"My mother's experience of being in A&E at Torbay hospital"

About: Torbay Hospital / Accident and emergency

(as a relative),

In August my mother had a fall.

She was just about to cross the road in Dartmouth when a car came up the road driving too fast. She went to step back on to the kerb, missed her footing and fell backwards, landing on her back.

My mother is in her 80s and has Osteoporosis.

Luckily people came to her aid and she was taken to Dartmouth Hospital. The nurse there ascertained that there were no major breaks, it was advised that she go to Torbay hospital for X-rays. My mother sufferers from terrible travel sickness, the last time I took her to Torbay she was sick and her retching and nausea caused her to have a very high irregular heartbeat - not good for someone with a history of small strokes. So it was agreed to keep mum in Dartmouth hospital and wait until she could have an X-ray there the following Monday.

During the next 24 hours, my mother was in a lot of pain and discomfort, in the end the decision was made to send her to Torbay Hospital via A&E so that X-rays could be taken..

As I live just outside Totnes, I arrived at Torbay Hospital before the ambulance had arrived with my mother and waited for her in A&E. At approximately 2 pm I saw my mother arrive. She looked terrible, extremely pale a little distressed. Due to the volume of cases my mother was 'parked' in the corridor with the other new arrivals and I went to join her.

The Paramedics who brought her were very good and one was attempting to hand over information about my mother to the A&E staff. The immediate response was a very curt 'I don't need to know all of that'. Indeed the nurse was walking away from my mother as she was speaking, the paramedic following her, trying to pass on what he felt was important information about the patient.

At this point my mother was retching, but due to her spinal injury this was very painful for her. Her blood pressure was also very low. The paramedics gently tilted the stretcher upright to make my mother more comfortable. At this point, the nurse who had previously walked away passed by and without looking or talking to her directly, demanded that my mother be moved so that her head was lower than her legs as her blood pressure was so low. This move was then made very abruptly causing my mother a lot of pain. She was also still retching and bringing up small amounts of vomit, so was now choking and even more distressed. The nurse then passed by again, this time she spoke to my mum directly and explained why she needed to have her head lower.

Over the next hour, various members of A&E staff came and spoke to my mum, asking her why she was there, what was wrong with her and what medication she'd had. All of this information was available, as she had come over from Dartmouth Hospital with paperwork which detailed, not only what medication she'd had that day, but what medication she took regularly, (including medication for a thyroid condition and others for her heart). In fact there was a massive great folder of all her past hospital notes (more about this later), however no one looked at this. Trying to be helpful, I started reading the notes out and suggested that her low blood pressure and retching may have to do with the Oramorph she was given before leaving Dartmouth Hospital.

My poor mother was in so much pain she kept saying her spine and ribs hurt, but still passing nursing staff either knocked in to the side of her stretcher or moved her up and down without consideration. When she was moved from the ambulance stretcher on to a hospital bed this was also done roughly and without consideration for the amount of pain she was in.

Eventually she was put in a cubicle and seen by a doctor, who asked her all the same questions as everyone else. By this time as well as the low blood pressure, my mothers heartbeat became very fast and irregular. The doctor was concerned by this, but kept leaving the cubicle stating that he would return and then not coming back for ages. At one point he fitted a cannula (badly) and left a blood spill on the floor, various nurses and he came in and out and ignored the blood spill. I eventually cleaned it up and then noticed how dirty the floor was. The doctor gave her Fenatyl anti emetics, saline, ordered a spine X-ray, took her notes and left.

Long pause and a different doctor appears, again my mum has to explain why she is in A&E, where the pain is etc. This doctor wants her to have a chest X-ray and admits her. She is then wheeled around to the ward and I am told in no uncertain terms that I had to wait in the family room, despite the fact I had been with her all afternoon.

I left the hospital at about 8 pm, my mothers heartbeat was still very fast and she still felt very ill.

The next morning, I was contacted at about 11 am to say that she was being moved back to Dartmouth hospital. I drove over to Torbay to see my mother. When I got there she looked a lot better and her heart rate was normal. She had been given a lot of pain killers so was more comfortable. A doctor came and spoke to my mum about a recommended regime to help her control the pain. My mum tried (not for the first time) to explain that she had been advised against certain painkillers due to other medications she was taking. The Doctor refuted this. After the doctor had left my mother said that she had not had any of her usual medication, because no one could find her file with her notes in and therefore they couldn't give her anything.

By the time my mother had arrived back at Dartmouth hospital the 'recommended regime' for pain relief had been altered because it was not compatible with the other medication that my mother has to take regularly! Thankfully however, her notes re-materialised.

I am not unsympathetic or unrealistic about the state of the modern NHS, indeed I was am employee for 12 years myself. I also have great admiration and respect for the hospital staff doing a difficult job in difficult circumstances. Most of the staff were caring and kind, (especially the paramedics), some were patronising and others rude (especially the orderly that aimed the trolley he was pushing my mother in straight at me)

The thing that really struck me about A&E was the lack of any team work or leadership. There appeared to be very little communication between staff, no conferring or sharing of information. No one looked at my mother's notes, in fact they got mislaid. I would suggest that this comes close to a near miss, as my mother could have easily been given the wrong medication, because no one was either checking her notes, listening to her, or conferring with each other.

Staff appeared to be operating in total isolation, indeed I picked up a certain amount of animosity between the different grades, rather than a sense of a team pulling together. I also picked up a sense of low staff morale. Whilst I am not naive enough to think that this wouldn't be the case, I don't think that patients or their families need to be confronted with it during a time of crisis.

My mother felt that the whole time she was at Torbay she was being treated as a statistic and not as a human being. This at a time she was ill, in a lot of pain and distressed. What she needed was to be listened to and treated with compassion.

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Response from PALS Dept, Torbay and South Devon NHS Foundation Trust

We are very sorry to hear about yours and your mothers experience and that the standard of your care fell below that which we strive to provide.

Your comments will be shared with A&E Department as we do learn from any negative experiences.

Kind regards South Devon Healthcare NHS Foundation Trust.

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Response from Torbay Hospital

Dear Enquirer, We are very sorry to hear about your mother's experience and that the standard of her care fell below that which we strive to provide. We would like the opportunity to discuss your experience with you and try our best to resolve it. If you are happy to talk to us about this, please contact our Patient Advice & Liaison Service (PALS) so they can look into your situation in more detail. A PALS Officer is available in person, Monday to Friday, between 10.00am and 2.00pm. You can contact them by calling 01803 655838 or on our 24 hour freephone number 0800 02 82 037. If you get through to the voicemail service please leave your contact details and you will receive a call back within two working days. PALS can also be contacted by Text Phone on 01803 654742, by FAX on 01803 617162, or via email to sdhc@nhs.net (your email will go direct to our PALS Service). We look forward to hearing from you so that we can address the issues you have raised.

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