"The difference in care when I ..."

What I liked

The difference in care when I was moved to an orthopaedic ward was staggering. The 'new wards' have a completely different ethos from the filthy, understaffed and overcrowded Ward 2, where I spent three days in early March. During that time there were no bathing or showering facilities and there was only one toilet with a tiny washbasin for a 22 bed ward. I have photographed these facilities. I had my very expensive iPod stolen but staff did not respond appropriately until my husband intervened. Many nurses use bullying to subdue 'difficult' patients, and, having been on this ward five or six times, now, I am appalled by the withholding of prescribed drugs, drug errors, and having my bloodstained bed left unchanged until I personally found some bedding and did the job myself. The ward is mercilessly noisy and ridiculously understaffed considering the numbers of critically ill patients. No patient was ever bed bathed or assisted with bathing. A bowl of tepid water was offered each morning but beds were not changed or patients washed unless they were soiled with vomit, urine or faeces. When I was re-admitted a few days later, to the Medical Admissions Unit, I was informed that Ward 2 would not take me. Hooray! I have been on both Wards 3 and 4 and they have the same basic difficulties as Ward 2, overcrowding and understaffing, but nursing care is vastly different. I was, however, disconcerted at having my possessions searched when my 'dispute' with Ward 2 came to light. MAU do not hand out the disclaimer form that they are required to do, and a very unpleasant staff nurse brought three other nurses to the bedside to search through my possessions without my consent. She made personal remarks about items in my bag and I was treated as if I were the thief, not the person who stole from me. Theft is rife; I only had to speak to a few other patients to learn of other incidents, and my husband learned of many more when he contacted the police on my behalf.

What could be improved

Extensive re-training of staff on both MAU and Ward 2. I would call for suspension of the nurse who led the search of my possessions. The closure of bathing facilities on Ward 2, supposedly a temporary measure during renovations, went on for three weeks. Despite the availability of Ward 3's bathroom, I only learned of this on the day of my discharge. Patients who need assistance with hoists and escorts had no chance whatsoever of keeping clean. The regular movement of patients around the hospital spreads infection (the reason for my second admission) and where those patients are dirty, through no fault of their own, there is a serious risk of infection. During the course of two admissions I was housed in an A&E cubicle, MAU, Ward 2, Ward 3 and Orthopaedic. Whilst I was grateful for the excellent conditions on Orthopaedic, I was well away from my Medical Team. I was having daily blood tests to get my INR up to a therapeutic level, and one day a report came back that I queried as I had not had blood taken that morning. A very large dose of warfarin had been prescribed, which I refused to take, and I had to get really annoyed before more blood was drawn. The 'second' result was completely different from the first, whoever's blood it was, and the prescribed dose of warfarin was subsequently lowered considerably. The error might have been spotted on a medical ward where they deal with anticoagulated patients on a regular basis.

Anything else?

I don't understand why patients are asked to take their own medication into hospital. On the day of discharge, all medication is sent to pharmacy where take-home prescriptions are issued. Drugs that have not been used on the ward are kept by pharmacy. I often lose drugs this way, and they are my paid-for property. I am on a controlled drug that could not be issued by the ward on disharge.This drug needs to be taken regularly. If I handed over all my drugs, as requested, I would have had a weekend of extreme discomfort. I was given a bottle of Oramorph, which had been prescribed on the ward, but I also received a full box of Gabapentin, unprescribed and unlabelled. Even if the correct drugs are ordered, patients have to wait for them in the 'Discharge Lounge'. This consists of a few plastic chairs that have replaced bed spaces at the end of Ward 3. There are no day rooms and the pressure on beds is so acute that discharged patients get dumped on Ward 3 at short notice, to await their drugs and lift home. This can take hours to arrange and is no food or medication available to discharged patients. The Ward 3 nurses serve tea and coffee but that is all. A wait of up to six hours is not uncommon. Lancaster Royal Infirmary never had the space for acute medical patients who used to be admitted to Westmorland General Hospital and this needs to be recognised. As for the LRI Medical Unit? It needs replacing. Not just altering. Replacing. It is an absolute disgrace. Patient care comes a poor second to the need to 'create' acute medical beds by various means. Aside from shunting patients around the hospital at all hours, they have 'part time' bed spaces with less room than the legal amount required . I have been in one and was at all times privy to the intensive nursing required by a very sick patient. A woman who had been transferred from MAU whilst lying on a bedpan, but that's by the by. Not even surprising.