The
following is a personal example which highlights the lack of NHS staffing,
inadequate implementing of procedures and blatant ignorance around how to
best meet patients' needs, as well as a refusal to engage with patients families, in particular of those who are very
seriously ill, frightened and in pain.
My sister
died in Farleigh Hospice on 31 July 2013, after suffering unnecessarily
agonising pain and bouts of what I feel was negligence, upon being diagnosed
with cancer on April 2013
at Broomfield Hospital, Chelmsford.
My sister,
I’ll refer to her as ‘Janet’, whilst undergoing a common-place surgical
operation was unexpectedly and shockingly diagnosed with cancer.
Janet was
discharged from hospital - it was agreed that she would receive chemotherapy. Several weeks passed with no sign of chemo starting. In constant pain and not being able
to keep any food down and literally wasting away before our eyes, on
attendance at an assessment appointment at Broomfield Hospital, Chelmsford,
on Wednesday 15 May, Janet took her overnight bag and insisted she
be admitted. She was placed on, the then recently opened, Danbury
Ward. Apparently her notes had either
been mislaid or she had been overlooked, the reasons for which were not made
clear to members of her family.
Sixty-four
year old Janet was a positive person, intelligent, caring, humorous and a
fighter - a business woman - socially engaging and until this illness was
physically building an extension to her house.
I do not
know whether this is typical of NHS hospitals but on a daily basis the level of
care and treatment of patients on Danbury Ward, Broomfield Hospital, in my
opinion, was deplorable. A few
examples:
* Shortly
after admission Janet was placed on a side-ward and we presumed that the
intravenous drip, which had been set-up for her, included nutrients, owing to
the fact that she could not eat due to pain and sickness. She was hoping that in this way she would
regain her strength thus making her physically more fit for surgery. It was discovered by chance, that without any
discussion with Janet, her partner ‘John’, or her family, the hospital had
independently taken the decision to place Janet on what we now know as, ‘The
Liverpool Care Plan’ (i.e. no food, nutrients or water by mouth or
intravenously). She and her immediate family were
very upset and angry and after they complained, staff began providing food for
her - though it was not suitable so her partner and children took more
appropriately prepared food into the ward for her.
* Janet
had various ‘tests’ and was told that as her cancer was not hormone
related she would not have intravenous chemotherapy but would be prescribed
medication in the form of a pill; this was impracticable as Janet could not eat
due to her pain. Her autopsy revealed that
she did, in fact, have ovarian cancer - which is hormonal.
* Cancer
patients on Danbury Ward were being left for over three hours with their
medication drip-feeds empty, therefore without pain-killers.
* My
sister, in great pain, ‘buzzed’ for a staff member several times but eventually
had to struggle out of bed and look for a nurse in order to be given her med.
* This same
nurse in the presence of other staff, on a doctor’s ward-round, accused Janet
of ‘feeling a bit sorry for herself today’.
* A staff
member attempted to take Janet’s blood pressure. This auxiliary/nurse
did not even know how to put the BP sleeve on my sister’s arm - Janet had to
tell her it was upside down. The ‘nurse’ then proceeded to take
other patients’ BP but appeared to write nothing on their charts - finally
walking away with the pulse monitor still attached to a patient’s finger -
almost pulling her out of bed.
*In my
presence, another patient, who had previously waited six hours for her
pain-killers, asked a senior member of staff (do not know her title) if
she would pass on that information to the relevant person so that something
could be done about it.
This staff member
replied, with words to the effect that, ‘it was nothing to do with her’.
* I made several
attempts to speak to the ward sister via telephone but with no success.
* Janet had
severe diarrhoea and although, again, had ‘buzzed’ repeatedly for help, finally
had to get herself out of bed and to the toilet - could not make it in time, then
slipped and fell in her own faeces. A
nurse, on finding her, scolded her for getting out of bed.
* John,
very anxious and upset at the poor management of Janet’s pain, pointed out to a
nurse that Janet needed her medication before meal times, to help her with the
pain related to eating, and that she was not getting her med. until after her
meal, so was unable to eat or even attempt to eat anything - plus Janet was
becoming panicked by the inevitability of her pain. John also suggested to the nurse that it
would make more sense if priority was given to those in most need, as it was
clear that some patients were more comfortable, they were watching TV or eating,
so able to wait a little longer for their pain-killers. The nurse ‘reported’ him to the ward sister,
he was reprimanded and nothing changed. It
seems that only one male nurse, I cannot recall his name, he worked nights,
used his initiative and prioritised patients.
Janet felt relieved each time she saw he was on duty.
* I telephoned
PALS - they were helpful and gave some advice.
On my visit
on Thursday 23 May 2013 it was clear that Janet was in excruciating pain, she
asked that we did not visit again until her pain was managed.
I phoned Danbury
Ward several times after that Thursday, to see how Janet was, also to arrange
to see a doctor. The phone was never answered.
* John,
told me that on one occasion Janet phoned him in tears after a doctor
said to her, ‘Does your family know how ill you are?’
How
irresponsible. Saying that to her
without speaking to one of her family first so we could be
there. It made Janet feel hopeless, plus it implied that her family did
not care or visit, which was not the case.
John
decided to attend Danbury Ward from 9am and sit and wait until a doctor was
available to speak with him about Janet’s care.
He sat and waited, until late afternoon, for two days and it was not
until the third day that someone became available.
Danbury
Ward was clearly understaffed, and some staff were unprofessional, obviously
not adequately trained and clearly had little respect or concern for the
patients. Examples:
*Staff Hand-Over
conducted in public places such as corridors or reception desks. Visitors and patients were able to overhear
the personal details of others.
*I
witnessed two female staff members, on the cancer ward, sitting virtually at
the foot of my sister’s bed, laughing/flirting with a male member of staff who
was standing several yards away, in the corridor. They were discussing their planned evening
out and the menu and how good the food was going to be - within easy earshot of
patients. I find this unprofessional
attitude and lack of respect, outrageous.
For staff to be so lacking in empathy and so dismissive of patients’ needs
usually means they are not being supported themselves, often due to poor
management.
*In the
few weeks Janet was in Broomfield she and her bed must have been moved at least
five times. Shunted around like a piece
of luggage.
Janet’s
family had repeatedly asked that something be done to help her and eventually
she was operated on in the hope of relieving her inability to eat without
vomiting or suffering pain and for a week or so she was able to take food and
keep it down.
On
speaking to a more approachable senior staff member, I discovered that staff
did not know that Janet and her family had only been aware of her illness for a
few weeks and were in a state of shock - let alone trying to come to terms with
the fact she was dying. Either this information
is not included in patient’s notes or they are not fully read by staff.
One of my
colleagues, who qualified in nursing over thirty years' ago, is infuriated
at the decline in basic nursing ability and upset at the reputation this gives
competent, professional NHS hospital staff. She assures me that
unqualified and auxiliary staff are
being used in many hospitals as they are cheaper - also and quite
controversially I imagine, she states that British born and trained staff do
not want to work with foreign staff who have not received UK NHS training, many
of whom cannot communicate clearly in English.
Whilst I
was visiting Janet, a male member of staff - a doctor? Stood at the end of her bed, trousers frayed
at the ankles - shoes with the sole hanging off, attempting to tell her
something. His English pronunciation was
so poor I could not understand him and Janet had to ask him several times to
repeat it. We finally understood, he was
telling her they ‘could do nothing for her’.
What a way
to tell someone they are dying.
The family
contacted a private consultant with a view to referring Janet on and requested
that a copy of her notes be forwarded to the consultant. I did not hear this conversation but I am
told that Janet’s family were refused copies of notes and informed by
Broomfield staff that they would have to go through Broomfield Hospital lawyers. One of Janet’s family mentioned contacting
the media - that seemed to have resolved the p
Janet
was discharged, it was clear she was dying, in severe pain and in no fit state
to be at home. Even her local GP was
shocked when he saw her condition on discharge.
However, this same NHS GP refused to process a prescription, which the hospital
had given Janet, for Paracetamol suppositories, as at twenty-five pound they
were ‘too expensive’. John had to drive
all over Essex to find somewhere he could obtain them. I found Paracetamol suppositories being sold
on a medical provisions website for five pound.
On Janet’s discharge from Broomfield, as far as I am aware, no support
was in place other than a MacMillan nurse.
No practical help was offered - her family bought her a purpose-built
bed and John was her lone-carer until she was re-admitted to Broomfield, then
finally discharged to the hospice
I do not
think the answer lies simply in private care. I have worked in
hospitals as both medical secretary and mental health therapist. My experience leads me to the conclusion that
whether private or NHS, all staff need a higher level of training, with
regular, independent supervision (i.e not by their own line-manager). All staff also must be able to communicate effectively
in English. But, as I
wrote in my letter to Secretary of State for Health, Jeremy Hunt, if the National Health Service
continues to be less about patient care and more about saving money and
box-ticking, then sadly, nothing will change.
