"End of life care"
About: George Eliot Hospital / General medicine George Eliot Hospital General medicine CV10 7DJ
Posted by justa (as ),
My stepfather was admitted mid-May, he was placed in a side room in the AMU, the ward where an extremely effective team had saved his life the year before. His care was good, but there was a problem with us being told conflicting information from one day to the next.
Two weeks later, my brother and I were ambushed by several staff. We were somewhat surprised to hear that we hadn't visited once when one or other of us had visited and stayed for some time nearly every day. We were also made to wear aprons and gloves for the first time, since he was admitted as the differential was query TB, even though he had been diagnosed with lung cancer by that point. Staff said it had spread to his liver, but that was apparently no longer the case a day later. We were asked to return to speak to senior staff about a care plan. My brother phoned his workplace in order to swap shifts.
Oddly, another sibling visited later that day and did not need to wear PPE for infection control purposes.
We were called and my brother was told off by a different nurse for not turning up to meet the doctor as promised...Just half an hour before our planned meeting! Our stepfather was quickly transferred to Elizabeth ward as the AMU was only for 72 hours.
However, we were pleased as the team on Elizabeth ward were very caring and helpful. The staff there clearly knew that he was dying and that we weren't stupid. He kept telling us to go and attempting to get out of bed and go home.
I was called the following day as the nurse thought he was going and wanted us to have the chance to be there for him. I called my brothers workplace and went to the ward. We sat with him, holding his hand, wiping his mouth, talking to him, sharing memories and old jokes. We returned from a break to find staff getting an ABG. The Dr and the nursing team (including HCAs, of course) were fantastic. We were also told that his lung cancer had spread to his liver.
I was called again on the next day. Again, we sat with him. Again, the staff were good. Marion from the palliative care team got him started on morphine and wrote him up for midazolam every two hours/PRN, he also got diazepam when needed to keep him comfortable.
On the following day, we arrived to find that he had had none of those medications. When he appeared to be having a seizure, I asked the staff to respond as we were not sure if he was in pain, agitated of seizing. Staff looked at him, said he wasn't in pain and walked away, refusing to administer any of the medications he was written up for. I called the number on the leaflet and left a message asking for help.
We left and I tried the out of hours number as it was a bank holiday. The person I spoke to advised me to ask to see someone senior who was on duty.
We returned and asked for that as we felt that the man who had brought us up was not getting the care he needed during that shift. Some staff then decided to argue the toss in the middle of a six bed bay. Then suggested that we were being disruptive and how would he feel about our behaviour? He would actually have been proud of us for standing up for anyone who can no longer speak up themselves.
We were told there was no matron on duty, as it was a bank holiday (which I knew was wrong, I have worked on a ward) so I asked for the senior staff to be bleeped. They turned up, but did not speak to us and it was suddenly a good idea to administer midazolam according to the nursing staff.
A manager who was not on shift miraculously appeared shortly after and were invited to share our views in an office. They soon realised we had a good point when she looked at the drug chart, saw he had not been given what he needed to die peacefully, and promised that the staff would be spoken to and that the next (non-existent, according to staff) ward manager would be briefed during handover.
We were called by the staff on night shift and came in to find him at peace. They were, again, very kind and caring.
You have some fantastic, caring and professional staff. In fact, they are very much in the majority. It is probably the ones who shouldn't be in the job at all (which you get in any profession) who damage the reputation of the hospital.