"A mixed experience of care for hip replacement"

About: Wrightington Hospital / Trauma and orthopaedics

(as the patient),

I had a total hip replacement at Wrightington in early January 2013. I had a mixed experience with some real highlights and some lows.

I was impressed with the service on my first visits to Wrightington where I really benefited from the displays in the foyer. By the time I'd read the information the majority of my questions were answered. I liked that when appointments were running late I was given a pager so that I could go the cafe until it was my turn.

My contact with the surgical team was all very positive. I found them to be informative, empathic and very respectful. I would have liked all copies of the letters sent to my GP/consultant as I like to have all the information available.

When I arrived at the hospital for my hip replacement I was put on the John Charnley wing as the other wards were closed for deep cleaning, and I was told that I would return there after my operation. I was really pleased with this and I unpacked my things and put them in reach of the bed for my return. However after my operation I was wheeled from recovery to Ward 5 which significantly added to my stress as I wasn't told that plans had been changed and I was concerned about how I would get my belongings. This felt thoughtless and was upsetting as I woke up expecting one thing and got quite another.

The staff in the anaesthetic room were lovely - very caring and reassuring as I was extremely anxious about the whole thing. Similarly the staff in recovery were also supportive and understanding.

On the day of my operation there was some issue with the phones and my partner was unable to get through to find out if he could visit so in the end he visited anyway and fortunately he was able to see me, otherwise he would have had a long wasted journey.

Once on Ward 5 I found some staff to be caring and helpful and others to be less so. Unfortunately I had severe IBS symptoms and this delayed my recovery significantly as I felt so unwell. This meant that I was in the middle of a ward with diarrhoea using bedpans with just a curtain around me. (The curtains all have reminders regarding patient privacy and dignity!)

The ward sister made the decision to put me in a side room as they were unsure whether I had IBS or something which could be passed to other patients. I found that one staff member in particular was unhappy with my being moved and I heard her talking with others saying that IBS is not a medical issue and that I should not be in a separate room. I felt that it was unprofessional for her to discuss this within my earshot.

This same staff member was unwilling to help me get back into bed after a period of sitting out for an hour (only the second time I had done this, as up to this time I had been very dizzy and faint) and told me that there were 26 other people on the ward and that I would have to wait. She returned after a period of 50 minutes. On discussion with her about this she informed me that she was being 'cruel to be kind'.

I felt then and still do now that I know best when I am ready to do things as part of my recovery and that while staff can offer advice my feelings, concerns and opinions should be supported and respected. I did feel that she shared her point of view with some other staff and that this affected their attitude towards me. I was very unhappy about this but after an operation I felt vulnerable and unable to pursue it any further - particularly when I could see how busy and pressured the staff were.

The booklets given to patients emphasise that patients are individuals and that they all recover in different ways and at different rates - I didn't feel that this was the view of all staff and think that this should be reflected in their training and their approach with patients. I think that the terms 'care' and 'respect' should be added to the mission statement alongside privacy and dignity. There are numerous research studies which support that patients treated in this way who feel they have control over their treatment and recovery are likely to recover more quickly and be discharged earlier.

The standard of care I received varied from being thorough and caring to distant and lax. On some days I received help washing and my sheets were changed and other days I didn't, for example one day I didn't have the opportunity to wash and change until after lunch. Overall though, I felt that most nursing staff did their best in what seemed to be a very demanding and busy role.

The care from physiotherapists was thorough and informative and they all had a sympathetic and professional approach. Because of their input I felt confident to be able to go home and that I knew how to follow the hip precautions and could move around safely.

The ward was spotlessly clean and the cleaners did a thorough job and were friendly and chatty. There were choices of food and this seemed adequate - although I didn't eat too much as I felt poorly with IBS. I would have liked fresh fruit at breakfast and meal times and some salad would be good with lunchtime sandwiches or baked potatoes. There is a snack round in the afternoon where fruit is offered.

I was glad to read in the response to someone else's feedback that there are plans to rebuild/refurbish the wards as I think that will improve things dramatically. I hope that the corridors will get a bit warmer and be improved at the same time!

Overall I was really pleased with the result of my surgery. I am in much less pain and the scar is really neat and has healed well.

In general the nursing care was good considering the constraints that staff were working under. It would be good if the standard of nursing care, including attitudes and approaches, was more consistent across all staff and if there were more staff accessible to have time to discuss any concerns or issues.

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Response from Susan Heighway, Patient Relations / PALS Manager , Patient Relations / PALS, Wrightington, Wigan and Leigh NHS Foundation Trust

Thank you for your posting. I have passed your comments to the the Head of Nursing for Specialist Services at Wrightington Hospital who has responded as follows:

Thank you for taking the time to post the comments about your experience at Wrightington Hospital. It is pleasing to read about the many positive aspects of your care, including how the Doctors, Nurses and Therapy staff contributed to a successful outcome to your surgery. I will ensure that this information is shared with the individual members of staff who were involved in your care.

It is concerning to hear about the difficulties you experienced while on Ward 5, specifically in trying to maintain your privacy and dignity, and feeling that your concerns and opinions were not considered. It is clearly unacceptable to experience such varied standards of care and I would like to apologise that this was the case. We are constantly looking for ways to improve the care that we provide and your experience will be used to direct our efforts towards addressing the negative aspects of your care.

Thank you, once again, for taking the time to let us know about your experience, and although you have made many positive comments if you would like to discuss your concerns further then please get in touch with the Patient Relations Department with your contact details.

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