"Horrific admission"

About: Aberdeen Royal Infirmary / Emergency Medicine Aberdeen Royal Infirmary / Plastic Surgery & Burns

(as the patient),

This is my second review on care opinion my first I spoke Highly about the consistently positive experiences I have had in ward 214 through this year due to infection following an operation. 

Therefore when I woke in the middle of the night feeling very unwell I knew I would get support from them and I did, they advised me to attend hospital and come via A&E due to current covid-19 procedures. 

This had been my experience when a similar thing happened in April, therefore, I was not to worried as care was quick and seamless, However, this time my admission via A&E can only be described as awful-degrading- absent care, lacking empathy-With questionable systems being followed in terms of medication.

Due to previous sepsis I got to the hospital quickly (2am) and had been informed by staff in 214 they knew of my pending arrival
The receptionist was abrupt in manner, almost huffy in response to my explanation that I had been advised to attend by ward staff, and there was no warmth or compassion shown whilst taking details And shown where to sit . Waited about 20 mins to be seen.
 
I had a positive experience with the intake nurse; smiley, empathetic and quick to undertake all the necessary checks and see me through to a bay
Nursing bay - student nurse and a nurse, they also demonstrated positive And empathetic care albeit it with obvious pressures as I was Left for periods of time whilst they went to go and get equipment etc with no buzzer etc however they spoke me through what was to happen performed ecg and on seeing my Obs and knowing I was hard to take blood from it was then my care became “doctor led”.

It was in this time, in the main A&E bays that, I experienced the worst care I have to date, truly awful and on reflection traumatising.
I would describe myself as a very patient person who gives my trust to the experts, I am aware of the pressures and challenged for staff in this department and empathetic to this however that same empathy and respect was not shown to me.

The doctor assigned to my care, had treated me previously which worried me as they were not empathetic at that time. After brief introduction, began attempting to take blood and whilst recognising my veins can be difficult particularly when so unwell. it is not an exaggeration to suggest this doctor must have inserted at least 20 needles into various parts of my arms/ hands including using a ultrasound machine, with no success. These attempts were frequently broken up by attending to other matters in bays around us and frequent disruptions from nursing staff coming to talk about other patients by name in front of me. Each failed attempt appears to cause the doctor to become less patient and left me feeling I was to blame and I was told on numerous occasions they could "only do as best as they can" and that they would keep going until a vein was found.

I had to request several breaks as it was clear this doctor appeared to have something to prove, as it is my experience following so many unsuccessful attempts to cannulate or get blood other people would try, this was not my experience here and my request for this to happen was met with passive aggression and an implication this could only be done by them.
When a canula was finally in, they commented that it was the most precarious cannula in their life but ordered fluids to be put up, by this time I Had been in a&e receiving this “treatment” for about 2 hours, thereafter at least four nurses came near my bed and I asked several times about fluids but that took at least an hour and when they started the precarious cannula wasn’t even in a vein. Again after more attempts another cannula went in and on flushing I could immediately feel it was sore however the doctor appeared not to hear this and went off.

Again lots of nurses around and no communication with me having to enquire on several occasions if I was still getting fluids or antibiotics. At least an hour passed (all whilst I was very poorly) and a nurse came to administer antibiotics all whilst talking to other nurses and never checking on my general well-being.  Again the cannula was not correctly in, causing pain, but allegedly did flush. The nurse went to discuss my pain with the doctor and never came back nor did I see the dr again. 
To my surprise shortly after this a different nurse came into my bay in abrupt manner with a tone implying I was refusing the medication, which I had been waiting for over an hour to be put up and making comments that “it was for my own good and what do I suppose they do” and despite the pain told me that the cannula was in and was informed me that it was for my own good that I try it and see how I go. I agree to this, mainly due to the fact I was exhausted felt bullied and humiliated as though I was wasting their time and the antibiotic was hooked up, I had instant pain in my arm and was advised, despite letting them know this, they would leave it for a few minutes and “see how I went”. The pain was excruciating and I had to scream out for a passing nurse who seeing my distress stopped it promptly. By this point my veins had already tissued and in agony, again an apparent inconvenience.
During the above horrific experience I was asked several times by doctors and nurses what I expected them to do. I was unwell and feeling very vulnerable and the only solution I had was to admit me to ward 214 who are familiar with my care, I was concerned about the delay of treatment in A&E due to the busyness of staff, no consistent person overseeing my care, a doctor and nurse whose attitude has been very degrading and uncaring And essentially being left to continually ask about any fluids and antibiotics whilst feeling so poorly.

As noted above the nurses and doctor appeared to think this was not possible until they had “ticked” all there to do list even though it was clear this was not going to be possible. The ward phoned down several times to enquire about me and luckily this appeared to bring my time in A&E to a quicker end.

To finish the horrific experience the porter arrived to collect me and a further 20 min wait ensued the nurse who did attend with me yawned and moaned about their shift to the porter all the way up and on arrival on ward said they were unsure about my circumstances as had been too busy to know what had been happening, luckily this is not my first experience and I was able to answer some of the questions.

Anyway, having arrived at 2am they finally appeared to relent to me going to my ward at 6.45 I feel that was almost 5 hours of wasted time for my care which I stayed in hospital for a week to recover. My experience in ward 214 was so different where I was met with consistent compassion and a cannula nurse attended promptly and inserted a cannula successfully in the first occasion and a huge contrast in care.

Therefore to summarise the above, which are example of my experience

- My care did not appear to follow protocol in terms of the administration of medication and cannulating

- Bar two of the nursing staff, each member whom I had interactions with in A&E, briefly and inconsistently were abrupt, ineffective, dismissive and definitely not patient-centred. In particular the nurse who administered the antibiotics into my vein did so despite knowing the pain and this could have had more significant consequences if I was unable to alert staff.

- the doctor leading my care showed these qualities too, and appeared to be stretched between so many patients that nothing was actioned promptly, consistently, or with any care, empathy or patients centredness.
 
-There appeared a lot of hustle and bustle with nurses and doctors moving around but no consistency in my care, despite there being a clear plan for me to go to ward upon confirmation admission was needed which was clear in the first consultation room. On the two occasions I did enquire, this appeared to aggravate the doctor who felt this was undermining their abilities and it was quite the opposite.

- there was no communication about timescales or next steps, huge delays from the decision to give fluids/ antibiotics for any attempt for these to be administered

- finally and ironically, despite coming via A&E as part of the COVID screening process having spiked a sudden temperature, at no time was I asked about any other potential Covid  symptoms or swabbed for this which I found quite baffling and I had to alert staff to this on ward in case it changes my care pattern.

I did enquire about the name of the doctor the following day but this never came to fruition as if I had this I would also consider following a formal complaint process as I do not want myself or any other person to go through what I went through during this A&E admission when I know care and standards have been higher previously and this experience impacted on my overall well-being and emotional recovery. 

Responses

Response from Sean Berryman, Unit Operational Manager, Surgical specialities, NHS Grampian 4 weeks ago
Sean Berryman
Unit Operational Manager, Surgical specialities,
NHS Grampian
Submitted on 01/09/2020 at 14:01
Published on Care Opinion at 14:01


Dear Larjag33

I am so sorry to hear about your recent hospital admission. I represent the surgical division so I will pass on your positive comments to the staff in plastic surgery.

I am sorry to hear about your experience in ED. I cannot comment on these and will leave my colleagues in that department to respond to you separately.

I hope you continue to a full recovery and I can only apologise for the care and experience you have received

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Response from Julie Wattie, Nurse Manager, Medicine 1 (Medicine and Unscheduled Care Division), NHS Grampian 4 weeks ago
Julie Wattie
Nurse Manager, Medicine 1 (Medicine and Unscheduled Care Division),
NHS Grampian
Submitted on 01/09/2020 at 17:27
Published on Care Opinion at 17:27


Dear Larjag33,

I am the Nurse Manager for the Emergency Department and am so sorry to hear about your recent experience. I have discussed this with our management team and when you feel able we would like to discuss this further in person with you. My phone number is 01224 552763 and my email address is julie.wattie@nhs.net.

I hope you are feeling better now and recovering well

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Response from Julie Wattie, Nurse Manager, Medicine 1 (Medicine and Unscheduled Care Division), NHS Grampian 3 weeks ago
Julie Wattie
Nurse Manager, Medicine 1 (Medicine and Unscheduled Care Division),
NHS Grampian
Submitted on 03/09/2020 at 10:01
Published on Care Opinion at 10:01


Dear Larjag33,

Many thanks for taking the time to contact me yesterday. I will be back in touch after we have looked in to this further and will feedback to you as promised.

Thanks again

Julie

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Update posted by Larjag33 (the patient)

Thank you Julie for following this up So promptly and it is reassuring to hear my experience will be taken seriously and that hopefully an isolated incident. Hear from you in due course

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