"The care I received was very poor."

One Friday in March 2019 I attended A&E with a severe foot infection that had spread through my lymphatic system.  I was diagnosed with potential sepsis and admitted to the Acute Medical Unit.

I was  put on intravenous antibiotics for 2 days, initially in the AMU and subsequently in the Short Term Stay Unit. 

The care I received, particularly the nursing care, was very poor.  This resulted in me going into shock when discharged home on the Monday March and required me getting an Out of Hours appointment in the early hours of Tuesday morning which was arranged by NHS 24 who were so concerned about my condition that they arranged for a driver to take me immediately to Kings Cross Health Centre.  They were also concerned about my discharge home so early particularly as I live at home alone with no-one to help.  I was subsequently diagnosed with shock by my own GP at a follow up appointment on Wed and I was signed off work for an extended period.

List of incidents:

1.  The bed I was first allocated to in the AMU had no nurse call buzzer.  The elderly person in the adjacent bed who had a call buzzer didn't know what this was or where this was because she hadn't been shown when she was admitted.  The elderly person kept asking me during the night to shout on the nurse for them.

2.  At approximately midnight on the first night in the AMU a nurse entered the ward and stood at the end of my bed accompanied by a porter with a wheelchair.  They shouted at me that I needed to get up and go for a foot x-ray.  I roused myself from sleep but not quick enough for the nurse who reached up and quickly whipped away the bedclothes.  I had not time to pack an overnight bag so I was just lying there with a long sleeved t-shirt and pants, almost naked from the waist down.  The porter stood there staring and burst out laughing.  I was very embarrassed and felt that my dignity had not been considered.

3.  On Saturday morning I was transferred to the Short Term Stay ward.  I had no jug of water by my bed and I was very thirsty.  I asked the Health Care Assistant if I could please have some water.  They stated that they were not ready to give out water and they were currently busy doing other things.  They never returned later to give me water and I had to ask the next staff shift.

4,  I was not shown where the nurse call buzzer was which happened to be placed high up on a shelf, away out of reach.  When I needed to go to use the toilet the nursing staff watched me hobble with my infected foot all the way along the ward and the corridor to the toilet. No assistance or support was offered.  I was later given a sock to put on my foot which very quickly became dirty.  When my husband arrived he was concerned that I had been left to make my own way back and forth to the toilet and he mentioned this to a nurse, who then came into the ward and shouted at me in front of other patients and visitors.  This was also very embarrassing and distressing.  The nurse said they had assumed I was able to make my own way to and from the bathroom.  At this time I could not weight bear on my right foot.

5.  No care advice was given to me regarding my foot.  It was not elevated to reduce inflammation or swelling and it was left to my husband to ask for an extra pillow to place under my foot.  One of the staff said that I only had a 'sore toe' and indicated that I was just making a fuss.

6.  I witnessed a senior nurse loose their temper with other patients in the ward.

7.  On Saturday night, another patient in the ward repeatedly screamed in distress all night.  By 11 pm at night it was too much for me to bear and I attempted to discharge myself home at that point because I just couldn't take it any more.  I stated to a doctor that I wanted oral antibiotics to take home and that I would phone for a taxi.  As I was on IV antibiotics, the doctor arranged for me to be put in a side room instead for some peace and quiet and discussed this with the nurse on duty. From the side room with the door open I was able to clearly hear what the nurses were saying at their station.  The nurse was not happy that I had made, what they perceived, was a complaint to the doctor and so I felt subsequently avoided tending to any of my care needs.  When I asked for pain medication which I was written up for they would only bring me a paracetamol tablet stating that it took 2 nurses to sign out the codeine tablet and that the other nurse was on a break.  I never got the codeine tablet even when the other nurse returned.

8.  I had 4 different cannulas placed into my arm at various stages of the IV treatment.  One of the nurses attending to me was not able to change the cannula site once it had got blocked.  The other nurse would not help.  The first nurse ended up calling for another member of staff to put in a new cannula.  They arrived and put in the new cannula so that my IV treatment could be continued.  I asked if they could remove the old one in my other arm and it was explained that the nurse that put it in should have done this and made a record of why it had to be removed and also the reason it was put in in the first place.  The nurses had not recorded this correctly, or if at all.  I had to persuade the member of staff to remove the old one and they agreed while stating that leaving in an old cannula could cause infection.  I heard them discussing this with a nurse at the station.

9.  On Sunday night I heard the consultant tell the nursing staff that I would definitely be discharged on Monday.  This was before they had visited me for a review.  The consultant had not seen me all weekend apart from a brief initial contact on Friday night when I was admitted.  At this point my foot was still very red and swollen and I could not weight bear.  I explained that I lived on my own and that I had no help.  I had reiterated this several times to staff.  One of the nurses made a physio referral and just before I was discharged on Monday afternoon I was presented with a pair of crutches which I couldn't use.  I was also given a Tramadol tablet when I was discharged which I think was far too strong for me.

10.  As stated above in the introduction, when I was at home alone on the Monday night I subsequently went into shock.  My blood pressure had fallen, my face was as white as a sheet of paper, my mouth was like cardboard despite drinking a pint of water and I was very disorientated.  I contacted NHS 24 in the early hours of Tuesday morning and got an OOHs appointment at Kingscross.  They were concerned that I had been discharged so early after being so severely ill and left to fend for myself with no follow up care being arranged.  This opinion was also re-iterated by my own GP.

Overall I feel that the lack of proper care and attention received at the Acute Medical Unit and Short Term Stay Unit hindered my recovery process.