation – Help, I’m turning into my Mother!
lol. Not a bad thing under the circumstances! Perhaps you should threaten to bring her along – they’re bound to have heard of her!!!
I can’t imagine this happening to another family, where someone wasn’t medically-oriented. Sounds like you have the situation under control. Good.
I hope he feels better soon.
Rookiegran – Nursing care is one area which definitely hasn’t improved over the years. People point at the increased education as part of the problem but that cannot be the case as otherwise they would be able to make fairly easy links between the necessity of ensuring, and recording, certain observations and then what to do if they saw deviations.
Vic – The moral is, don’t go into hospital unless you have a visitor who has read up about your illness/operation and is happy to put on gloves and an apron!
Cartside – Thank you. I’m determined that despite the hospital my son will recover.
punctuation – I’m saving her for emergencies.
Lisa – The laugh is that I’m a midwife, and apparently we don’t know how to nurse.
Please let me join the throng and say how horrified I was to read your son’s plight – and glad he’s recovering.
May I presume to offer you some counsel, won by hard, painful experience?
At least consider taking photos, video and audio of each and every phone and face:face exchange with NHS staff and hospital conditions. Especially if you feel that it may have to go to complaint (and you can never tell what twists and turns may lead that way). I can’t stress these two things enough:
1. Once it goes past the clinical, the admin and managers are exceptionally duplicitous and will perjure themselves to convince you that they didn’t say that or the other in their efforts to cover-up. Unless you keep scrupulous and meticulous records you’ll think you’re going round the bend.
2. How extremely disappointed and shocked I am that one has to do this.
Deb
Oh I’m so sorry this saga is so awful. I am horrified to hear of the dreadful conditions your son and the other patients on the ward are having to suffer. It is awful to think that there can be so many people working in the “caring” industry who really don’t seem too care at all.
Good luck with your crusade. I sincerely hope they all recognise that validity of your comments and act upon them. Fight the good fight!
Deb Acle – Love your blog – extremely informative.
Having visited son this PM I have to say that today the staff have taken my concerns on board and the difference was amazing!
I shall still go and speak to the matron concerned as the problems have been so pervasive, encompassing every area, that the behaviour must generally be the norm
Lucy – My ‘fight’ starts tomorrow.
I sympathise with your post/concerns – but I clicked a “possibly related link’ in your blog…
“AM I NOT A NURSE?” from June.
I know that every relative has the right to say anything to the nurses that’s taking care of their relatives. I mean, if I were on their place, I will also be concerned about my own family member in the hospital. What I don’t get is why some relatives tend to become so all knowing that it’s almost as if they’re already telling the nurses what to do.
Do you think it possible this son had been in and sat with dad when those same/similar nurses had ‘nursed’ him the shift before? I think he and you have as much right to request what you see as being important – regardless of technical knowledge – and to be given a satisfactory outcome, even if that only requires an explanation of circumstance. He was not a nurse.
In this example tho – I think explanations will be no more than excuses and I’m sure you’ll tell/told Matron how it is. This, as you describe it, is awful care and I hope you bring change.
Good luck
Mr Ian – After your comment I read the ‘Am I not a nurse’ and I could empathise with both the nurse and the relative. The nurse was obviously annoyed about having his nursing abilities and dedication questioned, whilst the patients son was concerned that his Father would not be receiving the same that care he was used to, he felt responsible for his Father.
I had been unhappy with the care being provided for my son the day before but I had decided to wait and see if it had just been due to ‘oversights’, then on Day 4 it became obvious that something, somewhere was wrong to the extent that I was worried about the welfare of the patients I had been helping.
Although I am upset by the oversights of the nurse involved I cannot lay the blame for lack of response at her feet, the lack of structure on the ward did not enable her to make the necessary connections which would have alerted her to any medical problems.
[...] them leave until DIL had provided 3 large pans of urine, routine when someone has been catheterised (unless you are on the ward son was on) but eventually her urine production passed muster and we could transport the new family home. [...]
I’m sorry to hear of your experience.
Alas your example is not the first I have heard. Thank you for your honesty.
Never does anyone feel so powerless when so sick and in the hands of supposedly experienced healthcare professionals. In the last year I have heard from the mouths of a few nurses their horrific experiences through being hospitalised in my country.
With hearing this I finally didn’t feel ‘alone’ with also being treated so appallingly. I used to think it must have been just me. Now I know its the staff’s own issues that cause them to neglect or abuse a patient. The ones who sand up like you have are the ones who may save somebodies life in the future.
I hope your son is doing o.k now:)
[...] from a family of nurses, and he compares and contrasts the past with the present as a response to this blog post by a [...]