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My father’s admission and death

Posted By Jude77

"My father’s admission and death"

About: Northern Ireland Ambulance Service / Emergency ambulance response The Ulster Hospital / Emergency Department The Ulster Hospital / General Surgery (Ward 3D)

(as a relative),

My dad was sent to the Emergency Department at the Ulster Hospital from a nursing home, after a visit from the GP with a suspected obstructed bowel. It did not begin well. 

The ambulance arrived at the ED at mid afternoon and my dad ended up waiting in the ambulance bay until midnight. An 8 and a half hour wait on a trolley in an ambulance. My dad is immobile, essentially bed-ridden and he had no air mattress, just the ambulance trolley bed. The ambulance crew was attentive but obviously could do nothing for him in terms of pain relief. They offered to get him food/drink but my dad was on level 5 dietary requirement so couldn’t just get a sandwich and a cup of tea. We were on to the third crew (due to shift changes) before he actually got into the ED. 

Once into the ED he was reasonably well attended to and assessment was reasonably prompt but we received mixed messages as to what the diagnosis was. After a CT scan it seems the medical view was that he was palliative but that was not communicated clearly to my dad or the family in the first instance. 

My dad was admitted surgically to ward 3D at approximately 1800 which was more than 24 hours after arriving at the ED. The next morning we met Ms McWilliams who was very sensitive and clear in her communication. We realised it was essentially end game for him. 

The care he received on ward 3D was compassionate and exemplary; he was kept very comfortable in terms of pain relief; his next of kin (us) were sensitively cared for. In particular the nurses Jeff and Jenny were so kind and lovely.

Once on the ward, his care was exemplary but getting there was not. We have doctors in the family and know how much pressure the system is under, but the process of actually getting to the right people and the right place seems unnecessarily cumbersome and traumatic. 

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Responses

Response from Neil Gillan, Co-Production & Partnership Lead, Quality, Safety & Improvement, Northern Ireland Ambulance Service last month
Neil Gillan
Co-Production & Partnership Lead, Quality, Safety & Improvement,
Northern Ireland Ambulance Service

Submitted on 05/03/2024 at 11:43
Published on Care Opinion at 11:43

picture of Neil Gillan

Good morning Jude77

My name is Neil Gillan and I am the Co-production Partnership Lead within the Northern Ireland Ambulance Service, where I lead on the development and delivery of an organisation wide approach to Patient Client Experience.

I am grateful to you for taking the time to share your experiences of the service. From the outset, I would like to offer my condolences on the passing of your dad and apologise to you and your family for the distress caused. As an organisation we aim to consistently show compassion, professional and respect for the patients we care for, we regret that this was not reflected in the story you shared and are sorry that we did not achieve the standards we aim for.

Please be assured that we are working closely with the local EDs to try and ensure that our patients can be handed over to hospital clinical teams as quickly as possible. I would like the opportunity to discuss this matter further with you, if you are able to and when the time is right for you, please contact me directly on 07880022791 or neil.gillan@nias.hscni.net.

Yours sincerely

Neil

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Response from Jenny McMahon, Lead Nurse Surgical Specialties, Surgery - General, South Eastern Health & Social Care Trust last month
Jenny McMahon
Lead Nurse Surgical Specialties, Surgery - General,
South Eastern Health & Social Care Trust

Submitted on 13/03/2024 at 12:18
Published on Care Opinion at 12:18

Dear Jude77

Thank you for posting your comments at this sad time for you and your family regarding your father's admission and care on ward 3D prior to his passing.

Ms McWilliams and the nursing team, will very much appreciate this, along with the mention of the nurses Jeff and Jenny.

The care of a patient alongside the family is so important and your comments demonstrate this so clearly. This enables the team given all the pressures to continue to main this quality of care, which means so much for everyone.

Yours sincerely

Jenny

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Response from Jennifer Nicholson, Lead Nurse - Emergency Care, Emergency Medicine - A&E, South Eastern Health and Social Care Trust last month
Jennifer Nicholson
Lead Nurse - Emergency Care, Emergency Medicine - A&E,
South Eastern Health and Social Care Trust

Submitted on 20/03/2024 at 15:45
Published on Care Opinion at 15:45

Hi Jude77

Thank you for taking the time to tell us of you and your dad's experience when attending the ED. Can I first of all express sincere sympathy to you and your family on behalf of the ED team.

Can I apologise for the long wait your dad had in an ambulance before he was brought in. This is unfortunately outside of ED control and there is currently a focus as a Trust to create earlier flow to wards and make space in what is an very overcrowded ED with up to 60 patients waiting on ward beds frequently. Impacting on that flow is ongoing pressure in getting patients discharged timely from the acute beds into the community. While I do appreciate this may not be news to you with doctors in the family and some insight into the pressures the health service regionally are experiencing but may help to explain the reason for the delay in bringing your dad into the ED.

It is often too early in the patient journey when the patient is in ED to make a definite diagnosis until all investigations are completed and often that is why patients are admitted to get all investigations completed and a definite diagnosis is confirmed. A scan alone is also often not enough to make a diagnosis and conversations are often needed with specialist teams and official reports received from Radiologists before conversations can be had with patients and families but that should have been communicated to you by the receiving in house team, apologies if that did not happen.

Thank you for bringing this to our attention and allowing us the opportunity to explain the patient journey which is more complex than we would aim for but with continued focus on flow and discharges the Trust hope to make some improvements over time.

Kind Regards

Jenny

ED Lead Nurse

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