"My deepest thanks to the whole team"

About: City Hospital campus / General medicine Queen's Medical Centre / General surgery

(as the patient),

I hadn't been feeling the best for a while. Could never really put my finger on it. Generally worn down and got side swiped by what I believe was a good dose of the flu at Christmas. Grumbled on through it but picked up one thing after another. Sniffles, bit of a cough, just generally running on empty.

Few weeks ago picked up a bit of an infection in the water works that I thought I had soldiered on through, with drinking plenty fluids and flushing it out etc, just like all the other sniffles and gripes.

I had a day out at the Nottinghamshire egg run to collect eggs for disadvantaged kids and promote Notts Blood Bikes at the same time. Out all day, rubbish weather, cold and wet but still a worthy cause etc. Went to bed that night and had a shivering fit in the middle of the night. Thought I had just got chilled right through from being damp all day and my body was warming me up from the inside. (In hindsight it was the beginnings of the infection taking hold and the shivering was actually my body trying to cool me down from a raging temperature even though I felt frozen).

Grumbled on through the week with work thinking ahhh just need a long weekend, things to be done, will sort it. Gets to weds and I now know something is not right, call the GP nothing until after Easter, busy time you know, too few GPs... Etc etc.

Finally finish work thurs pm and head home... Generally feeling rubbish but it's the weekend. steadily feeling worse bit by bit... Pain increasing with swelling increasing associated with the infection (as yet not realised what I was dealing with)... Middle of the night the shakes start again.... Don't want to be a burden.. GP closed... Walk in centre closed until 7am... Adverts off the TV ringing in my ears... Use the NHS appropriately... Wait until morning, man up, if absolutely necessary go to walk in centre when it opens...

Pain is now at a level I couldn't describe combined with just how long I had been in pain by this point my body and finally my brain was saying enough... Do something now...so I swallowed by big daft male pride and said that's it please take me to A&E which to me was breaking the golden rule.... Is this really an emergency... Am I using the NHS appropriately... I do not want to waste any bodies time. The system is at crisis... All the things I have heard in the media recently... Interesting what thoughts run through your mind whilst semi delirious from what I later found out to be a raging temperature..

Good Friday morning, walk into A&E, book myself in and expect a long and boring wait to be dealt with based on the NHS doing a bang up job of putting people back together after a massive night out in town on the first night of the long weekend. Pleasantly surprised although not in the best state to actually realise that the waiting room wasn't that full. Off into the little side room for triage and initial please explain why you have decided to come to A&E, take basic details, take blood pressure, tell me everything will be fine and then pops off to chat to someone whilst the blood pressure machine does its thing... Nice chap returns and after completing some more details, logging results from the machine etc says please follow me... This takes us back into the area with all the chairs where people sit to wait to be dealt with... Nurse I am following is asked by a young lass holding her leg and a pair of killer heels how long will it be mister... Who says anything up to four hours (me thinking) pretty much what I thought but needs must, I'll just sit here and watch TV with everyone else...

Nurse carries on walking into the next area with me tagging along, I later find out this is IAU (Initial Assessment Unit) pretty much put straight in a cubicle. Sit here please someone will be with you shortly. Sat stunned thinking hmmmm they got me in here pretty damn quick? Nice young chap comes in explains who he is, what he needs to do and starts sorting me out... Blood pressure repeated on a 'better' machine, slight looks of worry but calm and collected at all times. Explains they would like to run an ECG as my heart is running a bit fast... Just want to check it out.. Don't worry ECG fine but left three leads on to maintain the monitoring of the heart rate... All explained no need to panic...

Unfortunately it came time for the bit I have a particular aversion to. It's ok though again explains that to make things easier they will just put in a canulla ('permanent' needle in the arm with two tubes for connecting things to).... I thought I had pretty good veins (confirmed by the nice young chap) but three separate tries later he finally got a satisfactory line in (I am later told that the state I was in can make it difficult to insert the needles and not unusual, but the few choice words I said in my head whilst he tried didn't realise that at the time). Now a few sample tubes filled for various blood tests without any further incident.. Various other nurses/doctors coming and going doing specific checks of different things... Finally off to the next area (Blue 15) a treatment area with central nurses station and numbered cubicles for each patient..

Now more checks, breath sounds in chest, blood pressure repeated and monitored, temperature checked... Turns out my temp is peaking at over 40 degrees and my heart rate has consistently been 120-140 bpm since I went in and they initially checked it... All signs consistent with a raging infection that needs getting under control fast.. IV fluids and paracetamol to help with the pain and also start to drive my temp down..lots of very calm people coming and going, introducing themselves explaining what they are doing and why, all exemplary and controlled with no panic even though later on they explained they had been quite concerned about me until they started to get my temp and heart rate heading towards normal... Time moves on and more checks but steadily things are brought towards being more under control and many bags of IV fluids were being pushed into me as fast as possible as with the temperature I was running I was burning off fluids without even realising it and was very dehydrated...

Heart rate was still running high but heading down... Somewhere towards a more consistent 120bpm and temp was still high... It's ok they have found a bed for me and I will be transferring to the ward as soon as it can be organised.... Must have been 0700ish by now and they are trying to track down a specific antibiotic that is aimed at the area of the infection and would give them the best chance of starting to get it under control.... Many phone calls to various wards around the hospital but no one was giving up they knew they had some somewhere... Eventually tracked down to the drugs store in the ICU.. It was sent for and administered but time had moved on some so it was getting to be around 0800 and been there approx 4hrs and my feet hadn't touched the ground. Explained to me that patient transport doesn't start until 0900 at which point I will be transferred to the sister site at City hospital where the ward was they had found for me. A trip to discharge and wait for the transfer... Sitting there offered a cup of tea... Just sitting down to drink it and two nice men in green uniforms ask for me, explain they are the patient transport and off we go... Chatting to the guy sat with me I find out he is actually an emergency paramedic and he is here because this is classed as a high risk transfer as my heart rate is still so high... Explains this is quite regular/routine and the emergency paramedics are rota'd for patient transfer on a periodic basis. Listens to me ramble on during the journey which doesn't take long around the ring road from QMC to City at that time on a non working day..

Arrive at City and wobble my way to the ward having a laugh with the two guys and quickly arrive in the ward. Hmmm Urology and full of lots of old men. Guess who sticks out like a sore thumb.... Eventually not as I get to chat to the different people in the ward and see some other younger people in beds. Logged in and checked over... Assigned a bed and officially on the ward by 10am (not bad considering I only walked into A&E 5hrs beforehand), the docs are already making their rounds and I am tagged on the end. Assessed and put back on IV fluids and paracetamol followed by starting some broad spectrum IV antibiotics. Things are still not as they would like so obs taken every 30mins.. Temp and blood pressure..

Time just seems to melt away with so much going on. Things steadily get back towards where they should be and they start to slow the fluid input. Also something like 4D Casualty is going on all around so I watch and listen to what is going on... Such a melting pot of so many lives and people and stories for both patients and staff... I chat to people to pass the time of day. Unfortunately some of the old guys with dementia asking for family but not realising they asked 5mins ago, wondering off and then getting confused as all the bays containing 4 beds look identical. The unceasing patience of several of the staff returning them to their rightful place, time after time after time whilst still dealing with the needs of all the other patients and getting on with everything they need to do. Steadily over time I come to realise that the nurses within the ward are an amazing team, covering each other's allocated bays and dealing with things as they arise even if it isn't their allocated patient or bay or area. Being asked for things as they pass, saying they will sort it and some how never seeming to forget even if it is 5mins or 10mins or they get embroiled in an urgent assist with a patient for whatever reason. I came to have the utmost respect for them not that I thought anything less of them when I went in.

The issues they had to deal with that they just took in their stride... Bring me this, fetch me that, I have run out of sample bottles can I have some more please..... Harangued by stressed family members who maybe thought they weren't doing enough but didn't see the way they never stopped... Complaints that they had rung and rung but nobody answered explaining how they had to leave the phone ringing for 10mins not knowing that there are times when it just isn't possible to answer the phone. Change over times where the information is passed from one shift to the next is sacrosanct. The only other time where it is almost impossible is during the doctors rounds as the nurses are always present to hear the details of the latest check ups or test results and understand from the doctor exactly what the next steps are in the treatment of the patient especially as they may need to explain it to the patient several times or relay the info to the family or carers etc. The meds rounds where the drugs trolley is taken around patient by patient and the tablets are logged out of the store and logged in the drug chart for the patient with exactly when and what was administered. This cannot be rushed, cannot be interrupted, it is absolutely vital it must be done and logged correctly.

The nurses, on the different shifts, that I was allocated never showed their frustrations overtly however I watched and understood and later commented on various things that I witnessed. They appreciated that I saw what they saw on some occasions. Some unfair things were said and complained about like not answering the phone or the bathroom left in a state by the young lad who had been brought in as an emergency but just seemed to treat the place like a hotel and give the staff nothing but attitude rather than thanks, but these things were just absorbed in good grace and apologised for. They came back every day with a smile on their faces and I witnessed an incredibly strong team.

Finally I was considered stable enough in terms of temperature and heart rate and the nurse looking after me did everything she could to get my medication for release on time which was something I had seen her do several times before as she knew the best place for people was home. The ward never really stopped and wasn't a place for sleeping. Regularly being woken for obs to be taken or drugs to be administered. Emergency admissions at various times all greeted with a smiling face and helpful words of kindness and explanation of what was going on.

It was time for me to finally come home.... Relief washed through me... I really wanted to personally thank the nurses that looked after me so well but they had rushed off to deal with the next bed alarm going off or another emergency or cry for help from a colleague or patient. They never stopped.... I gave my personal thanks to the ward Matron and asked that she pass on my deepest thanks to the whole team and I explained I thought she had an amazing team and a few had stood out for me but she knew exactly who they were and why I said what I did. Exemplary........ Ward Harvey 2 at City Hospital in Nottingham and also the A&E dept at QMC.

This is why I wanted to write this, to really show my gratitude and hopefully let others see what I saw. The NHS isn't broken just creaking a bit, but there are people in there that are holding it together by shear force of will and doing their absolute best for the patient and consistently going above and beyond. If that good will is lost for whatever reason then we will all lose out. Maybe not today, maybe not tomorrow, it's been decades since I last needed the NHS to sort me out and put me back on my feet like it did this last weekend. I hope it will be there for all of us in the future. All I will say is just think about who you vote for as this little episode is going to make me think doubly hard…

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Response from Nottingham University Hospitals NHS Trust

Thanks for taking time to leave such detailed feedback of what must have been a rather frightening experience for you. It sounds like your care and treatment was smooth and efficient from admission to discharge. Our nursing staff (along with very many other colleagues) really do work very hard and try to do the best job for patients. We will share your story with the Emergency Department team and our staff on Harvey 2 Ward at City.

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Response from Nottingham University Hospitals NHS Trust

As the clinical lead for Harvey 2 I would like to personally thank you for your valuable time in writing such wonderful feedback. Knowing the team have provided you with such safe and effective care only confirms how proud I am to be working with such a committed team.

Kind regards

Stephanie Beasley-Thompson MSc, PgC RGN Clinical Lead

Cancer and Associated Specialties

City Campus

Nottingham University Hospitals NHS Trust