"Discharge planning"

I received a very unpleasant phone call from a senior member of staff at Hairmyres Hospital  in East Kilbride regarding discharge planning. The interaction was extremely upsetting and I felt that this needed to be publicly aired so that this does not happen to another patient or patient's relative. 

For context, which I think is important, I confirm the following : My father is in Hairmyres hospital and was admitted with aspiration pneumonia.  He spent 37 hours in A&E awaiting a bed prior to admission. He developed urosepsis from a kidney stone discovered on imaging a few weeks into his admission. During his stay on ward 14  there have been two Datix's completed and one which involved serious harm. Essentially, he was prescribed an antibiotic which the bacteria was resistant to rather than sensitive to. His treating consultant confirmed that the Microbiology report had not been acted on due to 1) human error by a junior doctor and 2) a systems failure where  a final microbiology report is not proactively shared with his treating doctors. This caused my father to deteriorate significantly, almost costing him his life.  The second incident involved auxiliary  staff not complying with SALT guidelines which were taped to bedside board.

The stay has been tumultuous and culminated in the phone call where I was told that my dad was to be discharged to a nursing home that the family had been considering, however, which was very much not decided due to outstanding funding issues, concerns about transition to  a different Health Board and different Local Authority & ongoing rehabilitation. I was told that I was delaying making a decision, that I had been out at the home at the weekend and moving to a different Health Board was not an excuse to stay in hospital.

I was told erroneously that he had been discharged from physiotherapy. I let the member of staff know that he had an upcoming bedside physio appointment, to which they shouted over to a nearby physio to confirm. They then seemed to suggest that he only had an appointment at my request rather than clinical need. I tried to explain my concerns about moving my Dad to a home 55 minutes away and that his care needs were complex and I needed to make sure that his care plan could be effectively managed, particularly as he was moving out with Lanarkshire Health Board and out with Social work catchment area. I tried to explain it was a big decision for the family and we need to think about it. They told me to phone my family and just make a decision. I also tried to explain about funding but they just cut me off and wouldn't let me explain the complexities of cross border local authority funding application(s). 

They kept saying that they needed the bed again and again so I then asked for my Dad to go to a step down ward on an interim basis as I accepted that my father was not in acute medical need. They then shouted at me, saying that this is still hospital and he should not be in hospital.  At this point I broke down crying and asked them why they were being so nasty and combative. Their way of dealing with this was to tell me that they have a zero tolerance abuse policy, which completely dumbfounded me as they were the aggressor in the situation. I can only imagine this was said for the benefit of ward staff around them as this phone call was not taking in place in private, given they had been shouting over to a physiotherapist during our call. They then proceeded to tell me that I was combative. They seemed to be parroting the same phrases I had used to describe their telephone manner, which I found very odd indeed. 

It is very concerning that someone in a senior management role cannot tell the difference between raising a legitimate concern such as being pressured into making a decision into my Dad's long term care and verbal abuse.  I can only imagine that they felt their authority was in some way being challenged and their way to deal with that was to go on the offensive rather than attempt to navigate what is a difficult discharge in a respectful and rational way. 

The conversation took place while I was in an open plan office with 5 reliable witnesses who can confirm what I said and how I said it.

I believe that this member of staff has tried to bully me into making what is a very difficult decision and in doing so has breached their nursing code of practice, which is all the more serious given they are responsible for incapax  and vulnerable elderly patients.