"Dad's hospital stay"

My dad was admitted to Milton Keynes University Hospital one Friday, having been treated with antibiotics and diuretics at home by his GP. His sodium levels were low, so the GP decided to admit him to the Acute Medical Assessment Unit (Ward One), although for some unknown reason my Mum was asked to take him to the practice first for a blood pressure check. On Sunday he was transferred to Ward Two, the Short Stay Ward. I arrived from my home in Scotland on Tuesday. There were a few things I observed that I wanted to bring to the ward's attention. 

Firstly, I do not think there is enough attention paid to fluid and nutrition on that ward. When I arrived at lunchtime, my Dad's tray table was positioned over the top of his bed rail, so that it was much too high for him and he was one handedly reaching up to try and cut an omelette. He was not put on the "red tray scheme" even though his intake is poor and he requires assistance. After one mealtime we observed someone coming round to record what he'd had to eat, but this did not seem to be consistent, and neither was the recording of his fluid intake even though he was on a fluid restriction of 1.5 litres. 

Secondly, I think record keeping in general could be better. The chart that is used to record his positional changes/checks often says things like "intact" - does this refer to his skin or a dressing? When I asked about his bowels, a nurse admitted that although it did not appear from the records that they had moved, sometimes people forget to write it down. 

Thirdly, on the Thursday morning, there was a gentleman admitted to my Dad's bay who was clearly in distress, possibly suffering from dementia or delirium. The behaviour of the staff was completely inappropriate. They were trying to find some music that would calm him down - fine in itself, but they were talking about him in loud voices that the gentleman and the whole bay could hear saying things like "he's blind", "is he in pain?", "no he's had paracetamol and midazolam","try 40s music, that might shut him up" and "I'm moving him to your bay" "Oh no, I've got four already (meaning noisy patients)" "exactly, in for a penny, in for a pound".

Not only were they breaking confidentiality, but also talking about someone who's already distressed in that way (someone's son/dad/brother), did nothing to allay his distress and quite possibly added to it. This did not appear to be a ward where the staff were rushed off their feet, there always seemed to be heaps of staff hanging around the nurses station, and there were student nurses and healthcare support workers around too, yet nobody seemed to consider sitting with him as a way of supporting/calming him.

Fourthly (a minor point), there is a little white board outside bays C & D saying which staff are on duty. This was not updated when we were there, so we had to find out for ourselves who the relevant staff were. 

Finally, we were told twice by a registrar on Wednesday and Thursday that my Dad would be kept on Ward Two. I even asked if it not be better for them and him if he were to move, as I realised that this is a short stay ward (and as you can see from my comments above, I wasn't sure that this was the best place for him to be cared for), to which they replied that when they say they'll keep him here that's what they'll do, and said that we could come in early on Friday so that we could see the consultant.

On Thursday evening, a nurse told us that my Dad and the man in the bed next to him were going to be moved to Ward 23. I asked what sort of ward that was and whether he would be under the same consultant, and mentioned what the registrar had told us about him not being moved and seeing the consultant. The nurse said it was a medical ward and that they weren't sure about the consultant but that their plan of care/management would continue. The same nurse returned a short while later to say that the bed manager said we could stay.

I unpacked my Dad's stuff that I had prepared for him moving, explained to him that he wasn't moving after all and got ready to go home. On passing the nurses' station, I said to the same nurse who had spoken to us earlier to please let us know if anything changes to which they replied that my Dad and the man in the next bed would be moving. I could see this written on the white board - their bed numbers and "ward 23 surgical". I went back to repack my Dad's things and told his neighbour (who had not been told by the nurse), and thought I would wait so we could go with him and make sure he was settled. It became clear nothing was going to happen quickly, so we gave up and went home.

I have absolutely no problem with my Dad moving, I understand the pressures on hospital beds particularly in a short stay ward, and actually don't think that's the best place for a frail elderly person to be cared for anyway. My issue is that a) we were given a false promise that he wouldn't be moved  and b) the lack of communication about the change of plans.

I also saw one nurse in particular who clearly cares about their work and their patients, who tried their best to explain to us what was happening, apologised for some of the things I highlighted and was very kind to my relative when he was upset at having to leave. The registrar too went out of their way to spend time with us and come back the next day to update us on what was happening.