Tuesday (early hours of the morning) -The response to my 999 call was first class. After an hour or so in A & E my wife was transferred from a bed to a chair because of a shortage of beds and was subsequently moved to the Medical Decision Unit. At one point patients on ambulance trolleys were queuing in the corridors!
My wife remained in the chair for 7 to 8 hours before a bed was made available. During this time the portable oxygen cylinder ran out and as there was no replacement she was crammed between to hospital beds to get access to the ‘piped’ oxygen supply. This resembled a corridor the width of a chair and frankly bordered on a shambles. Once settled in bed a drip was rigged up, a length of bandage being threaded through the loop of the plastic container and hooked over the end of the curtain rail - No drip stand!
The following morning (Wednesday) I was asked by a nurse if I could bring in two of the items on my wife’s prescription because they were not available from the hospital pharmacy. When I returned to the hospital I gave the tablets to the nurse who taped them to the Medication Chart. That morning I learned my wife was to have an Ultrasound and when I asked, when, was told ‘when a porter turns up’. At this point I decided to talk to Pals (Patient Advice & Liaison Services) who subsequently put me in touch with the A & E Matron. I explained my concern at the apparent haphazard way things were in the Department. What appeared to an outsider as being chaos was typical of what happens in A & E it seems. Many of the problems stem from the fact that you cannot close the doors to A & E which means unless you can maintain a steady flow of patients through the system and out the other end chaos will ensue. To get patients out the other end, in many cases, you need beds and they are simply not there.
That afternoon the Matron, on checking, assured me the Ultrasound would take place at 10am the following morning – in less than half an hour of making that statement a porter arrived to take my wife to have her scan - perhaps there was a cancellation! After the Ultrasound my wife was seen by a doctor who said it would be about 2 hours before the scan results were available. 43 hours later I was advised the results were NAD (Nothing Abnormal Denoted).
On Wednesday evening my wife was transferred to the Medical Assessment Unit (MAU) and later
that night she was transferred to XXX Ward. My daughter visited the hospital at 9.30am on Thursday and when I arrived at approximately 10.15am she was walking the corridors looking for her mother! She had reported to the MAU and told that Mrs X was not in the area. It transpired that no one seemed to know my wife had been transferred to XXX Ward and that in effect she was temporarily lost! A number of staff was involved in tracking down my wife’s whereabouts and soon my daughter and I were reunited with Mrs X.
During the afternoon I asked the nurse dispensing medication whether she had the tablets that had been taped to the Medication Chart. She said no and that she had ordered the necessary medication from the hospital pharmacy. I responded by saying ‘this morning you lost the patient and now you have lost the medication I had specifically been asked to bring in’. Before leaving the hospital that evening I checked for the results of the Ultrasound and they were still not available.
I arrived at the hospital at 9am on Friday and requested to see a doctor who hopefully could give me the results of the Ultrasound. Two and a half hours later I met a doctor who was debating whether he should take responsibility for my wife or whether another chest specialist (who my wife had seen as an out-patient some 9 months previously) should be involved. This doctor said if my wife came under his care he could tell me anything from this point onwards but could not comment on any matters arising before this time. That afternoon my wife had a CT chest and abdomen Scan and I was told the results would not be known for 24 hours. I telephoned the hospital at 12 noon the following Monday and was told the results of the CT Scan were still not known. Five minutes after that call my wife telephoned to say she could come home. I went to collect her and again enquired about the CT Scan results. When I was told they were not known I asked whether it was right for my wife to be discharged without knowing the outcome of the Scan. The nurse said Mrs X had not been discharged and then queried it with her. My wife explained that a doctor, who she had not seen before, had said ‘Would you like to go home’ to which she said ‘yes’. The nurse went away and on returning said yes it was alright to go home and that the CT Scan was NAD!
Between my wife and I we survived the week but it certainly was not without incident! I have total admiration for many of the staff but there are fundamental issues that need to be addressed and in my view a starting point would be to listen to the Matrons etc who I am sure can see ways for improvement and who are doing their best with the resources provided.
It appears to an outsider that:
- The records held on a patient in a variety of handwriting and umpteen pieces of paper could lead to inefficiencies
- It is easy to mislay a patient
- It is easy to lose a patient’s medication
- The hand over procedures from one medical team to another is inadequate.
- Full time Staff dedication is difficult to maintain when Agency staff are paid substantially more for similar work.
- The cost of Agency staff could be diluting the available funding for necessary expenditure in the hospital.
There's a lot to think about here for the politicians who will be in charge of the NHS over the next few years. This is one anecdote, but we've all heard others. Are they representative of what hapoens in hospitals each day? I'd like to think not, but if they are, there isn't a politician in the land who can truthfully say they can turn this round quickly.
National targets have a lot to answer for. But in the end, this chaotic situation is the responsibility of local NHS managers to sort out.