"Lack of privacy and dignity during my Grandfather's stay"

I refer to my grandfather’s recent stay at Bassetlaw Hospital in April, and would like to point out a number of issues/failings experienced during that time which I have officially complained about on his/my family’s behalf. These are outlined in detail below.

My grandfather, is 96 years old and suffers from COPD. He has a home oxygen unit installed.

At approximately 5. 00 pm he was admitted to Bassetlaw Hospital A&E Department by ambulance with breathing difficulties. He was placed in cubicle 3 within the A&E area, seen by a doctor in A&E at 9. 40 pm and admitted to the Assessment and Treatment Centre at just before midnight the same evening.

1. Lack of Privacy and Dignity

During his time in A&E (cubicle 3) my grandfather told me that he needed to use the toilet to open his bowels and was extremely concerned that he may soil himself. I went to find a nurse who told me that he would have to use a commode. I explained the situation and asked if he could use a toilet instead which was directly opposite his cubicle, approximately 5 feet away. We were told that he would have to use a commode behind a paper curtain in an area where there were at least 10 other people (patients and their relatives) in close proximity.

As you can imagine it was a dreadfully embarrassing experience for both my grandfather and the people in the area around him. I left the area to go and make a phone call outside and on my return I found him shouting for me. When I asked him what was wrong he replied he didn’t have any toilet paper. I was so upset by this - in fact I was in tears as I couldn’t believe that my grandfather of 96 was not given the privacy, dignity and respect to go to the toilet in private and worse still they hadn’t given him any toilet paper.

When I addressed this with a nurse I was told that my grandfather’s safety was her first priority. I questioned why they couldn’t have taken him to the toilet opposite on a wheeled chair with mobile oxygen and was told they didn’t have mobile oxygen in A&E. I understand that safety is paramount for patients and service users, but this clearly shows a failing of privacy and dignity and a lack of values based practice.

2. Waiting Time in A&E to be seen by a Doctor

Whilst in A&E my grandfather’s observations were first taken at 5. 35 pm and an early warning score of 3 was recorded on his observation chart. His observations were again taken at 8. 10 pm when a score of 4 was recorded.

At approximately 9. 30 pm I questioned why he had not yet been seen by a doctor as it clearly states on the early warning score notice in the A&E cubicle that patients should be seen by a doctor after 30 minutes on scoring =/>3. In addition why weren’t his observations taken hourly as again stated on the notice?

A doctor came to talk to me and told me that because my grandfather suffered with COPD and was on oxygen at home he was expected to score highly therefore the procedure on the notice is not followed in every instance. He also said that the Department was very busy.

I feel that this explanation was an attempt to pacify me at the time - if it is the case that patients with COPD do score highly on the early warning score sheet then why isn’t there any text on the notice to explain this? Contrary to this whilst he was on oxygen on the wards during his stay he was scoring 0s and 1s therefore the A&E doctor’s explanation does not make sense.

I accept that it was a bank holiday - a very busy time for the A&E staff and that people are dealt with on the severity/urgency of their cases, but also feel that my grandfather should have been seen by a doctor sooner than he was. I believe that the frustrations patients and their families experience when having to wait long periods of time to be seen by clinicians can be eased and lessened if they are communicated with on a regular basis throughout their wait. There was a clear lack of communication with us during my grandfather’s wait in A&E.

3. Meal Provision

As mentioned previously my grandfather was admitted to the ATC at around midnight in April, following which he spent a period of time on Ward A5 and then the final part of his stay before his discharge was on Ward B5.

On the evening of his transfer to B5 I visited him around tea time and a Healthcare Assistant asked my grandfather what he wanted to eat. I explained that I had completed his menu choices the evening before when he was on A5 to be told that meal choices do not follow patients when they transfer wards within the Hospital.

I was both amused and disgusted by this – my grandfather ended up with a meal choice that another patient had ordered; it was a small portion and was basically one sausage and one scoop of mashed potato. My grandfather may be 96 but has a very healthy appetite!

Food is part of our basic needs so surely this should be considered a key part of the patient experience!

FINALLY, and something which has caused us all the most upset and anxiety and should, in my eyes, be a NEVER EVENT ……….

4. My grandfather was discharged from Bassetlaw Hospital and brought home.

On sorting through his bag of belongings I came across an envelope which stated contained important medical information about him. I opened it up to find that it was a DO NOT ATTEMPT CARDIOPULMONARY RESUSCITATION notice.

I cannot begin to tell you how horrified and upset I was, and still am about finding this.

Before I read the full contents I asked my grandfather if he knew anything about it – in hindsight I wished I hadn’t now because he didn’t so I therefore ended up with the heart breaking task of explaining to him what it said! I cannot begin to tell you how it felt telling my lovely grandfather that if he went into cardiac or respiratory arrest he would not be resuscitated. Something I will remember and regret for the rest of my life!

I am aware that the Trust policy is that such decisions should be discussed with either the patient or the patient’s relatives, and this is also clearly stated on the back of the form under the heading ‘Communicating DNACPR Decisions’.

The notice states the reason for not discussing this with my grandfather was because ‘it will cause distress’. What about the distress that has since been caused by the manner it has been done?

My grandfather has full mental capacity and is remarkable for his age – he should have been given the respect of having his future discussed with him. I agree that he would have more than likely been upset about it, who wouldn’t? , but I can assure you he would have taken it on the chin and come to terms with it, especially coming straight from the mouth of a consultant in the field of medicine who he would have respected!

As a family we visited my grandfather every day during his stay in hospital, we were a visible presence throughout his stay so why wasn’t this communicated to us if it was felt my grandfather wouldn’t cope that well with the news?

It is absolutely disgusting practice to find a letter shoved in a carrier bag which determines someone’s future and I cannot begin to describe the anguish and upset it has caused us all. My grandfather is still the figurehead of our family and deserves more respect. The consultant responsible should have sat the family down privately and discussed this with us instead of stuffing the letter in with dirty washing! My grandfather’s life may not mean that much to the consultant, but it does to us and we will cherish whatever time he has left with us.

In summary, I feel that there have been a number of failings related to privacy, dignity, respect and communication towards my grandfather and us as a family during his stay at Bassetlaw Hospital. He is fortunate in that he has us to fight his corner but I cannot help being concerned for other elderly patients who don’t have family to stand up for them.