"In patient experiences at Tameside"

As the wife of an in-patient at Tameside Hospital during May and June this year, firstly on ward 46 for four and a half weeks, then after being home for a week back into ward 31 for over two weeks, I have been appalled at some of the incidents that have occurred during my time on the wards. The shortage of staff being partly to blame, a lack of correct communication between members of staff and illegible notes in files that even other members of staff cannot decipher, and also problems with language barriers.

It also appears that due to 'Hospital Protocol' and Health and Safety regulations, basic common sense is not allowed in a lot of situations. Having been with my husband on the wards morning till night during his stays I have picked up a buzz of discontent amongst several of the staff, who would agree there just are not enough 'hands on' staff to work efficiently. When agency staff are used matters get worse, many having far from perfect communication skills with the English language, which makes things difficult for patients and staff alike.

Within 24 hours of admission, my husband had sustained two skin tears and a bruise on the back of his head although I had stressed to all concerned that his skin is very fragile on his arms and even a gentle grip would cause damage. By the time he was discharged he had several dressings on both arms due to skin tears, in my opinion unnecessary, I have handled my husband at home for over two years in this condition and have only ever caused skin damage once, this taught me to 'Handle with Care'.

He was padded up for weeks, although I had made it clear that he was totally continent and could use a urine bottle if assisted, consequently he was constantly wet through and his skin became very fragile, his bowels had not been opened for approximately 10 days after admission, I had mentioned this to staff several times, he was eventually given an enema, which got things moving, but then he was plied with laxatives and lactulose, which then caused uncontrolled bowel movements in pads, until 2 days before his first discharge when I asked for a commode, which is probably how he contracted U T I.

There seems to be more concern with weighing patients and taking blood sugars which in my husbands condition at the time were fairly irrelevant, but look good on paper, than individual personal needs like has a person passed urine or had a bowel movement.

Regularly during both stays my husbands feet were jammed against the bottom of the bed, with protective heel pads part way up his legs not on his heels, and his heels not raised off the bed, I had mentioned this on each occasion to the staff and the ward manager, on one occasion his feet were bruised by pressing on the pump fixture at the base of the bed, but it still continued to happen.

There were errors in documentation on files, age 89 not 85, one statement said 'moves himself'', which would indicate to staff that he did not need moving or repositioning in bed, 'I wish! , amongst other mistakes. My husband was put on a strict fluid restriction of 1 litre a day to include allowance for food, but behold communication from persons unknown changed this to one and a half litres, I queried this with two members of staff to be told it was correct as it had come over at handover, I checked with the doctors who said it should not have been altered, but no one knew who was responsible.

On one occasion I was told they were moving my husbands bed where they could see him, this was another patient, another occasion a nurse came to put a bed pan under my husband, yet again, wrong patient, had I not been there he would not have known any different, another I was told in the morning he had had antibiotics for a U T I, including what sort they were, when I asked if he was to have them at lunch time I was told he was not on antibiotics, nurse said she had got confused it was another patient!

There were several errors with medication which had I not been there would probably have passed without notice which I find inexcusable, I pointed this out to ward managers and staff, one of the occasions his tea time medication had been missed, which included warfarin and I N R was out of range, the member of staff had gone off shift, the medication had not been signed for but no one knew whether or not he had been given it, I knew he had not as I had only left the ward for a couple of minutes, it was eventually given to him as I insisted I knew he had not been given it earlier.

During the first stay, hand hygiene between patient contact was not adhered to, again I spoke to the ward manager about this. Also during this stay a 94 year old man was taken into the toilet by an agency worker, who left him there and went off his shift without telling anyone, fortunately after 20 minutes another man on the ward heard him and went for a nurse.

Although on thickened fluids due to dysphagia, my husband was given unthickened drinks several times, put into bed on an air pressure mattress and chair without the pump being on, an oxygen line left off after a procedure which I put back myself, only little things but still important.

One day I arrived to find my husband naked in bed with just a pad on and a sheet covering him, no one knew how he came to be like this, I was told perhaps he was to warm, nevertheless, where is the dignity in that? , another 2 occasions I found him with a bottle in place under the sheets, but again nobody knew how it got there. During the 2 stays 2 pairs of pyjama bottoms and 2 towels mysteriously vanished I presume with the hospital laundry, for which I blame myself, I should not have taken them in the first place.

Some recordings in files were illegible even other staff could not read them, no wonder there are breakdowns in communication, if they cannot be read why bother to log them? Surely patient files are supposed to be records of their treatments and what is going on, what is the point if they cannot be read and understood?

If a bottle or commode was required, more often than not by the time staff had done what they were doing, and five minutes turns into half an hour, it would be too late, no disrespect to the staff who often needed more than two pairs of hands! My husband had a sheath on at night at my request but to use bottles in the daytime, sometimes it would be on, sometimes not, sometimes left on half the day, surprisingly one member of staff had no idea what a sheath or convene was when I asked for it to be taken off, another had never had to put one on or take one off as it was not part of their training! On both occasions after having problems with bowels and urine incontinence, after 24 hours at home there was no longer a problem my husband was back to toileting during the day and using a bottle at night, so why did this happen in hospital?

Even to the last when preparing for discharge, the person assessing for social input at home, got half way through filling the forms in and said 'so you are Elsie?', that is not my name, she was filling another patients form in, and to add insult to injury, even though my husband was discharged medically fit but going home before the care package was in place, I was assured by the ward that the referral would continue as they were just waiting on Cara contacting them, I had a friend coming in to help in a morning and son at night, after 4 days and hearing nothing, I phoned Cara who knew nothing about the referral and so gave it up as a bad job.

I spoke to hospital inspectors during their 'planned visit' it was quite obvious that an inspection was pending although I had not been told about it, by the amount of staff on the ward running round like 'headless chickens' printing, sticking charts on walls, filling in bits of files that should have been done earlier, all to look good for the inspection, needless to say all this was at the expense of the patients welfare. Two weeks after admission I was asked to sign a valuables disclaimer, and also if my husband had his own teeth, a little late I might ask? What is the point in giving advance warning of an inspection, surely they need to see things as they really are.

I could go on, there were lots of other things with other patients, but not for me to say, common thought seems to be 'we don't like to complain in case the patient suffers for it' although I know relatives of two other patients on the ward were putting in complaints.

Surely there should be some 'plan of action' for each individual to be easily seen and understood by all members of the team, which would avert the inconsistency.

Two years ago we had a similar experience at this hospital, which I had logged daily, but had not got the spirit to complain, but feel this time I can not remain silent.

I must add that the medical teams have been extremely good, and most of the staff have been good, there just are not enough of them, some go 'above and beyond' what they are paid to do, some work with 'their heads and their hearts' and my thanks go out to them, some do their jobs efficiently, and others just seem to have been worn down by the system. My experiences over the past few weeks have been 'soul destroying' and leave me with little faith in the hospital or the N H S.

I am hoping that this get 'read and digested'

Hopefully and sincerely.