"Variable; excellent to totally..."

About: Russells Hall Hospital

What I liked

These comments concern the treatment of my elderly Mother. EAU doctors and nurses were fabulous. They worked together well and provided outstanding care. The nurse in charge of my Mother was also excellent; working proactively and with a high level of professionalism. The specialist nurse and palliative care doctor were both outstanding, providing excellent support. They were both professional yet very approachable, keeping us informed and inspiring confidence. They worked hard to prescribe good pain relief and were able to treat both family and patient holistically.

What could be improved

The problem came when my mother was transferred to A1 at the weekend. It seemed that weekend staffing of this ward is inadequate with little supervision or doctor input. Communication was not effective, may be relating to ineffective handover routines. On Friday evening my Mother was left for two hours agitated and in pain in spite of repeated relative requests for help. This was due to poor communication between departments so that A1 did not have her medication ready on time. The Fy2 doctor was unhelpful; she seemed to have no training in defusion strategies. The nursing staff constantly told us the medication was in hand when it was not. We thought we had complained sufficiently to ensure this did not happen again but on Saturday night the situation repeated itself. The bank nurse who had worked hard all day was unaware of the medication. She did her best to help whilst other nurses sat chatting on the nurses station. Eventually the medication arrived an hour late when my relative was again suffering pain.

Anything else?

Supervision and adequate staffing is needed at weekends because people can be ill at any time of the week. As a lot of care is given by FY2s they need to be trained in defusing situations where relatives and patients are distressed. Nurses need to communicate effectively, particularly at handover. Staff should be trained to be proactive and to respond to concerns in a sympathetic and caring manner. Pain relief should be a priority; a patient should not be left for two hours in pain and a highly agitated state because nurses have not responded to the prescription from the palliative care doctor.

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Responses

Response from The Dudley Group of Hospitals NHS Foundation Trust

Thank you for taking the time to post feedback about your mother’s stay in our hospital and thank you for your positive comments about the care you received by our emergency team.

We are concerned, however, by your comments about your relative’s stay as an inpatient. This is not the kind of experience we would want anyone to have as a patient in our care. We always strive to provide the highest standard of care and we are very sorry if, on this occasion, our standards fell short of those we aim to provide.

To address some of the points you have raised, we are upset to hear that your mother was agitated and in pain. We would like to assure you that we are investigating your concerns about the timeliness of pain medication and will check the systems we have in place.

We regularly review staffing levels to ensure we are able to provide appropriate care to patients. Staffing levels on Ward A1 are the same at weekends as they are in the week. We have a consultant ward round each day, including at weekends, where treatment plans are discussed with junior staff, and implemented.

Junior doctors do receive training in effective communication and it appears that on this occasion we could have done better. Please accept our apologies for any distress caused to your mother.

We welcome all feedback and would like to assure you that all comments are taken seriously and acted upon as part of our ongoing commitment to improving patient experience.

You have raised a number of issues which have been forwarded to the matron responsible for this ward. She would welcome the opportunity to discuss your concerns with you so that we can learn from your mother’s experiences and would encourage you to contact matron’s secretary on (01384) 456111 extension 4781 to arrange an appointment.

Alternatively you may contact our Patient Advice and Liaison Service (PALS) on 0800 073 0510 who will be happy to discuss your concerns.