"Non patient centred care"

 

My relative is elderly, frail and has multiple co-morbidities including hearing, sight and cognitive impairment. They also had delirium during a recent hospital admission.

An acute admission from ED for overnight observation in MAU in RAH although managed by competent and caring medical and nursing teams was made unnecessarily complicated, lengthy and distressing due to what we perceive as non patient-centred bed management processes.

Moving a very scared and vulnerable patient in the middle of the night to a ‘downstream’ medical ward (27) without any communication with next of kin (or indeed cautioning them that this may be a possibility) was in my view inappropriate. They had to wait all of the next day into the evening for consultant review although they were medically fit for discharge from early in the day. By the evening they were exhausted and on the verge of having to stay another unnecessary night increasing the risk of HAI, prolonged hospital stay and delirium. I discussed this several times with ward medical and nursing staff. When I mentioned the potential of needing another overnight stay due to delay in discharge I was informed that my relative would be boarded again as a patient who I observed sitting in a chair on oxygen was waiting for their bed.

Eventually a kind and helpful registrar made the decision to let us go home without having to wait for the consultant. By this time my relative was utterly exhausted and distressed by the whole experience.

Having been involved in bed management I absolutely understand the challenges especially during the busier winter months. However I would make a plea that patients are not ‘conditions’ or pawns to be moved around the hospital chessboard without considering the whole picture and increased clinical, social and psychiatric risks associated with unnecessary and potentially detrimental moves.

Had my relative remained in MAU they would have been seen and discharged the same morning. Not only would this have been a much preferable and safer outcome for them it would also have had the knock on effect of having an immediately available bed for the poor person waiting for hours in a chair on oxygen.