"The care I received in A and E was very..."

What I liked

The care I received in A and E was very good from medical and nursing staff. I felt that I was listened to and that the appropriate tests and treatment were carried out as speedily as could be expected. While the small cubicles are not good from a privacy point of view they were adequate while an assessment was being made.

What could be improved

I am a trained nurse and midwife and have worked on busy wards that are similar to two of the wards. I am fully aware of the stresses and demands of nursing very ill often elderly patients. I therefore, do not want to be critical of the care given not just to me but to other patients. However, I feel there are some basic needs which are not addressed adequately from my observations.

1. The ward was exceptionally hot with poor ventilation and no means of adjusting the temperature. While I accept that I am relatively young with a good circulatory system complaints about the heat were also from frail elderly patients too. I was admitted with a high temperature and it was difficult to cool down in the heat while laying on a plastic mattress with plastic pillows. I resorted to sitting on the balcony when possible or asking for a fan.

2. I feel a basic requirement to aid recovery is to rest. This was made almost impossible by the level of light during the night and the noise from fellow patients and staff. While I realise how difficult it is to control noise from confused, deaf elderly people I think that they were woken by the level of noise on the ward throughout the night. When I was nursing light levels during the night were kept to a minimum with corridor lights off and bedside over head lights kept on dim over patients who were unwell and needed monitoring. Staff didnt seem to moderate the volume of their voices or take care when carrying out tasks such as hand washing to be quiet. One morning I was woken at 5am to have routine observations carried out after only a few hours of broken sleep.

This was for the convenience of the nursing staff. Night sisters should be monitoring the levels of noise and light on all wards. Nocturnal disturbance was not a deliberate ploy by the nurse to keep us awake it was just basic lack of awareness and inability to envisage how else to do things. They had no strategies for dealing with patients who called out all night.

Anything else?

While the food in general was poor. The choices for breakfast were appalling. We were offered cereal such as cornflakes or rice crispies and white bread with margarine and jam or marmalade. The nutritional content of this meal is poor. It could be improved just by offering fresh fruit and yoghurt. This would not entail any additional work for staff.

I believe passionately in the NHS and wanted to be able to give really positive feedback but I observed in depth what was going on for the 3 days that I was admitted and feel that care was poor mostly because standards are not being upheld. The large number of care assistants who now do the bulk of patient care are often pleasant people but I noticed that their work was largely unmonitored and their understanding of why they were carrying out specific tasks was inadequate.

I would welcome the chance to talk about my experience. I have never been an inpatient before and was saddened to find that the tabloid scare stories I had heard were not so far from the truth. I dont wish to be critical but I feel I do have an insider's understanding of the problems of working on a busy ward and that some solutions would not be so diffcult to find.