"Extremely bad night care over a 5 day ward stay"

In late June 2013 I reported, as requested, at 8am at Lincoln County Hospital, Surgical Assembly Lounge (SAL) for a pre-arranged ankle fusion operation and was released at 1. 30pm.

I am used to living under duress, having been in the military for a considerable time and my training made me accustomed to stress and “Hard Living”, even so I found my stay stressful and, at some stages, traumatic.

I wish to be constructive, not critical, so shall go through a factual account of the reasons for my unhappiness.

Diary of Events

1. Having followed the pre-operation eating and drinking rules from the night before, I sat in the SAL all day until finally I was taken off for my operation at 4pm by which time I was getting a little weak and agitated as, up till then, nobody could give me any idea of what was going on and I had drank little and eaten nothing.

2. Although, during the day I was on gas and air and strong pain killers and was thus not fully aware, there seemed to be sufficient staff on duty and everyone was as helpful as they could be.

3. It was during the night hours that it became a nightmare. Once the day staff had gone off I do not recall seeing any staff during the night hours unless one was lucky enough to have one react to your call button. Two of us were on drips and/or monitors and were immobile following our operations. I was also on laxatives. Yet, on only two occasions did anyone respond to our calls within 15 minutes (too late for someone on laxatives. On three occasions there was no response although we could hear our call tones beeping and the staff talking. I will relate these events.)

4. The 80+ gentleman next to me was immobile and was beeping and shouting for a nurse and, hearing his panic stricken calls the rest of joined in but there was no response, eventually I heard him drag himself out of bed and he started crawling towards the toilet. It appeared to me it was only then that staff responded and had to overpower him to calm him, such was his panic and anger.

5. I had two such experiences. Here is the first, I needed to defecate urgently during the night and buzzed. 20 very long minutes later a nurse wandered in and when I said I needed to go to the toilet she stared pointedly at my “Piddle Pot”. When I explained what I needed she said “Well what can I do about it? ” I explained that the last time I had managed the “Drip Tower” and the nurse had pushed the mobile commode. This she did and left me saying that I should buzz her when I was finished. I did this and when, after 20 minutes she had not responded I managed to navigate myself back to my bed. I never did hear her come to check.

6. That same night, I woke feeling very cold as the ward windows had been left open after a warm day. Again nobody responded to our calls so I managed, very carefully, as I had a drip attached, to pull my track suit top on. Unfortunately, during the night my drip needle tore out and I woke up with my right sleeve soaking with blood. Fortunately, this time my call was answered in 2 minutes!

7. It honestly got to the stage where all 4 of us in the ward dreaded being left alone at night due to our mutual experiences. On one night I reached such a state of panic I asked to be sent home. It was thanks to a sympathetic nurse that I did not pursue this course.

Recommendations

8 Whilst I am aware of the financial stresses on the NHS, my previous auditing experience brings me to make three recommendations. The first is Lack of Sufficient Supervision. The failure of the obviously overworked nurses to respond to patients calls (which seems to me an essential requirement) would have been noted by an effective supervisor. The other is Poor Organisation. The experiences related above plus other events I have not related indicates that staff are working to a routine that needs examining and improving. Could not the SAL staff be kept more up to date with the progress of operations and thus be able to keep patient better informed?

I feel these three faults could be rectified locally and without extra expenditure.