"My journey from fall, to fracture, recovery and rehabilitation."

I was recently admitted to A&E, NDDH, Barnstaple. Having fallen that morning taking my granddaughter into breakfast club at school. Orthopaedic staff and x-ray confirmed a Left fractured neck of femur.

A&E staff were efficient, responsive, caring & helped to control my considerable pain and discomfort.

The on-call orthopaedic doctor discussed my previous medical history, (unexciting and minor) as well as enquiring about my usual mobility, which was very good. He explained what was likely to happen-surgery, hopefully within 36 hours for the best outcome, (wherever possible). I moved to Glossop ward that afternoon.

During the afternoon/evening I was visited by the same orthopaedic doctor who explained it may not be possible to meet the 36 hour window, it would depend on the list! Happily for me the next morning I was NBM from 6 am, I would have a total hip replacement that afternoon, within 36 hours of admission.

One of the surgeons popped in briefly and said that if all went well I could even be home by Sunday! My thought was he doesn’t know how many steps and stairs there are in our house, and no downstairs toilet!

Nursing staff were all kind, caring, responsive & managed my pain. Yes, of course it hurt, but not unbearably.

When I went down to theatre the pre-op Staff were amazing. Through the use of fentanyl they enabled me to sit up on the trolley, crouching forward so that the anaesthetist could perform a peripheral nerve block, without me being in excruciating pain - skilful it must be said.

Sedation meant I was unaware of anything until I was about to be wheeled out of theatre, but importantly for my overall recovery time I hadn’t had a general anaesthetic.

The staff who brought me down from the ward before surgery, were in Recovery to monitor me and then take me back up to the ward. Returning for a 2nd night to a side room. Lucky me!

Meanwhile the OSD (Orthopaedic Supported Discharge) team had swung into action. An OT assistant spoke to me on the day of surgery, found out how I usually managed for all Activities of Daily Living (independently) and where there were likely to be issues on discharge.

I knew our house wasn’t a property chosen for when I fall, have an operation, need walking aids, and want to be discharged ASAP.

The OT Assistant rang my husband, arranging for a colleague to visit our house. She took with her 1 raised toilet seat, 1 toilet frame, 1 commode to use downstairs- just in case I couldn’t make it upstairs every time!

They had measured my lower leg, knew my height (or lack of!), she put in place the correct raise on the toilet seat, correct height toilet frame, checked the lounge chair I usually use (which would be suitable). Oh and took a perching stool, with arms, for the bathroom to help me wash and dress independently.

She assessed that once I had been taught to use crutches on steps and stairs, the 2 steps between the lounge and kitchen, 2 more in the hallway, to reach the stairs which did have a handrail one side - wouldn’t be a problem! Nor would the half landing at the top of the stairs, where I had to do a right angled turn and negotiate 2 more steps (no handrail) before reaching the bedroom & adjacent bathroom- all on the same level - hooray!

Meanwhile Friday morning saw 2 physios come to get me out of bed and walking a few steps for the first time, my blood pressure didn’t co-operate and dropped like a stone, although thankfully not me as they were only too aware of this sort of issue!

I returned to the bed, had some IV fluids, and they returned for my first successful walk - yippee!

Over the weekend I continued mastering walking with a Zimmer and basic independence, encouraged & supervised by OSD OT/ physio staff who do work weekends!

Sleeping (or not) in a 6 bedded bay Friday, Saturday, Sunday night was interesting! No one’s fault- that’s how it is! But as sleep deprivation hit on Monday morning, the ward round confirmed I was medically fit for discharge!

Just stairs with crutches to master, no problem with an experienced physio to teach me!

Thank you to the nurse who ensured I had a shower & hair wash that morning, to all the nursing staff who were empathetic and caring. They talked to me at the right level, taking my previous experience into account.

Thank you to medical staff who informed, discussed, and included me. Who realised this was a Fragility fracture, started me on Vit D, are putting in place arrangements for a Bone density scan as an outpatient.

Thank you to the Surgeons!

Thank you to ancillary staff who chatted, supplied me with drinks and meals, as well as keeping the ward clean.

Thank you for the efficiency and calm of the Discharge Lounge, resting on a bed. A peaceful 4/5 hour wait before a 2 man ambulance took me home, amazingly, as OSD team had assessed the slate & step entrance was risky, make sure your patient is safely inside the house!

Follow up visits from OSD team at home, mean I am now walking confidently with one crutch & planning to go out.

This is exceptional treatment and care from NDDH & the NHS, except that it is routine, well planned and happens day after day, even in the lead up to Christmas. Thank you.