Monday, 13 December 2010

To Assume Makes an Ass of U and Me

I've listed the catalogue of failure that even my discharged caused here :

and here:

-One of my drug prescribed as tablets instead of injections
-One prescribed in 25mg ampoules that no-one thought to tell me I should only draw up a quarter of.
-Only enough painkillers to last until 5am Sunday morning
-No pharmacy chart to help me keep track of what meds to take and when
-No pager number or ward number in case of emergencies
-Sending me home without checking if my copious bleeding had stopped (despite a new drug they'd started me on carrying the warning " For this reason you should tell your doctor immediately if you experience any of the following symptoms while taking this medicine: unexplained bruising or bleeding, "

You might also remember I'd been asking for a urine test for days,** but on discharge, I'd left a sample in the toilet. In the end I'd got the sample dish myself. When I was discharged, I'd had no idea if they'd actually even checked it.

This morning, I woke up with a raging fever. At first I didn't know what was wrong. I'd been cold and shivery all night, but just assumed it was the icy December frost, not me. This morning, my own sobs woke me up. I had cramps in my muscles and a splitting headache.

I did a wee and the smell actually made my little boy gag. The penny began to drop, and I asked Dave to call the ward to see if they had results for the sample I left. 

You can guess what they said can't you?

Yes, the sample had shown infection. 10 days ago.

No-one had thought to call.

No surgeon will operate on a patient with an infection. If I hadn't called today, but had arrived on the 21st for surgery, I would probably have missed my slot.

Are you all starting to get a picture of patient care here? This isn't a one off, it's perfectly normal. If they can make this many mistakes over a simple discharge, are you not all starting to get really quite frightened indeed?

The ward staff "assumed" I was just panicky. The doctors "assumed" I was just making a fuss over a heavy period. The consultant "assumed" I only didn't want to go home because it made me "panic."

I will keep on, plugging away with the same story I've been telling for nearly two decades, but surely, this time people will listen? Surely this time they'll stand beside me and tell the NHS - "Enough is Enough?"

**I asked for the test because I'd had foul smelling urine for days.


  1. I will say something which will probably be extremely unpopular here:

    Yes, I get that the way the NHS is handled is stressful. I get that nurses are overworked while consultants completely out of touch with reality breeze in for their five minutes of fame and make their decrees - and leave the nurses to pick up the slack and the mess. I get that they're stressed out, have been working for 14+ hours four days a week and it's a total drag.

    But at the end of the day, NHS staff clocks out - they go home, have a beer, bitch to their colleagues and put the day behind them in preparation for their next shift.

    But if you've got an illness, you don't have the luxury. We do this 24 hours a day, seven days a week, on top of trying to raise our children, clean our houses, cook meals, struggle to work, and somehow live. Most of the time, we don't manage.

    It's a job to other people, but for us it's our lives. We get "stroppy" and "uncooperative" because we know how these things affect us and we're trying to make sure we keep going for another day. If we don't, we get ill, it becomes harder to cope and all too often puts either ourselves or our loved ones in danger.

    My mum worked for the Mayo Clinic - I have heard my fair share of hospital drama from her, so I'm not completely out of touch with the plight of people who work for NHS. But at the same time, I don't feel bureaucratic pressure is an excuse for poor care, or bullying tactics, or treating a patient like dirt because they don't understand you've just had a blazing row with your superiors. Chances are you don't know what it's like to fight an illness that is killing you rather unpleasantly either.

    I don't want to point fingers at the nurses as the problem, because they aren't - and I hope nurses understand that in blogs like this. But being dismissed isn't of benefit to anyone. If NHS isn't functioning as it should be, then yes, complaints will be filed and I for one will make as loud a noise as possible so it gets changed. Conversely, I put a good word or ten in for the one nurse who treated me with above-the-board care when I was in hospital as I'm sure he was going to get slammed for not following "procedure" whilst doing it.

    There's got to be a way to change things for the better without either patients getting rightly infuriated about their poor care and tarring everyone with the same brush, and the staff of NHS bristling and refusing to listen because they're tired of being under fire....but hell if I know what it is. Perhaps a bit of forgiveness both ways and a consolidated effort. Or perhaps I'm just tired of idealistic.

  2. Oh my God Sue, I am starting to get angry now, I can imagine how you and Dave and your Mum feel.. This is incompetence at best, in fact I think it is negligent and downright unacceptable.
    I could sob, or scream with you!!!!!
    What now????

  3. Sue, shoudln't your GP have been informed of this infection?

  4. Sue - As if you don't have enough to cope with!

    Oya's daughter

    I completely understand your fury and frustration. You are so right when you emphasise that the patient can't walk away from their symptoms ... and no-one should be put in these situations.... and that we should to focus our anger towards the powers that create those situations.

    There is a desperate need to increase the number of nurses on the ward ... nurses are not being replaced leaving those remaining to do the extra. I know that most nurses are doing unpaid extra hours because they are not prepared to abandon their patients or colleagues when something goes wrong. There is absolutely no slack in the system. The nurses are over-worked, under-appreciated by their managers and many are totally burnt out. These are the perfect conditions for compassion fatigue and these potentially dangerous lapses.

    The anger should be directed to the top of the management tree!

  5. Hi Sue,

    I don't think it is a matter of Nurses being indifferent. There are always lots of patient's concerns that I thought were important and wanted to deal with on my shift that get handed over to the next shift and so on and so forth. Before you know it 4 shifts have passed before that sample is obtained.

    It isn't that a particular patient's problem isn't important. A Nurse with multiple patients has to decide if it is important compared to what else is going on.

    Say I have one patient with pain and she is my only patient. Her pain is my top priority.

    Say I have two patients. One has pain and one has 02 sats of 75% a temp of 39 a BP of 60/30 and a pulse of a 130. Now the second patient is priority and the lady with pain is secondary until I can deal with this other problem.

    Say I have three patients. One has pain, one has sats of 75 a temp a low BP and a high pulse and the third patient has lost consciousness and is breathing 3 times a minute.

    Now patient number 3 is priority, I only get to deal with patient number two after I stabilise patient number three (will have many time consuming orders for patient number three). After I sort patient number 3 I can go back to patient number 2. Once I get her sorted then I can go back to the pain lady. IF I don't get patients 2 and 3 sorted I can never get back to the pain lady. This does not mean that I do not care about her pain and do not want to sort it out, or think it is important.

    Now multiply this scenario by 18 patients and you see where your average ward nurse is. They cannot even keep up with all the information that is getting thrown at them for all those patients. My HCAs come to me with a lot of stuff that deserves attention but does not get attention. It's not because I think the patient is lying, overreacting or attention seeking. Not at all. It is purely lack of time in most cases.

    Bleeding a lot than normal during a period is of course a huge deal. Especially with the kind of meds you are on. But if your HB was stable and your BP was okay I can see the possibility of the Nurse not getting back to it. Really it depends on how your bleeding compares with what is going on with her other patients. If your HB was dropping along with your BP then that would propel you to the top of the line.

    But otherwise I would keep and eye on your bloods, the obs (I hope to god they were at least checking those), put a note out for the doc who was due to review patients etc. We often wait 8 hours for him and he wouldn't come any faster than that as long as you seemed stable. Sick isn't it?

    This kind of prioritizing that staff are forced into is often what leads to failure to rescue in hospital. Failure to rescue is a term you might want to google. It is what happens when a patient's problem doesn't get looked at before it causes them to become unstable.

    Once you become unstable then I can move heaven and earth and get all of ITU down to the ward. Before you become unstable I have to put you at the bottom of the list because of other unstable patients. Failure to rescue is very much associated with staff to patient ratios.

    Sucks. This is why I am pushing for adequate staffing.