"My experience with staff on the Neurosurgery Ward"

I attended Barts Royal London Hospital at very early one morning for an L4 Laminectomy and Lateral Stenosis Decompression procedure.

My appointment had been cancelled a couple of times and so I was anxious that it went ahead this time. I anticipated a pleasant stay at the hospital and I hoped that a good experience would speed my recovery and enable me to return home quickly.

My operation took place in the afternoon and the Neurosurgeon and his team, the anaesthesiologists and nurses who prepared me just prior to going into Theatre and who took care of me up to that point, were wonderful.

However, after my operation was over and as I was being taken out of Theatre 11 into the Recovery Ward, I was attended by a nurse. They walked alongside my bed as it was being wheeled into the Recovery Ward and I was in tremendous pain. I was crying out for pain relief, moaning and groaning.

The nurse put their hand on me and she said very loudly and in a mocking tone, Alright dear, calm down. You are not in labour. The nurse said this in front of approximately six other ward staff. I couldn’t quite believe what I had heard and challenged the nurse by saying that as a matter of fact I had given birth and was well aware of the pain felt during labour.

I raised my voice and asked how they dare speak to me like that. The nurse responded by trying to make me shut up. They kept saying Shhhhhh, Shhhhhh. Quiet now. Shhhhhh. I asked again how dare the nurse speak to me like that, weren’t they aware that people process/feel pain in different ways and that just because I had been under a general anaesthetic, it didn’t mean that I was deaf or unaware. I informed the nurse that they were being rude and inappropriate and that I had heard every word they had said. I was not impressed and I told the nurse not to touch me again and that I thought they should receive further training in how to comfort patients, how to feel empathy and how to manage pain relief competently.

I found the nurse extremely patronising. I continued to request pain relief and eventually my surgeon appeared and asked me how I was. I told the surgeon what had happened and the barefaced nurse stood in front of me and said they did not say that at all. I must be mistaken. They did not say that. They would never say something like that. In any event, I suddenly received my pain medication and the nurse disappeared. The nurse could have gone off shift or they could have been removed. I really do not know what happened to the nurse and I couldn't have cared less. I was observed for a little while and then moved onto the RHLWard 3D, Neurosurgery.

Unfortunately, this was the first of a number of atrocious incidents which I still cannot believe I was subjected to. I say subjected to because all of the trauma I suffered following this initial awful behaviour seems to have been directed solely at me I feel.

I arrived on the ward and after two or three hours I was in severe pain again and asked for pain relief. I was once again left in agony for hours without adequate pain management, to the point where I was in tears asking for someone to help me. The HCA’s would hear me calling for help but would only respond if I pressed my buzzer. I would ask for pain relief and the standard response became that they would let the nurse in charge know but I would see neither the nurse in charge nor the HCA again for long periods of time. When I did see a nurse I would ask again and would be told that the key to the drug cabinet could not be found or that they were busy. Most of the night on that day August into the early hours of the next morning, I was left writhing and shaking with the pain. I cried for the first time this day.

In the early hours of the next day, I was given morphine but as I was deep in pain by that time, the relief was slow

Activity was frenzied that night, with people rushing back and forth. I hadn’t slept at all from 6. 30am on one day and still had not slept by the early hours of the morning on the next day in August because of my pain relief mismanagement by the nursing staff and then as a consequence of the lady opposite being unwell. After things calmed down a little, I asked a HCA for help. The HCA looked over her shoulder at me and just walked away without responding.

My medical notes were left on my bed and I decided to take a look. It was documented that I slept between 1. 00am and 4. 00am, during the period which straddled this lady being unwell! I questioned this discrepancy with the nurse in charge as I had not slept the whole night and had witnessed everything. I told the nurse that there were mistakes and I wanted them changed. The nurse seemed unconcerned and matter of fact. Because of this, I looked through my notes and made the necessary changes to reflect facts, the things that had actually happened and which had not been fabricated by staff on the fly.

Later on the same night, as I couldn’t walk to the bathroom, I requested a bed pan but as I wasn’t helped, I couldn’t get onto it. So I asked for a commode instead. Once again, the HCA who brought it to me just stood there watching me. So I sent them away and tried to help myself. I did manage to get onto the commode although it took me a long time to manage. It took me some time to clean up with antibacterial wet wipes I had brought into hospital with me, change my underwear and nightgown and get myself back into bed. I could not cover the commode as I wasn’t given a cover for it. I had just struggled to get back into bed when my closed curtain was flung back and two porters strode through my sleeping area to collect a patient for a CT scan. I wasn’t warned they were coming onto the ward nor was I asked if I was decent – nothing! When I complained that this was wrong, it was insinuated that the patient they had come to collect was more important than I was and needed more urgent care and attention than me and that I should be ashamed to complain.

Later the same day on Saturday afternoon, my daughter came to see me and she brought my grandson with her. I was unaware that children were not allowed onto the ward as no one had told me. When she arrived, I was summoned from my bed and unceremoniously placed onto a commode and wheeled out into the open public reception area to visit with my daughter and grandson. I was just glad to see a friendly face and my grandson did me the world of good. However, at the end of the visit, my daughter pushed the buzzer and asked staff at the reception if someone could please take me back to the ward. The person she spoke to should not be on front office duty as they were rude, unpleasant and nasty and kept asking who it was that my daughter wanted taking back to the ward. My daughter tried to explain who I was and whilst all this was happening, I was left in reception on the commode waiting to be let back onto the ward.

Eventually a lovely HCA kindly came and wheeled me back in. As I was being wheeled back past reception someone at reception shouted across the desk in front of a number of other staff who were standing there that I should not complain as my well being and timely discharge from the ward depended upon the flick of their pen. They all laughed. It seemed I had become the centre of their entertainment. After my daughter left, I could hear the undignified and unprofessional sound of staff who should know better, gossiping, hooting and hollering in the ward office. Despite the door being closed, they could be heard across the whole ward. Far from showing empathy they began insulting me, describing me as that woman and who, her, shouting about the fact that my daughter had dared to point out to them that they had been rude and talking about my grandson and laughing. To reinforce this, I heard someone questioning whether or not my grandson was my daughter’s child or mine. They concluded that I was probably not his mother as I was too old!

The same night, I tried to bring to the attention of an HCA that the lady opposite appeared to be lapsing into unconsciousness again. I had been calling out to her and she appeared to be in an unresponsive state. Instead of immediate action being taken, I was told very aggressively that I should leave her and them alone so they could get on with their jobs. I was shocked and fell silent after advising them that I would be filing a formal complaint. After the HCA and the nurse in charge had seen to the lady, the nurse came back to my bedside and gave me a full apology, explaining that they had been aggressive and rude and that they apologised. I accepted the apology but said that I would be making a complaint nonetheless.

Later that night and once again, after reassurances from doctors that I would not be left without adequate and timely pain relief, I was left in pain and ignored by nurses for 30 minutes. I have to emphasize that I in no way blame the doctors for these failings.

After having my wound dressed and covered with a ‘waterproof’ dressing, I had a shower on Saturday. However, on Sunday my dressing had lifted a little. I brought this to the attention of the nurse in charge. By the time the nurse came to take a look, the dressing was completely off and my drain was hanging on without support. Instead of changing the dressing for a clean one, the nurse put another one on top of the old dressing and advised me to bring it to the attention of my doctor when they made the rounds later on that day.

In the early hours of the morning, I pressed my buzzer and requested pain relief. I was made to wait 39 minutes (until 2. 36 am). It was eventually explained to me that my medication could not be dispensed as apparently no one was available to do it as they were all checking the CD cupboard at the same time. However, I actually heard a number of night staff having a lovely time, laughing and giggling whilst I sat waiting once again in severe pain.

I decided to make a comparison so that it could be seen for what it actually was;

1. The lady opposite me requested pain relief and received it in 10 minutes

2. A new lady who had been admitted earlier on in the day asked for attention to adjust her drain. They also asked for a piece of toast. She received her toast and her drain had been adjusted in 10 minutes

3. A lady on the far side of the ward requested assistance with her arm sling and received it within 10 minutes

At one point I lost my temper and asked a staff nurse why I was not having my observations monitored even though all of the other patients on the ward were receiving regular obs. and why once again I was being made to wait for pain relief instead of receiving it at regular and timely intervals or as and when requested. I pointed out that unless I requested that my observations be taken or unless I asked for pain relief (during the day after speaking to the doctor during rounds), I did not receive any help although everyone else did. This was the case intermittently during the day but was particularly awful at night. People seemed to become deaf at night even if I used the buzzer, which I became reluctant to do as it disturbed the other ladies. The nurse in charge explained that my observations were being taken six hourly and that pain relief would be given if I requested it. This was absolutely not true. I cried for the second time this day.

The next day at 4. 10am, I requested pain relief as I had only been given half of my previously requested dose. Unfortunately, my file mysteriously ‘went missing’. This appears to be a stance adopted when the staff require an excuse not to dispense medication or when they wish to change notes on a file. This was done to me and to another woman on the ward I know of. My file was finally found, my dose discussed and I finally received a full dose nearly three hours following my initial request for pain relief. Following early morning handover, I was ignored for pain relief and completely overlooked by the nurse in charge. I asked to speak to the nurse but they never came.

Other incidents;

· I was left with oxygen tubes in my nose despite the fact that it should have been removed by nursing staff following my surgery in the morning. The tube was finally removed in the afternoon two days later, following ward rounds when the doctor asked me why I was still using oxygen!

· Male and female visitors used the patient toilet

· Visitors ate patient’s food

· On several occasions, the keys to the drugs cabinet could not be located especially when I needed my pain medication

· Patients' visitors wandered around freely whilst patients received treatment or when eating evening meals.

· On a particular day, the nurse in charge was concerned with my heart as it was racing. The nurse did an ECG as I had been tachycardia for a couple of days (I think it ran at a maximum of 127). They later brought it to the attention of the doctor during ward rounds and the doctor put it down to inadequate pain management as opposed to an irregularity with my heart!

· My surgical stockings were removed and not replaced despite the doctor instructing nurses to do this.

· My doctor administered anticoagulant during ward round and instructions were left that no more be administered. Despite this, on three further occasion’s nurses tried to administer it again. I had to refuse to have it administered and referred them back to my doctor.

In conclusion, I can only conclude that this behaviour was in retaliation for my complaint against the nurse. I do not and have never met any of the people who treated me in such a way and I have no personal connection to any of them. I was never abrupt or rude to any of them and I was always taught to say please and thank you, which I did. My only complaint at that point had been against the nurse who had been rude following my surgery.

Despite these unprofessional, potentially harmful and puerile actions, the majority of the caring staff that I came into contact with during the day may have had issue with me and knew about my complaint against this nurse but they were professional. They may not have agreed with my complaint about the nurse but they nonetheless behaved with cool professionalism. They did not respond in an impersonal and uncaring way. However, there were those who I assume had heard about my complaint and who, I believe, took it upon themselves to behave unprofessionally and to show me how people are treated when they complain. Staff who were not involved with this whole situation suddenly became involved. It became very much like a school playground, with staff passing by to stare at me without saying a word but just glaring.

As a result of this behaviour, I pushed myself to become mobile as quickly as possible. I was determined that I be allowed to go home. The evening following surgery, I walked every day as much as I could and did as much for myself as I could especially washing myself and visiting the toilet. The other ladies on the ward told me I was doing too much but I didn’t care, as I just wanted to go home. So early on the morning a few days later, my doctor finally discharged me during ward rounds. I was being discharged I believe in a deliberately slow way. I didn’t leave the ward until approximately 7. 00pm that evening.

A porter came to wheel me down to the discharge waiting area and my daughter helped to walk me to the car which was 200 yards away. I can honestly say that I have never been happier than I was that evening to be leaving that ward.