"Person-centred care"

I was admitted to the Royal Cornwall Hospital last week. Staff suspected Appendicitis. The journey through A&E (via an emergency ambulance) was all but the usual journey through a very busy day.

(1) A question from my first contact with a doctor from the surgical team made me feel sad for others who don't have the same understanding as myself (I work in primary healthcare, delivering services for Adults who have a learning disability). The doctor asked me name, my DOB, maybe a few other questions related to my immediate care but also (I felt) then stumbled into the resuscitation question. My concern being for those who may feel so unwell at the time they could be feeling they may not come round from a procedure because the doctor has posed this question in this way or they could think they have to go along with whatever the doctor is saying.

As I said, the A&E journey was the usual. Problems started however, when I was being transferred to the Theatre Direct. By this time the hospital was extremely busy. Staff were saying it was totally full.

(2) On arriving at the holding lounge for Theatre Direct the nurse was informed there were no spaces. This caused some friction between the staff. The Theatre Direct lounge staff were saying they had told the Bed Manager there were no beds and the A&E Nurse was saying the opposite. Of course, this held up the Nurse who had transferred me. I just felt sorry for all staff concerned. I wasn't the only patient waiting in this 'inbetween queue'!

A seat was found for me. The doctor then came to see me whilst I was in this lounge to tell me the results of the CT scan. He said I didn't have appendicitis but had diverticulitis. He then left. No further information was given to me.

I remained in this lounge until past 10pm (apparently the lounge is supposed to close at 7pm). I was taken to the Theatre Direct ward. Here is was given a drip of fluids (maybe something else as well, but I was tired, in pain, confused, worried etc).

(3) I tried to sleep but there was too much noise coming from outside the window. I later found out that was people congregating at the entrance of A&E. In the morning I contacted the Patient Experience team and this was rectified immediately. What a wonderful team.

(4) The drip of fluids that had been put up the night before had been stopped (I am not aware of the reason why it was stopped). I had had only a small amount of this. I asked staff several times throughout the day if it needed to be restarted, they said it did, but no one reconnected it.

(5) The surgical team came to see me. They said I would be able to go home once my blood results were back. They also said I needed more antibiotics. But I wasn't told what they were or when I needed them.

(6) In the evening someone came and measured my legs then put some surgical stockings on my legs. I was not told any reason for this. After a few hours, my legs were hurting very much. I pulled the stocking down, that relieved the pain. Eventually I took them off.

I was moved to another ward at 03.00. I only knew about this when a porter arrived. I was taken to Eden ward.

(7) On entering Bay D I could hear the awful noise of the air conditioning machine/compressor. By this time I was quite annoyed and distressed. I voiced my concerns to the nurse on duty. She asked why I wasn't wearing my stockings, I explained, she said, I had capacity to decide. (But I had not been told why I was wearing them!) I was given the antibiotics I should have been having and given the fluids from the previous night.

Another night of no sleep.

Thursday. The surgical team came to see me. Again they said I could go home when the blood test results came back. I was convinced I was going home today. I waited and waited.

(8) At around 7pm a nurse told me I wasn't going home. The F1 had been to the ward and told the staff this, but not me. I'm afraid I was furious. The nurse on duty called the F1 and told him to come back to explain to me. By this time I was hell bent on discharging myself. I had telephoned my husband to collect me and spoken to my daughter. The F1 came back, said i needed to stay for more antibiotics. I tried to explain that I was finding it hard to stay in the current noisy conditions. I asked if he could send me home with antibiotics in tablet form. He said no. Neither of us were backing down. He went to get the self discharge form and talk to his boss. When he returned with the form was the only time I had been told what my infection rate was. On hearing this I immediately backed down. I was given the necessary treatment and discharged the following day.

I implore RCHT to improve their communication with patients. Surely they should informed appropriately to enable them to understand and make the right choices about themselves. If I had not witnessed this myself I would not have believed it.

Also, The Nursing staff are fighting a losing battle. They are constantly fire fighting in their roles. They do amazing work but departments are not joining up to work together.

The NHS will be losing many talented people if things don't improve.

Thank you