"Feeling reassured and hopeful for the future."

I was a fit and healthy wife, mum and granny. I previously  worked  for NHS Tayside for almost 20 years. I enjoyed work, family, keeping fit,  knitting and baking in my spare time.  On the morning in February I woke up as normal but excited because I was getting my hair done. I headed off to the hairdressers and popped up to the bank to withdraw cash. The next thing I knew was that  there was  a man knocking on my car window asking if I was okay. He had witnessed me veering off the road, mounting the pavement and then hitting the bank wall and 2 lamp posts. I do recall thinking I’d hit 2 pot holes in the road. I still have little recollection of the crash.

The man asked me if he should call my husband but I wanted to do it my self. I remember trying to grab my bag from the passenger seat to get my phone, my left arm just wouldn’t move and I became really worried as I knew things weren’t right. Meanwhile ,the man had called for the police and for an ambulance… he ultimately saved my life.

The ambulance arrived quickly which they cared for me and saved my life with their intervention and expertise! The paramedic and attendant were amazing from the start.  The paramedic reassured me at all times and explained what he was doing and why.

I heard him mention the stroke protocol to the technician, I was aware of it due to my NHS background; my fears grew even more but I felt in safe hands in the ambulance. My husband and son arrived on scene and going by their faces they too were extremely worried. With my consent the paramedic explained everything to my husband and son. When I heard the word stroke my fears were confirmed and they then they escalated. The paramedic explained the next plan which was to get me to Ninewells Hospital asap.

Thombolysis was started in  the ambulance, again every step was explained and reassurance was given. I was “blue lighted”to Ninewells. Not a journey, I want to repeat  any time soon. I worked as an Ambulance Technician but had never experienced travelling lying down on a trolley bed  in the back when the ambulance was moving let alone in an emergency situation.This might be a beneficial experience for students undertaking the paramedic degree course. On arrival at Ninewells I was quickly taken to A&E , and then admitted to ward 33. Going through A &E was efficient and thorough. I had a CT scan that confirmed a stroke and remember thinking “ oh my days.. this is  real” .

On arrival to ward 33 I was placed in a side room which offered me peace and quiet. I was then put into a bay of 4 patients, not so quiet or peaceful. I was introduced to some of the nurses and health care workers.  I had a particularly horrendous experience in the bay. I  had been very constipated and received an enema to relieve my discomfort. I needed to use the toilet to open my bowels. I requested a bed pan and for whatever reason that was not possible.The charge nurse placed a mat underneath me whilst I was lying on the bed and told me to defecate on the mat. I was humiliated and embarrassed. Why was I put through that?

A bed became available in the Stroke Unit, PRI. I was to be  transferred to PRI to be nearer my family/home.  I was relieved that I was leaving ward 33 and heading to PRI as I knew I would be in safe hands. I  knew that the Stroke Unit was an excellent rehab ward where all disciplines worked as a team. I arrived onto the ward and was placed in a side room, again privacy, peace and quiet. I was introduced to my named nurse and a health care assistant. Both staff members were excellent, I immediately felt in safe hands and settled in and again felt reassured.  I was then moved into a bay of 4 patients, again, not so quiet or peaceful and it offered little privacy. In the bay, I felt as if I was  intruding in another patient’s room. Sadly one of the patients had complex needs and needed a lot of input from the staff, so much so that whenever a buzzer went off in the bay, all staff members automatically arrived in the bay and went to that patient which wasn’t great when there was another 3 patients in the bay with their own nursing needs. I feel the patient with complex needs would have been better placed in a side room, allowing her peace and quiet and privacy.

I settled in as best I could and was introduced to more staff members. The consultants were amazing and very human and approachable and they answered any questions/ concerns I had in laymen terms. The qualified nursing staff were professional, empathetic, caring and approachable and very experienced in stroke and the stroke rehab process. One incident was worrying, a staff nurse used my big toe to lift my affected leg to place  it in my splint.  

The charge nurses and staff nurses were gems and hard working as was the senior charge nurse.  He was very empathetic, one day he came and warned me not to listen to the news on a particular day. There had been a shooting incident in America, the charge nurse was aware that I suffered PTSD after being one of the first responders at a massacre. I was relieved he had warned me.

There were another two big negative nursing experiences in the bay. The first being that two staff members, one staff nurse and a health care assistant, transferred me to the toilet using the encore stand aid. For what ever reason they unclipped the belt clips from the machine and moved the stand aid to the other side of the bathroom out of my reach and away from in front of me, I preferred to have the stand aid left in front of me for the feeling of security, I was always fearful of falling. I still don't know why I didn’t challenge them at the time but should I have had to ? The result was I did fall onto the floor, hurting my left side which was my affected side. I pulled the buzzer for assistance. The buzzer was answered quickly by a health care assistant who found me on the floor with my bottom half naked.  I was embarrassed, in pain and cold. Unfortunately the health care assistance didn’t know how to use the buzzer system to summon help to assist her to get me off the floor. The most painful part of the incident was that I never did receive an apology from the 2 staff members or their acknowledgement about their part in my fall. A few days after the incident, the health care assistant asked me if I was going to face plant on the floor again today which I did not find  appropriate or funny at all.

One of the charge nurses completed a datix and took time to listen to my version of the incident, she reassured me that further training around the buzzer system and moving and handling was required and would be actioned. I had asked a nurse for a complaints form but didn’t receive it. I wanted to make a  formal complaint to save another patient from having to go through the experience. My left hip is still painful and stiff to this day. I also asked a different nurse for a complaints form as I wanted the incident dealt with. I didn’t receive the form and didn’t make a formal complaint as a result.

All of the charge nurses and staff nurses were brilliant, experienced, knowledgeable in stroke rehab. On the whole, the health care assistants were diamonds and most were fantastic, they should be cloned and used throughout PRI and Ninewells. There were just not enough of them to cover the ward effectively and efficiently. Unfortunately I found there were 2 rough diamonds in the group who appeared to put on a hard outer shell, which was a shame because they had a softer caring side under the hard shell when working one to one. One would shout at me in order to waken me some mornings. I did notice that she was more vocal if she had an audience but was never challenged by other staff members. One morning I did complain to a charge nurse who was going to monitor the health care assistant’s behaviour. My daughter in law witnessed her behaviour one evening and was angry for me but as we were in the bay at visiting time she didn’t challenge as she didn’t want to cause a scene. 

The same health care assistant would often berate the patients, 3 of us, in the bay, because we needed assistance around meal time.  We were told meal times were protected but we weren't sure what that meant. The patient with complex needs was often assisted onto the bed pan using the hoist just  before our evening meal or when we were having our meal, not pleasant at all for anyone. Perhaps a “welcome to the ward" leaflet could be drafted to explain the working of the ward with procedures that all patients should be made aware of?

I asked for a bath one day but was advised that I couldn’t because two staff were required to undertake  a bath. I did get a bath one day but it was at 11:00 pm at night. It was the only option I was offered. The other 3 patients in the bay needed two carers every day to get up so it could have been possible with  a bit more planning, a timetable would be beneficial to manage all of the patients on the ward.

The other big concern I had about nursing staff on the ward was the bank staff, not the NHS bank staff but external agency bank staff. For example I buzzed to get assistance to get to the toilet, the agency staff member answered the buzzer and looked down at me with a look of panic on their face as if they didn’t have a clue what to do; it did not fill me with confidence. Another example was when a another agency health care assistant was again assisting me to the toilet. I needed assistant to don my splint and shoe to enable me to walk safely to the toilet with my stick under supervision. The agency health care assistant tried to don my splint over my shoe and was frustrated that they couldn’t get it to fit.  They thumped at it but to no avail  I had to advise them of the correct procedure. A basic knowledge of strokes and stroke moving and handling should be a minimum requirement before staff are permitted to work on the Stroke Unit.  Another example was when an agency staff nurse asked me what what way round I wanted to face on the toilet after she wheeled me through to the toilet on a commode. Was I man?

The other big negative experience was  bladder training.  The buzzer was not answered timeously on several occasions, resulting in me having embarrassing accidents in the bed. Humiliating for me  and it put my skin at risk of risk of deterioration. Surely a simple solution would be to get  a portable buzzer with a different sound.

The porters were professional, experienced and bright, The domestics were also great, they always said good morning or hello which was a a nice distraction and interaction,. One of the domestics would arrive on the ward and would lift everyone’s spirits, both staff and patients - her spirit should  be bottled up and shared around the hospitals. Both the Physio and OT teams were knowledgeable, professional and caring, again I felt in safe hands. The ward staff undertook rehab activities as directed by the Physios and OTs. I set joint goals with the Physios and OT s which also was agreed with the nursing staff to continue rehab on the ward

As result after 4 months on the ward, I left walking with one stick. I began to feel happy and hopeful for my future. The only negative would be that I was referred to the Orthotist. I still don’t remember ever having a conversation with the physiotherapist about the referral or consenting to it, the first I knew about it was when the nurses said I had to be ready early for the Orthotist. I was cast for an ankle/ foot orthosis. (AFO),I would have preferred an alternative if there was one as I understand it is a treatment for dropped foot. To this day I don’t like the AFO as it rubs on the ball of my foot and other areas which is painful and the pain impacts on my walking, my progress and my confidence.

Since discharge from hospital, I have attended outpatient appointments with the Orthotist but feel my concerns re the AFO haven’t been listened to or resolved. At one appointment, I did ask about the consent to orthotics when I was on  he ward only to be told it was a general consensus that AFOs were part of the treatment.  Surely, I should be part of the “ general consensus”? Whilst at orthotics I was advised that my shoes would need a heel raise to improve my gait,  but was told that I wouldn't like it. I did consent to the raise. The Orthotist had planted that seed and yes I didn’t like it and still don’t as it causes pain  and discomfort which effects my mobility and rehab.

The OTs helped me work in the kitchen on the ward as this activity was important and meaningful to me, plus I got to have what I’d prepared for breakfast on the ward, therefore a healthier start to my day. Hospital food was edible but repetitive. I found the healthy eating option had cheese or mayonnaise on  it or a cheese sauce. 

I am  currently at home with a HART. The HART carers are excellent , caring, hard working and very good at re-enabling me to help me return to and regain my independence; the only negative is the timing of the visits.

I currently attend out patient neuro, OT and Physiotherapy, which I find hard work, but  essential  and rewarding, the staff members are knowledgeable , caring, realistic and honest,which I like and respond to , my fears have been listened to and addressed with new goals set and actioned. With their input I feel reassured and hopeful for the future.

Staff attitude

Staff skills

Team work

Seeing the whole me

Treatment