"Poor communication / Poor Person Centred Care"

About: University Hospital Wishaw / General Surgery

(as a relative),

My mother was admitted to Wishaw General Hospital on Wednesday night into Ward 18, she was settled into bed and was going for an abdominal XRay at some point that night. Nurses were very helpful and friendly and told my sister and I when we were leaving to call just after midnight.

She was nil by mouth, had been commenced on IV Infusion and also they had passed a urinary catheter, she was also going to have an abdominal CT Scan the next day.

We called in the morning, my sister and her husband visited in the afternoon and my husband and I visited the following evening. No-one, doctors or nurses had asked to speak with us.

Mum had now been moved to another ward. Mum was sitting up at her bedside and I asked her how she was feeling, she replied, 'not very well and I have to go for an operation tomorrow. ' Mum has Dementia and I suspected that this was not correct information and went to speak with a nurse.

I had to wait to ask her Named Nurse about her progress.. She didn't know that she was going to theatre for an operation tomorrow until she checked her notes and noted that the surgeon had been in to see her that evening and documented in the notes that she was to have a laparotomy and sigmoid resection tomorrow.

I was shocked as no-one had spoken with us re findings of her CT Scan, no surgeon had asked to speak with us, no family was with my Mum (who has Dementia) and no nurse was with the doctor when he told her that she needed an operation.

This is certainly not Person Centred Care.

Her named Nurse said she would see if there was a doctor available to speak with me, but she thought they were in theatre. I eventually left. I called the ward in the morning, I left for work but became very concerned about Mum and the details of her impending operation.

I decided to phone to ask to speak with a doctor, I was awaiting on her Named Nurse coming to take my call when my a doctor phoned me on my mobile to explain that Mum was going to theatre within the hour.....the scan showed that she had a volvus, a twist in the large bowel, it could cause ischaemia and she really needed this operation for the obstruction in her large bowel. She would have a laparotomy and sigmoid resection and she will have a stoma.

I thanked her for the information but told her that I was unhappy that I hadn't been told the day before, that I was not with Mum and that the Named Nurse didn't even know that she was going to theatre for surgery.

I explained that this poor communication resulted in my Mum being told on her own that she was for surgery, she didn't even know what she was getting done or why.

At least, a nurse should have been with her to explain and reassure. The doctor offered to speak with me if I came down to the ward. I went down to see Mum before she left for theatre, the anaethetist came to visit her whilst I was in, he explained that it was a big operation that she was getting done and that she was elderly and frail but she had no medical history/concerns. I left Mum and she was waiting to go to theatre.

I got a call that evening that she was in Adult Critical Care after her surgery, my sister and I went down to see her, I asked the nurse who was looking after her if there was any cancer that caused the obstruction but she said that cancer hadn't been mentioned but the tissue is sent to lab as usual.

The surgeons were still working in theatre so no contact was made again; the following 2 days we still didn't speak with medical staff, I thought we would definitely see someone on the Monday. On the Monday she was moved to the step down cubicle in Ward 18 as she was improving. I didn't think she was too good on the Monday afternoon, the Nurse was very kind and helpful, he told me that I could visit in the afternoons this week as I was going to be Nightshift and unable to visit in the evenings.

Tuesday morning I phoned in the early morning to ask how she had been overnight, whilst trying to phone the ward, the nurse phoned me to tell me that there had been a deterioration overnight in Mum's condition, they were discussing transferring her back to Adult Critical Care and the anaethetists were with her and would like to speak with me.

I left home immediately, she was extremely poor, her condition had deteriorated.....one of the anaethetists told me that the operation for the CANCER had all been to much for her, that her organs were failing.

I said, my MUM doesn't have cancer, that was the first time cancer was mentioned. Mum was moved into a sideroom and I sat with her, she died peacefully 20 minutes later, my sister didn't arrive in time before she died.

The Nurses in this ward were extremely caring and compassionate but the lack of communication between the doctors and the nurses, and the medical staff and the family is very poor. This can be avoided, this can easily be improved.

Also, patients with dementia should not be treated in this way.

During Mum's short illness she had been been well looked after by the nurses and she died peacefully and with dignity. It now helps me to know that she didn't know she had cancer or that she had a stoma, and that she didn't suffer.

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Response from Gillian McAuley, Chief of Nursing Services, University Hospital Wishaw, NHS Lanarkshire

picture of Gillian McAuley

Dear CatherineMo,

I am so sorry to hear about the passing of your mum, please accept my sincere condolences to you and your family.

I read with great disappointment, your description of the lack of communication we provided to you and your mother at a time of great stress, please accept my apologies. I would be really keen to meet up with you if you felt able, as this would allow me to target specifically the nursing and medical teams who need to learn most from your experience. I can be contacted via Yvonne Ross our Patient Affairs Manager on 01698 366558.

I was hearted to read that you felt your mum was well looked after by the nursing teams, however, this is not the standard of communication and person centred care we strive to achieve.

Please again accept my apologies and I really do hope you feel able to contact us.

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Update posted by CatherineMo (a relative)

Thank you for your response, I do feel strongly about our recent experience at Wishaw General Hospital, and would like to think that changes could be made to improve the quality of care to patients with dementia, and the communication between professionals and also between the medical staff and the family. I would meet up with you if you thought it would be beneficial. Thank you.

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