"Patient care in colonoscopy procedure"
About: Eastbourne District General Hospital Eastbourne District General Hospital Eastbourne BN21 2UD
I was not invited to give feedback following my recent colonoscopy procedure in the Endoscopy department, however I feel that I should reflect my experience back to the DGH in order that improvements may be made to patient care and welfare. It must be a common experience that, since no fluids are permitted within two hours of the procedure and it is following profound evacuation of the digestive tract, a degree of dehydration means that veins can be difficult to find for cannulisation. I know that routinely my veins are not particularly easy to find or enter, however the preparation/recovery room staff have cannulisation as an invariable part of every preparation and might be presumed to be adept at it. Three different people, one of whom was a general surgeon, made a total of five attempts to cannulise me. None was successful until a staff nurse stepped in. I was made to feel that I was being problematic, holding up proceedings and that perhaps I would lose my place in the list for the colonoscopy. Whilst that may be the inevitable consequence this is unsettling for any patient, who is bound to be feeling apprehensive anyway. It was not handled sensitively and I was made to feel that I was causing the staff problems. I’m sure the DGH would not wish this to be the case. The preparation leaflets make reference to possible “discomfort” as of “trapped wind” during the colonoscopy procedure. At one point I experienced sudden severe pain, not discomfort, in the higher part of my colon. Through the fog of sedation it was difficult to deal with. For some days afterwards I had the physical “memory” of the pain at the site. Nothing was said to me to explain why it should be so different from what I know of others’ experiences of colonoscopy and what I was led to expect. I believe I should have had just a couple of minutes of someone’s time afterwards to talk me through it and perhaps explain how: “... it can sometimes just happen, something was unusual about my colon, that degree of pain is to be expected, something went wrong or was difficult to achieve ...” just something to rationalise and explain a very painful experience. I later read on my report reference to part of the procedure being undertaken “by trainee” – I am inevitably left wondering whether this is connected to my bad experience, but since no one talked with me afterwards I cannot know. A quick “de-brief” is not just a valuable thing for a patient but also a learning opportunity for staff. One further point: On my admission my nurse was accompanied by a trainee nurse who was introduced by name as being a trainee but I was not asked whether I minded her presence. I did not mind in the slightest but felt I should have been asked. Further, if as appears to be the case, part of my colonoscopy was carried out by someone being trained, should I not have been asked for my permission or is this implicit in signing the consent form?