"No way near acceptable"

About: The Royal Victoria Infirmary / Accident & emergency

(as the patient),

I was taken by ambulance to the RVI following a car crash when a car hit from behind. In the ambulance concerns were for a very painful knee following a Total Knee Replacement some 9 weeks ago and whiplash injuries and high B/P.

My B/P was very high 220/117 P100. This morning it is 142/80 P 70 (not bad for 70)! A student took my obs and said that my BP was still high but I was shocked when they said they couldn't do neuro obs as they had new charts and there was nowhere to record them. That was the only time obs were done.

In A&E I spent the most part of 6 hours on a trolley in a corridor, even having a Dr discuss my care there in public, and 1 hour in x-ray after I asked for the loo and told by staff I would be fast tracked to x-ray and could go there.

When I returned to A&E from x-ray I asked for the loo again in desperation, I was eventually pushed into an office and given a child size bedpan with flooding result. So much for dignity of patients.

I asked for painkillers, I was offered codeine, oromorph, nefopam, naproxam (all absolutly lethel) and Ibuprofen which was on my allergy list. My post op painkillers which suit CoDydramol 10/500 were not stocked by the hospital so had to wait until I got home for pain relief.

The next day I spent with a violent headache, nausea and vomiting and it is only today I am beginning to feel more normal but not well enough to go out.

Sorry RVI A&E but having been to other departments and wards at the RVI your care came no where near acceptable.

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Response from The Newcastle upon Tyne Hospitals NHS Foundation Trust

I am very sorry to learn of your experience in the Emergency Department and would wish to apologise that your experience was below the standards of care that we would expect to provide. It appears that there was a miscommunication by the student nurse. The Trusts observation charts have recently changed to a National Early Warning Score, previously all observations could be recorded on the one chart. The new system now requires a chart specifically for patients who require neurological observations to be recorded, we have invested significantly in training all staff, including students, in regard to this change but it is evident that the student nurse was not familiar with some of the detail of this change. Irrespective of the chart if neurological observations were required then a baseline set should have been taken and documented in your records until clarification had been obtained regarding the correct chart and I would wish to apologise for this.

I am sorry that you remained on a trolley for a prolonged period of time and would wish to assure you that is not the standard of care the department aims to deliver, I am unsure of the exact day and time you attended but any extended wait on a trolley was most likely due to increased number of patient attendances at that time. I am sorry that the doctor proceeded to discuss your care in a public and assure you that this has been discussed the staff in the department to remind that this not acceptable.

Once your request to go the toilet had been made staff should have responded promptly and assisted you, again I would wish to apologise that this was not your experience. I can however assure you that we do not have any offices in the Emergency department, you will have been taken into an examination room, most of which have a desk and computer in so it may have appeared to you as an office. In respect of the bedpans they are disposable as they are for single use and fit into a standard bed pan holder, we do not have any child size bedpans in the department. I am unable to comment as to how the flooding occurred, but I would wish to apologise for the distress caused by this.

In response to the painkillers offered I would wish to reassure you that those offered to you are all standard and safe medications. Unfortunately I am unable to comment on those received by your good self. Often the prescribing doctor will start with one medication low dose and evaluate the relief gained and then alter them accordingly. Unfortunately as you were advised Co Dydromol is not available as a stock medication in the department so that is why the doctor offered alternatives. I am sorry to learn that you reacted to the medication prescribed at the time of your attendance.

I am sorry that you were so dissatisfied with the service provided to you on this occasion.

I have ensured your comments have been shared and discussed with the staff in the Department to ensure that the Trusts expectations regarding standards of care are clear. If you would like to discuss your concerns in more detail please do make contact with myself Angela McNab on 0191 2829927 or Paul Anderson in the Patient Relation Department on 0191 223 1382.

Update posted by Annodoremouse (the patient)

Neuro obs were always done on pts with whiplash injuries with headache. They were not done at all in A&E, the reason given was the charts.

As for the bed pan incident, ask any nurse on the dept how much urine can their bladder hold and would one of those tiny bedpans be big enough.

I know the answer to that, having recently retired after 53 years nursing. It is more than those tiny bedpans can hold.

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