"Good communication skills would have gone a long way"

Working in the NHS myself, I was reluctant to comment on my experience in Ward 19/20 as I understand the pressures staff are working under however I had a very mixed experience.

My 2 year old daughter was to Ward 19 by my gp at 10.30 with concerns that she was vomiting and refusing oral fluid intake. I was told that she did not need to be assessed at that time but was given open access to the Ward if she did not improve. I was happy with this and when I phoned the Ward, they were helpful and there was no issue arranging an assessment.

On arrival, the Ward was busy, but we were shown to a waiting room and triaged promptly, where my daughter was found to have a blood sugar of 1.7. This was treated promptly by nursing staff with good communication of what was happening and my daughter was quickly taken to a treatment room to have blood taken and a venflon inserted. My daughter was then put in a bed.

I was told my father and 10 month old baby could not stay as this would mean there was 3 visitors around the bed and the Ward policy is 2. I feel that some discretion could have been used here but it was a minor issue. I was asked to take a urine sample from her and give her a glucose drink. My daughter was lethargic and was refusing oral intake as she vomited every time she tried to take fluid, as she did during her triage, and therefore despite me trying, she refused the glucose drink. I informed nursing staff of this promptly. 

The next time we saw nursing staff was for a set of observations, when I asked when a decision would be made regarding admission as I am a single mum with a 10 month old who I would need to arrange childcare for and it was  now evening. I was told medical staff would come and assess my daughter. She fell asleep 10 minutes before being reviewed by medical staff. I did not feel it was appropriate to keep waking her as I had done as she continued to refuse fluids and I had informed staff and was distressed ++ when woken.

The member of medical staff did not introduce themselves to me. The opening sentence was that a decision could not be made on whether my daughter would be admitted or not if I don’t try and give her fluids and that this staff member had been busy dealing with an emergency. I would like to clarify that I never commented on how long it took my daughter to be reviewed by medical staff and that I only asked when a decision would be made to allow my 10 month old daughter to be taken home if my 2 year old was being admitted as it was 8pm at night, no childcare arrangements had been made and we live a 30 minute drive from the hospital.

When I tried to explain that my daughter was referred as she was refusing fluids due to associating this with vomiting as she had been unable to keep fluids down up to this point and that I can’t force her to drink when she does not wish to, I was told I was “confrontational”. I was upset by this as I am a medical professional myself and did not raise my voice or use abusive language. I had also spent by this time the best part of 24 hours trying to get my daughter to drink and failing and I felt it was implied I wasn’t trying hard enough.

This medical staff member then proceeded to try and take an extremely brief history, which I feel may have been helpful initially to understand why my daughter was there however any rapport was lost by this stage. Examination was through and I was told my daughter would be admitted for Iv fluids and to no longer try to give her oral fluids and allow her to rest, contradictory to what I had been told by the same member of staff 10 minutes previously.

She was transferred to Ward 20 and I cannot speak more highly of the night shift staff who took care of my daughter. I was allowed to settle my daughter in the way I felt appropriate, was shown around the Ward and my daughter was checked on frequently and appropriately. Communication was excellent and I was aware of what was going to happen and when. There was toys available on the Ward which helps keep the children entertained, particularly if they can’t leave the bed. 

My only other issues with Ward 20 is that adult cutlery is supplied with meals. My 2 year old couldn’t fit the spoon in her mouth making it difficult for her to eat the soup so more age appropriate cutlery would be a good idea. My daughter also had a cows milk allergy and I had to provide my own food as there was no appropriate alternatives on the ward, however I appreciate this was mainly due to time constraints. There did appear to be a lack of communication among staff about dietary allergies as my daughter was given food with milk in it and although meant kindly, the member of staff did not appear to realise my daughter’s allergy. In this case, not a huge problem however in more serious allergies, this lack of communication could have had serious consequences.

I appreciate staff are extremely busy and are working very hard however no parent wants their child admitted to hospital and good communication skills, particularly from medical staff more than nursing staff in this case, would have gone a long way to making this a better patient journey.