"Poor care on a surgical ward"

About: Tameside General Hospital

(as the patient),

i was due to be admitted for a cholesystectomy in nov and the day prior to my admission, it was cancelled. i was informed it was due to lack of beds.

i was then informed to go to the surgical ward at 7.30am on the friday. i turned up at the time requested and was informed to wait in a small waiting area in the middle of the ward. i was with 8 other patients, some elderly. i sat there for 5 hours before i was taken to a bed and prepared for theatre, where i was then taken about 30mins after getting my bed. it was literally one out... one in. for most of the morning there were more patients on the ward than beds which i felt was not acceptable. no one came to see who i was, so i had to ask if they knew i was here. no one seemed bothered that we were sat on very uncomfortable chairs which were in the way of staff. i could have been anybody with a bomb/gun/or stealing patients things etc as no one checked who i was. i felt this was poor safety management.

some of those waiting were not that lucky. several were taken to the toilet and asked to change into a gown and their dressing gowns and taken to the theatre from there. some of these patients were again elderly. their bags were taken to another ward whilst they went to theatre and were waiting for them in this ward. after my surgery, i asked several times for pain killers and eventually my husband had to ask the staff after 2 hours.

during the night i wanted something to eat as i felt sick due to being starved for nearly 24 hours and had no call bell to call for staff.

during the night, no staff came to see if i was ok, and if i needed anything, so i had to wait for staff to come nearby and shout to them. in the morning, there was only 2 staff on the ward as it was originally a monday to friday ward and there were no beds for the ward patients to go to on other wards. the staff were very busy dealing with several poorly patients and i had to get up and have a wash on my own following surgery.

i had to wait till tea time before staff had time to discharge me back home.

i felt that:

1 staff had no time for patients as there were too many patients on the ward

2 we were on a conveyer belt

3 it was not acceptable for patients to be admitted in a corredor and to change for theatre in a toilet

4 no adequet staffing levels

5 poor security

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Response from Philip Dylak, Director of Nursing, Tameside Hospital Foundation Trust

I am very sorry to hear of your experience during your time at the Hospital.

When emergency demand for beds significantly exceeds capacity, we have to make the difficult decision to cancel planned patient admissions. We do this very reluctantly, as we appreciate the distress and inconvenience this causes. When we are in a position when we have no alternative but to cancel admissions we obviously try to give patients as much notice as possible.

Our Surgical Elective Facility (SEF) usually takes only elective admissions. We plan how we utilise our beds very carefully. Unfortunately on this occasion, emergency patients were admitted to the beds on the ward that would usually be reserved for elective patients. The result of this was too many patients for the number of beds available at that time. However, the ward was expecting to discharge patients so that we could accommodate patients such as yourself.

As patients on SEF are usually admitted directly to a bed, we do not have a large waiting area. Consequently, patients were asked to wait in a small “sub waiting” area. I acknowledge that this is far from ideal. However, following your comments I have asked the ward to purchase some suitable chairs so that if the situation ever arises again patients are made as comfortable as possible.

I am sorry that you were not greeted and kept informed by ward staff in the way that I would expect. This has been addressed with the staff concerned and I do not expect this to reoccur. Asking patients to change in toilet facilities occurs only as a very last resort and only occurs if the patient consents to this. Again, I would like to reiterate that this only occurs in exceptional circumstances and is offered to ensure a patient’s operation is performed rather than cancelled.

I am very sorry that you had to wait for pain killers after your surgery. Without specific patient details it is very difficult for me to comment on this as on some occasions it is not always possible to administer pain killers. This is dependent on for example, what pain killers have been given in the theatre environment and how long ago they were given.

Following your comments, I had asked the housekeeper on SEF to ensure all bed areas had a call bell available. I am reassured that all beds have one in place. I have also asked the housekeeper, as part of her daily checks, to ensure every bed as a call bell available at all times.

It is correct that SEF is usually a Monday to Friday ward. Additional staff were secured for the Saturday morning in question and arrangements were made to transfer the patients who required higher levels of care to more appropriate areas. I apologise that this took priority over facilitating your discharge. However, I am sure you will be pleased to hear that at the hospital we are now performing laparoscopic cholesystectomy as a day case procedure. Patients are now discharged home 4 to 6 hours after their procedure. Research suggests that patients recover better at home following this type of procedure.

As a Trust we recognise that it can be difficult at times of pressure to balance elective admissions with emergency admissions. The hospital is working extremely hard to ensure that both patient pathways are managed effectively at times of peak pressures.

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