Day Two

It is difficult to believe that an 82 year old woman in day two of a stroke, unconscious, mute and incontinent, could be ignored by a ward full of nursing staff for over 4 hours at least,  but, my friend, that is what happened. This blog was intended as a chronicle of the journey of someone who cares about a woman experiencing a stroke: stroke is not talked about enough, the support for people who have had strokes and their circles of support is thin and arbitrary. My intent was to offer support and insight, not to criticise, to have a conversation with you about stroke and its effects. But…..but…..but…..it is hard not to be critical after the experiences we have had within a 48 hour period. I will walk you through it……brace yourself.

Once I had recovered myself from  the shock of watching Stroke inhabit my Mother, I did the usual things, bought some new nighties and Simple toiletries, bought the trusty Telegraph to keep me company, packed my sketching things, and set off for the hospital to keep Mother company and get up to speed with her condition. My eldest daughter, who works in a Nursing Home, came with me, and I made sure to take a photograph of Mother with my late Father to reinforce her as a human  being with her carers, and plenty of get well cards ditto, which would be displayed on her locker. Arriving in the early afternoon I discovered my Mothers nightie, in which she had arrived at the hospital, soaked in urine and stuffed in one of the drawers in her locker. I recalled the efforts, detailed in my first post, I had expended trying to establish a continence care plan with the nurses the day before………. I checked her charts: the aspirin she had been due at 08.00 had yet to be given by mid-afternoon.   She had a chest infection and was on antibiotics – the aspirin was not a luxury. I was concerned, but not yet angry – I understand the pressures on time on a busy ward, and have some sympathy for overworked staff, as you will know from my previous post.

My daughter and I were chatting to my Mother, who slipped in and out of consciousness and did not respond at any point – but we kept up the gentle chat, as you should do. We sat by her bedside, arranged her cabinet drawers, read the papers, chatted with her. After a couple of hours she had had no nursing attention whatsoever – none, nil, nada, zip. It may be difficult to believe that a vulnerable 82 year old stroke patient with a chest infection was effectively ignored by an entire staff of nurses, but that is how it was, and how it stayed. My daughter and I, unable to comprehend the neglect and unable to get the attention of the nurses – when they did appear in the bay, infrequently, they looked distracted and when asked a question replied that they “were not at this end” or “don’t usually work this ward”and shimmied off, and when eventually at a much, much later time I found someone who worked at this end on this ward she was unable to tell me the name of my Mothers consultant or the result of the chest X-Ray she had had that morning and continued to fail to offer any physical nursing – we decided to check Mothers sheets and clothes. We found her continence pad in the wrong place so that it failed to collect any urine passed, which also meant that her sheet was soaked and sticking to her vulnerable skin, for which she had not been turned to relieve pressure. We washed and changed her and her sheets, replacing the pad in the correct place and trying to make her comfortable. We struggled with the electric bed without any assistance from nurses who ambled past and when we asked for a clean sheet we were offered no assistance or support and not asked any questions, and no-one appeared to notice that my Mother was still being neglected by those paid to nurse her.

My daughter and I were in shocked disbelief at the staggering casual neglect. I waited, politely asked to speak to a nurse, waited, asked to speak to a nurse, waited, waited, waited, waited. Eventually, about four hours after we had arrived and during which time my Mother had been entirely and thoroughly neglected by staff, I stalked and held on to a nurse in dark blue, who it appeared was the Ward Manager -I had checked the picture board, as still no-one had yet introduced themselves to me or to my daughter. Courteous and pleasant throughout I asked her why my Mother had had absolutely no nursing attention in the four hours we had been there, and of course we could not know how long she had been neglected prior to that, although the urine soaked sheet might give us a clue. I pointed out, politely, that she would still have been lying immobile and mute in that soggy sheet if my daughter and I had not, in desperation, changed it two hours previously. I asked how I could know if my Mother was turned and washed, had any mouth care as she is nil by mouth, had any continence care or planning, received her medication, and had medical reviews as the only chart in existence, the meds chart, indicated that she was already neglected and had not yet had her 08.00 aspirin and it was now nearly 18.00 and in the four hours we had been there none of those things had taken place. Ward Managers answer was that I should understand that they were short of staff, it was a bank holiday, she shouldn’t even be there herself, it was a busy ward, and that they were very very busy. Still politely, I explained that that was not my problem, and that her job was to manage things so that an 82 year old vulnerable unconscious mute woman received the nursing care that she needed and was not entirely neglected for over four hours at least. I asked why there was no care plan and no charts. Her reply, unbelievably, was that they were not used because they were not a requirement. Quietly, and politely, I pointed out that the evidence seemed to indicate that they were in fact necessary if only to prompt the nurses and assure us that nursing was actually taking place  – although given the level of engagement shown so far I am not confident that they would be read anyway.

Just to be clear, as I find it hard even now to comprehend: we were there for over four hours during which time not a single nurse offered my 82 year old vulnerable unconscious mute stroke victim Mother any nursing care whatsoever. No turning to protect the skin, no washing, no pad change, no mouth care, no sheet change, no aspirin which should have been administered at least seven hours earlier, not even any casual checking , no kindness, no words of comfort. There were no charts to record any care that might have been offered so no way for successive nurses, had they chosen to check, to know when care was last given.  No-one introduced themselves to the people by the bed who happened to be the daughter and granddaughter of the person they were being paid to nurse and who were still struggling to absorb what had happened and no-one offered any information, comfort, or even an idea of where one could get a cup of tea.

I believe we are in the year 2010. I believe we are told that the NHS is in reasonable shape. I believe nurses think they do a good job, according to their representative bodies who take all opportunities to say how short staffed and undervalued nurses are and how they work hard and deliver. My experience of the past 48 hours tells me that nothing could be further from the truth. I have witnessed the casual abject neglect of a vulnerable elderly woman, been subjected to discourtesy and flannel, and left despairing that any crumb of care or humanity might be left lingering on hospital wards. My daughter pointed out that if she or her colleagues in the private sector behaved in such a way they would be in some deep trouble.   I have personally sacked people for less. These people should be ashamed to claim to be nurses, should hang their heads low and reflect deeply on their purpose.

I said earlier in this post that, at that time, I was not angry, just wanted to find out what was happening and extract the best care for my  other. Well, I am now angry. Before I left the ward I explained – always courteously – that I expected a chart in place to demonstrate the care given, and that I expected the care to actually be given. Another dark blue uniform clutching a chart destined for my Mothers bedside told me, yet again, that they had been short of staff, very busy, that actually the nurses there were very good. I will say that again: she really did tell me the nurses there were very good. Astonished, I ran by her again the catalogue of neglect I had just witnessed and patiently explained that I had absolutely no confidence that my Mother would be nursed effectively. Given the evidence of our own eyes, nothing she could say would restore that confidence. After I had managed to pin  down the dark blue nurse, miraculously two nurses did emerge to offer some basic but quick care to my Mother, changing sheets and using a suction machine for her – if I had not collared the blue nurse I am absolutely certain this would not have happened.

I cannot believe that my experience of the last 48 hours is unusual or unique – the evidence so far points to it being all too common and all too accepted – none of the nurses appeared surprised by or ashamed of the neglect, it did not seem to impact at all.  I will continue to post. Let’s hope next time I have something more positive to bring to you. My fears and shame about leaving my Mother with strangers was appallingly accurate. Who do we trust if we cannot even trust people with the word “care” in their job description?

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9 Comments on “Day Two”

  1. Andrea Evans says:

    Oh my God! I get frustrated where I work but that is horrific! You have brought up a load of issues that we fight on a daily basis! That one about “I’m not on this end” makes my blood boil. Fair enough if you don’t know the patient but find someone who does!!!! I could say, is your mother on a pressure mattress, has she been referred to SALT, and why is there no Care Plan??? Would love to know what proof of care that hospital has if they ever have to go to court! It really is embarrassing! I have found that ward staff often resent family members who have medical experience which is very wrong. Normally though it does tend to keep staff on their toes but obviously not in your case. I have just come back from work and had to deal with a really stupid situation today that made no sense to me. Will message you with that one! In the meantime I am really hoping that the staff are getting the message from you that you will not put up with their lack of care. And, I would have offered you a cup of tea and a meal voucher for the restaurant if you were on my ward!!

  2. Claire Jones says:

    Bernie that is just awful, and brings back memories of the early days of my grandmother in the acute hospital after her stroke. We also were greatly concerned especially as she was so out of it she couldn’t make a fuss herself, and we worried so much about what was not happening when were not there. Thankfully she was moved to a stroke rehabilitation unit within 3 weeks and things got much better and she got the care and attention she needed. Please please please complain about it, if you don’t nothing changes.

    • Thank you Claire. I am so sorry you have also had to face this kind of thing. The word you used, “fuss”, sums it up for me: it feels like we are making a fuss, when all we are doing is ensuring that we are included in this part of my Mothers life and that she gets the right nursing care. It shouldn’t feel like a fuss, it should be a natural part of the caring process. The energy it is taking just to keep on top of it and do the nurses thinking for them is phenomenal. But your support and good wishes are so much appreciated. Thank you.

      • Claire Jones says:

        You’re absolutely right – you shouldn’t have to make a fuss, but if you don’t…….Not how it should be at all. Quite an eye opener.

  3. Akin Thomas says:

    Hi Bernie

    Firstly thank you for sharing this. I’m really sorry that your mother and you have had to experience this. I wish I could express surprise, but unfortunately I can’t. This is a very powerful story that needs wide coverage, for those who will follow you and your mother.

    ‘m currently developing a very innovative training solution on patient experience and I would like to use the themes of your experience (no details will be given), has part of the training experience for NHS professionals. Staff can’t hid behind, this wouldn’t happen here, because clearly it could. Would you have any objections to this. Happy to discuss in more details

    Akin

    • Hi Akin – I would be happy to have a conversation about it. I am clear that, while this particular place has allowed exceptionally poor practice to develop and should be challenged, there are many other places and people who would not tolerate it and have managed it well. If I can support that in any way I would be happy to do so. Thank you – for your good wishes as well as your comments .

  4. Ailsa says:

    I’m so sorry to hear of your experience. My father is currently in hospital having suffered a stroke & I came across your site when looking for info.

    It’s disgusting the way people are cared for.

    I think many people out there feel the same.

    X

    • Hi Ailsa, thank you for your comment. I am sorry your Father is unwell – I hope he recovers and receives the treatment he needs. I am thinking of you and of him. My experience – more importantly my Mothers experience – was indeed appalling, but there are other places that offer much better care and support. It is, unfortunately, a “lottery” as to what service you get. I have had some contact with the hospital featured in my blog and will be updating the blog soon. Sadly I have been unable to focus on it recently because my Mother died and we have had repatriation, funeral and estate matters to manage. But the services offered to people who have strokes matters so I have not gone away!! In fact, our local MP became involved, so there will be much to catch up on when I get back to the blog.

      Thank you for taking the time to comment. My best wishes and hopes go to you and your Father.


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