"End of life care and symptom control"

During visiting a friend who was end stage palliative care I identified to senior staff member that pain relief was needed. In the space of 30min I had to approach staff 3 times. Considering palliative care and syringe driver had been commenced that afternoon I felt IV paracetamol wasn't sufficient to the level of pain being experienced. I requested a doctor review pain relief and was told that the hospital at night team were always very busy. This made me feel that my friends suffering wasn't a priority to that senior staff member nor would it be a priority to the hospital at night team. I noted that they did not once ask my friend how the pain was nor how severe he felt it was, in fact they did not speak to him at all.

Another staff member arrived to the side room to administer IV paracetamol via PICC line and I had to ask for them to put on an apron and also had to ask for them to use sterile gloves as they were about to proceed to use the PICC line without sterile gloves. I also had to ask the staff member to check for flashback before proceeding to use the line. I found this to be unacceptable infection control. The night staff member took my concerns on board and did speak with the hospital at night team for breakthrough doses to be adjusted and sadly my friend passed away in the early hours. I feel there is a lot of learning about palliative care symptom management required and also infection control around the use of PICC lines.

A further upsetting issue was that my friend was in bed with only an incontinence pad on and although I acknowledge that he always felt warm there was no reason for him not to have at least underwear on to preserve his dignity