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"My mother's hospital experience"

About: Borders General Hospital / Acute Assessment Unit Borders General Hospital / General Medicine Borders General Practices

(as a relative),

Situation:My mum, aged 75yrs normally a capable woman who lives independently on her own.She has been admitted to medical wards at BGH.

Background: she had a few days of some confusion,  tired and had a fall at home. She has heart failure and bereaved of her husband October 2020.

Situation: a call to GP practice was followed up immediately and she was seen and given a thorough check up..the ANP was wonderful and listened to mum and myself as I filled in the blanks when mum wasn't able to.  She was admitted to ED.

The nursing staff, technicians and porters were fun and kind. The medical registrar was again very thorough and listened to her experiences and explained what she would like to do. She was aware of mum's bereavement. 

Admitted to MAU, Ward 6 and her stay here was worrying for us but staff were available to meet her needs and speak to me about how she had been and plans of her care. This was very important because as the sole visitor of a large family of siblings home and abroad, who was keeping the family updated. This meant the family did not need to call the ward too. 

After 48 hrs mum was moved to ward 4. This was where her husband had died, months previously. Despite being next of kin, I had not been informed of the move.  When I tried to book a visit to see her that day, was informed the visiting hours were reduced and only available 2-7. In MAU, it was 10-7.  I am very unclear why the change..surely BGH have a visiting policy? Also, in MAU I was to wear a mask and sanitise hands, in ward 4 mask, gloves and apron. But was the only visitor in a bed area of 6, sat by my mum and held her hand, hugged and kissed her.

The biggest change was the staff. The ward clerkess is wonderful.  Kind, cheery and nothing is a problem. 

When visiting,  I stand at the door buzzing for up to 12 minutes,  waiting for someone to open the door and check out my covid tick boxed chart. Or if a friendly domestic answers,  i can walk straight in, unchallenged by any trained staff who are sitting at the PC at the nurses station or standing outside the rooms noting in charts. NO eye contact,  no welcome,  no information given.  When asked for updates I was advised 'I've  been on days off..I'll get -- to speak to you' or 'she only came here today, i haven't had handover' , or another, after my 45 mins allocated visit was finishing, 'I know you are wanting to speak to me but, the Dr is just coming,  they'll talk to you.

Mum, as she became clearer, was aware one of her possible diagnosis was same as her husband died of on Ward 4 in October last year.  

Recommendation: Communication skills of staff on this ward need to be vastly improved.  Given there are very few visitors visiting at any one time, could they make themselves available for an update about your relative. A smile, acknowledgement and a little compassion would go a long way to making a very worrying time a little easier for the visitor and patient.

As a confused lady, my mum could not tell me with any confidence about her condition or plan of care. 

I did speak with the Consultant..she took time to talk through all the symptoms,  the possible causes and the plan moving forward. Sadly,  I have not felt confident in mums care in ward 4 because of my experience as a daily visitor. She has, after a full week,  come back from any confusion.  A member of staff told her she'd ' been off her head'.

I hope by sharing our experience,  staff can learn from this and recognise that communication is vital. 

I would like to end on a positive.  When my step dad was in BGH last year, there was no visiting which was very difficult however,  the communication was excellent! Daily medical and nursing updates. And as he died and visiting afterwards,  staff were available and kind.  

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Responses

Response from Kirsteen Guthrie, Clinical Midwifery Manager, Maternity, NHS Borders 6 months ago
Kirsteen Guthrie
Clinical Midwifery Manager, Maternity,
NHS Borders
Submitted on 25/05/2021 at 17:01
Published on Care Opinion at 17:01


Dear Concered29,

I am very sorry to hear of your experience in ward 4, this is not the standard of care we wish to provide We take all care opinions seriously and as such. I would like to give you the opportunity to speak with us regarding the issues you have raised.

You can contact Senior Charge Nurse Margaret Stewart directly on ward 4 01896 826004 or speak with myself, Clinical nurse Manager Audrey Bell 01896 826034

Audrey Bell

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Update posted by Concerned29 (a relative)

Thank you for your response Audrey, I appreciate it. This is not a complaint but rather our experience and as such wanted to share our thoughts. I do not feel we need discuss these further but it would be good to know if you do take any actions from the issues raised.

I feel the points raised are

*Staff communication..verbal and non verbal. Perhaps there a training need. It would have been valuable for the nurses to share information about patients day and not leaving all communication with relatives to medical staff. Having an understanding of how my mum managed with mobility; was she less confused; did she eat and drink well, are as important as understanding her medical plan.

*Differences of Covid 19 visiting policy on wards is disjointed and should be universal.

*Staff being aware of recent bereavements and options to avoid same ward areas, if at all possible.

* Patients dignity..telling her she'd been off her head is really not acceptable

Thanks again

Regards

Response from Sarah Horan, Deputy Director of Nursing, Midwifery & Allied Health Professionals, NHS Borders 6 months ago
We are preparing to make a change
Sarah Horan
Deputy Director of Nursing, Midwifery & Allied Health Professionals,
NHS Borders
Submitted on 26/05/2021 at 11:46
Published on Care Opinion at 12:11


Dear Concerned29,

Thank you for engaging with us on care opinion. When we get things wrong for families we want to learn how to improve.

I will take your comments on visiting back to the group that is supporting the clinical teams so we can review the current arrangements that are in place.

Communication with families has been really challenging over the pandemic but as my colleague Audrey has said we can and will do better as you have told us about your step dads care and the clerkess in Ward 4. However we acknowledge we haven't got it right for your family this time.

One of the really difficult things in a small District General Hospital is that wards and clinical areas hold some painful memories, but we try to be mindful of this and take a person centered approach.

I hope your mum is improving now.

Sarah

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Response from Audrey Bell, Clinical Nurse Manager, Borders General Hospital 6 months ago
Audrey Bell
Clinical Nurse Manager,
Borders General Hospital
Submitted on 26/05/2021 at 12:15
Published on Care Opinion on 27/05/2021 at 11:55


good morning Concerned 29,

Thank you for getting back in touch. We will follow up on all the points you have raised with ward 4. I appreciate you do not feel the need to discuss further but should you wish to at some point in the future myself or Margaret are very happy to do so.

Thank you for your valuable feedback.

Regards Audrey

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Response from Sarah Horan, Deputy Director of Nursing, Midwifery & Allied Health Professionals, NHS Borders 5 months ago
We have made a change
Sarah Horan
Deputy Director of Nursing, Midwifery & Allied Health Professionals,
NHS Borders
Submitted on 24/06/2021 at 14:52
Published on Care Opinion at 17:04


Dear Concerned29

I wanted to update you on the plans that we have in place to address some of the issues that you have highlighted about your mothers experience as a patient with us.

The Senior Nursing Leadership team work together on an improvement program called Back to Basics - Forward to Excellence. This has a few work streams one of which is Communication. Your mothers experience is being added to our evidence of how we need to work in a different way and learn, so your time spent in sending this experience to us will have an direct impact with our clinical staff and support change and learning which I can see is your desired outcome.

The visiting group have discussed your feedback and are using this and others experiences to support the ward teams to be able to take as person centered approach as safely possible to bring loved ones together.

I hope this is useful update for you.

Best wishes

Sarah

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