“No room at the inn”: my Christmas with the NHS
03 February 2017
Christmas cold
My father became unwell in the weeks running up to Christmas. He presented with the symptoms of a normal cough, and due to the time of the year and many such coughs and colds around, and due to the fact he is normally fit and well, it was originally believed that he just had a normal ‘virus’ which would pass.
However, due to breathlessness when walking up the stairs and feeling generally under the weather, he visited his GP who prescribed basic Amoxicillin and advised it sounded like a chest infection. Due to the fact my father had had a DVT about 4 years previously, the GP sent him to hospital for a precautionary chest x-ray. The x-ray was carried out just after Christmas and we were advised that the results would be back to the GP ASAP. They never arrived.
Probably pneumonia
The antibiotics came to the end of the course with not much improvement, so my father visited the GP again. At this point he was advised that his chest sounded a lot better and therefore no further antibiotics or treatment were needed at that stage. However, he still felt unwell and so he visited the GP for the third time. More antibiotics were given with a view to returning after the weekend if there was still no improvement. It was identified at this time that he was probably suffering from pneumonia.
Unfortunately, he did not have a chance to return to the GP. On the morning of Saturday 7 January my father collapsed immediately upon getting out of bed and starting to have strange ‘seizure-type’ episodes. My mum called the ambulance and the call-handlers stayed on the telephone whilst he came around and was more comfortable. She was advised at the time that there was a large backlog of calls but that they would prioritise this. She waited about 90 minutes with my father having small ‘seizures’ throughout that time.
No room at the inn
When the paramedics got to the hospital we met the ambulance and were amazed to see ambulances all lined up with patients on them, unable to be moved into the accident and emergency department. We were told that they could not go in due to lack of space and that we would have to wait on the ambulance until space became available. It was not only frustrating for us but also for the paramedics, who were not able to get out and attend other emergencies.
When we got into the emergency department it was absolute chaos. Because my father had another small seizure as soon as he was moved, he progressed through the department much quicker than he would have done otherwise. We were essentially very lucky that this was the case as this meant a diagnosis was arrived at much quicker.
All around us, however, there were people lined up on trolleys all along the corridor just waiting, many elderly and alone, looking extremely unwell. It was reminiscent of the scenes you see on television of hospitals in a war zone, which sounds a little dramatic I know but it did feel like a very chaotic place to be.
Our own experience of A&E was actually quite positive. We waited about 3-4 hours but during that time we were questioned in detail by a Senior Nurse and then subsequently by a Consultant. They were concerned about the seizures and although it was believed that it was likely to be pneumonia, they arranged a chest x-ray and a CT scan on his lungs and brain to rule out other more sinister illnesses.
A clot as big as his lung – but it’ll have to wait
We were then lucky enough to be moved straight into a high dependency ward. That afternoon we were told that my father had a clot on his lungs that was as big as his lung, which had been blocking some of the arteries to his heart. This had caused him to collapse. It was extremely serious.
They advised that the best thing for him was to be moved to another local hospital which had the correct equipment and more specialist staff to deal with this illness. They said this could happen within the next few hours but since there were no beds at this time, they would commence treatment on the acute care ward. Because we were advised that the best place for him would be the other hospital, we were obviously keen to get him moved as soon as possible. This actually never happened. Despite being ‘top’ of the waiting list, 7 days later we were still waiting.
Amongst very unhappy people
Upon visiting my father the following day it seemed like a completely different place: the nurses had previously been very kind and reassuring, but it was abundantly clear that we were now amongst very unhappy people.
Because my father was very poorly we were situated right next to the nurses’ station, so we were perhaps party to more than most of the patients would have been, however some comments were also heard just when walking through the ward. We heard many comments such as:
“Don’t you dare talk to me like that”
“I’ve had enough already. If this carries on I’m going home”
“I’m sick of this place – the last 2 days have been awful”
A doctor who attended my father that morning was extremely rude to my mum. When my mum mentioned that my father was not receiving the hourly checks that we had been told were necessary, she snapped: “There is no way anyone would have approved that.” It was very unsettling as we were obviously conscious that there was a huge blood clot that needed dealing with; we just wanted to make sure he was getting the right treatment.
Stress for them; stress for us
A huge argument broke out amongst the nurses and a registrar. We were right next to them all arguing about not wanting a certain patient to be admitted onto their ward. The registrar ended up shouting, “This is the situation we are in, we just have to deal with it” and all the staff dispersed, complaining loudly.
That evening the nurse on duty went to give an injection to a patient on our ward. Just as she was about to give it, another nurse shouted to her that she had got the wrong patient. She laughed as she said this. The nurse that was about to give the injection was mortified, saying “Oh my goodness I have never done anything like that before, that’s because we are all so stressed”. My mum later asked the other nurse why she laughed, explaining that, from a patient’s perspective, this was not funny at all and could have been extremely dangerous. The nurse took this on board and apologised.
The nurses did not have time to help with the basic things such as washing or helping with the commode so thankfully my mum, who was by my father’s side all the time, did a lot of the work. My father had had a huge ‘bleed’ over his sheets when the nurse changed his intravenous medications – she had been shaking so much when she did this as she was rushing.
Whilst our nurse was trying to work out the medications with the pharmacist, she was constantly being interrupted by other staff. She had to keep breaking away and coming back to it, which was quite concerning as she clearly couldn’t concentrate. She had to eventually shout to stop the interruptions and leave her alone. Every time medication was given we did feel quite nervous about whether we were getting the right thing.
At one point the meal trolley came and was just left at the ward entrance for the nurse to give out (I was of the understanding that the meals were normally given out by the auxiliary staff). She commented “Oh that’s my job now as well is it?”. I offered to help out but wasn’t allowed to, so I said I really wished I could do something to assist. She replied “Please complain and then something might get done.”
Denied dignity
One day a patient arrived onto the ward, opposite my father. He was clearly extremely poorly and it soon became apparent that he was close to passing away. We were unable to close our curtains to allow him and his family some dignity and privacy, as the nurses needed to see our monitor. We all felt extremely uncomfortable and devastated for the poor family who were all there saying their goodbyes with a whole ward full of people surrounding them.
Their curtains were pulled at the moment of the gentleman passing away but we all felt intrusive. We realise that space is an issue but were surprised that families of dying patients could not be offered more privacy. The following day we asked another nurse whether this should have happened and were advised that the nurse on duty at the time should have allowed everyone to close their curtains on that occasion.
Following this incident, the body of the gentleman was left in the bed for 6 hours. When the porters came to move the body, they were laughing and joking (it was the middle of the night).
Thought he was dying
When my father was finally ‘stepped down’ a level into another ward, he was put into a bed next to someone who had obviously died. The curtains were pulled around this person but the body was left there for hours and, when the body was moved, those present were laughing and joking and making lots of noise. They also kept moving the curtains into my father’s section which meant that he was forced to catch glimpses of what was going on. He became very emotional at this stage and found it hard to understand why he had been moved into this ward – he was not thinking rationally and thought they had moved him there to die.
We realise that the ‘laughing and joking’ might be a way of dealing with things at a difficult and uncomfortable time or to try to distract patients from what is actually going on, but the clunk of the trolley and the noise of the bag being zipped up was so loud that it was quite obvious what was happening. We are not naïve enough to not realise that people don’t all survive a hospital visit, but were surprised at how this was dealt with in the wards we were in and thought patients would be afforded more dignity.
Not a priority
There was a very unwell elderly patient on our ward who also had MS. No-one was ever available to assist him as he struggled to get comfortable or cut his food, so a visitor from the bed next to him did this for him.
We would not expect visitors to receive drinks, but during the first 48 hours my mum spent two whole nights in a plastic chair next to my father. She didn’t want to leave his side and was therefore unable to access drinks or food until I could get there. We were worried she was going to become unwell too.
When the tea trolley came round at 8am on the second morning my father asked if they could give my mum a small cup of tea too. He got a very rude reply stating “I have got 60 patients to serve on this ward – if I gave a cup of tea to all of the visitors too I would run out of water”. She said she would come back at the end of the round, but she didn’t.
The patient toilets in the ward were overflowing and blocked. Faeces were on the toilet seat and floor.
Some porters came to move a patient into another ward. When they went to move the bed, they noticed that there were 3 full bottles of urine waiting to be disposed of. One of the ladies shouted that the nurse should have done this, exclaiming “It’s not my job to move someone else’s ****.” The other porters just got on and did this with no problem whatsoever.
Conclusion
We do not hold the GPs at all responsible for missing this illness as we realise they have limited time and also can only deal with the symptoms presented. However, we were disappointed to note that the blood clot was not spotted in the chest x-ray that he had specifically attended the hospital to rule out; that the results were never made available; and that he was probably sent for the wrong kind of scan in the first place. This could have been a potentially fatal omission.
The outcome for my father was thankfully a good one, despite never getting the bed at the hospital he needed. During the first week he responded well to medication and came off oxygen and, with the bed at the other hospital not forthcoming, it was decided to slowly get him off all intravenous meds and out of hospital into outpatient care instead.
I want to stress that we are extremely grateful to all of the staff that helped us during our time. We were all very upset to see the level of chaos that was going on around us, but we do realise that the staff all do a tremendous job under very difficult circumstances. At no time did I feel that the problem lay with the nurses, however, there seemed to be a lack of awareness of the impact their reactions to the chaos had on the patients and their families.
My father had been lucky that he had his family with him to keep an eye, ask questions, clean him up when needed and make sure he was comfortable. But what I really took away from this experience was that the situation was different for those patients without a ‘voice’ to question the chaos.