"much better care needed for elderly"

In November I spent a week in ward 37, an orthopaedic geriatric ward (by whatever name geriatric is now known.) I was mentally and physically fit apart from a broken leg, so was in the rare position of experiencing a geriatric ward from the inside, and unfortunatly I saw some very poor care and lack of kindness.

(However, I would first like to thank the medical, physio, OT, cleaning and catering staff and aftercare teams who were excellent. I have no complaints about my own nursing care and certainly witnessed some compassionate and skilful nursing practiced by some individuals. These were special people much appreciated in ward 37.)

Patients ignored: Some staff spent almost every moment in the ward, reading notes and failing to engage with, or even acknowledge patients.

– refusal to make any unnecessary eye contact, was very common to almost all staff – which meant they did not even see when one lady was quite obviously in severe pain, or when another became uncharacteristically lethargic. Several times I had to call staff and ask them to help someone – not easy to do as I knew it would annoy them.

Understaffing: It was generally down to fitter patients to stop confused ladies with broken hips from climbing out of bed.

It was also up to us to try to reassure severely anxious or confused ladies. Staff often told them off and seemed ignorant of how to speak to a person with (possible) dementia or confusion.

Maintenance: I was in the bed 10 and it was freezing. There was no heating, and the draught from a very badly fitting window, visibly raised the thin curtain and blew straight on me all night. I asked for more blankets but even so, barely slept with the cold. I was later moved to a centre bed but was horrified see the next new patient admitted to that bed. On requesting to speak to the ward manager I was told they were in a meeting and when it finished would be off going duty. Why did someone, of the fully dressed and active staff not see the cold as important for their undressed, and immobilised patients?

My suggestions: 1. Mix the wards: keeping geriatric patients in a separate ward means are no witnesses to poor care; it means distress and pain become ‘normal’ and some staff cease to notice- or care? In a mixed ward fitter patients might help with older vulnerable people; and finally, as an patient in W37 you are exposed non-stop day and night to disturbance - why us? 2. Re/train all staff in dementia awareness.

3. Have a named nurse or health worker personally responsible for each elderly patient – and introduce them.

4.Have large visible name badges for staff. Get patient feedback.

5. Strong and visible nursing leadership is urgently needed in the ward, role modelling and teaching best practice.

6. Clearly privatisation, underfunding and understaffing are a massive part of the problem.

7. Finally, thank you again, the amazing individuals who in spite of everything showed tireless professional care.