"Dying without dignity"

My palliative grandmother was an inpatient in Ward 7B in the Royal Victoria Hospital in April 2023. She unfortunately passed away in the ward. The care was substandard from admission but the poor standard of nursing care was really highlighted as she approached end of life.

For the last few days of my grandmother's life, we were by her side 24/7. Most of the family work in healthcare. If it was not for the care we provided as family, my grandmother would have had close to nil care or comfort. Just because family are present, this does not justify an absence of nursing care. My grandmother received the absolute bare minimum. Staff did not acknowledge us whatsoever.

My grandmother was repeatedly called by the wrong name by one of the nursing staff. My grandmother's name was not similar to the name they kept using at all. This caused significant distress and agitation to a palliative patient, leading her to believe she was receiving the incorrect medication and so on. Causing such distress to a patient at end of life repeatedly was extremely unfair. This staff member was corrected multiple times and expressed nil apology for same.

There was no Calogen supplements available on the ward for days, which was one of the only things my grandmother would take. No alternative was offered. I found the ward manager was dismissive and offered no assistance whatsoever. Therefore, my grandmother and possibly other patients were going without their nutritional supplement for days if not weeks (obviously we brought them from home when we received no solution from staff). It should not be up to family to ensure a patient receives adequate nutrition when in hospital.

We were aware of but not informed that my grandmother was approaching end of life. We were only informed when my mother complained to the palliative team regarding lack of communication from staff.

A Doctor told us my grandmother was eating and drinking (she was not), and fit for discharge. We argued she needed to stay as it would be unfair to transfer a patient at such a late stage of life. She may have been able to die with dignity in another location if we had of been given fair updates throughout but unfortunately it was left too late by staff. She died a few days later.

When my grandmother died, we received nil support, care, compassion or consolation from nursing staff. She had passed away no more than 5 minutes when a nurse rushed in to take the syringe driver down. The nurse did not speak to my grandmother, gruntled to us 'take driver down', proceeded to pull my grandmother's blanket back, and take the driver down. She then walked out the door. No 'sorry for your loss' or 'do you mind if I'. I will never forget the way this nurse treated us or my grandmother in those moments. Those moments were stolen from us. It was completely intrusive, inappropriate and unfair on the family, and extremely undignified for my grandmother.

The rest of the staff on duty offered zero condolences, or any communication actually, barely looking up from the nurses’ station as we left. The only staff member who was kind, considerate and compassionate when my grandmother died was the doctor who completed the verification of life extinct. He was also the only one to offer any condolences.

We know what governs us as healthcare staff ourselves, and we are clear that those caring for my grandmother on this ward did not meet the standards expected of them. We believe they absolutely failed my grandmother in her last few weeks, days, hours, minutes and after death.

I believe some learning could be done here in Ward 7B in regards to dignity when dying and caring for palliative patients at end of life.