"HDU and CCU and the PACU. PACU ..."

What I liked

HDU and CCU and the PACU.

PACU were excellent.

What could be improved

My Mother had a # Neck of Femur and then had an MI.

She was getting better well but she obviously quite immobile.

She could not move around the bed and was on a ripple mattress.

1 I asked if she could be moved more to prevent a pressure sore. I was told by an HCA that "we don't need to be that any more, because of the special mattresses".

I was horrified.

Any Spinal Injuries Nurse ( who do this ..so called "basic" care so superbly) would have recoiled at that remark.

.....And, so do i, as a Nurse for the past 25 years!

2 Anyway...you know what's coming next.....she got a sore sacrum.

The Nurse came to see her and said it was very superficial and clean and it was so painful because it was superficial (which i understand).

In fact, the TV Nurse was a little "off" and seemed to think that she had been called unnecessarily and she was used to dealing with much loftier problems.

Mum deteriorated and could not get out of bed any more.

She needed very good skin care and pressure care.

The day that she died (Monday 26th April)....she was turned and repositioned for comfort......low and behold a huge sore on her Sacrum, about the size of the palm of your hand, and with now much fuller thickness.

She asked to be moved as her bottom was "agony"....her word.

I was appalled and extremely angry that she was going to die like that.

To all staff out there....i don't care who you are...you DO have to move your patients with monotonous regularity i'm afraid and no amount of fancy mattresses will ever do your job for you!

Anything else?

Can i also say that we were told that Mum should have an NG tube passed and various other things should be done as the doctors felt that they "hadn't tried everything yet".

This is in spite of a DNR order some days previously and we refused.

I spoke to a doctor who agreed that End of Life Pathway care could commence and that a "palliative" drug chart would be written and everybody informed etc.

This conversation was at approx 5pm on 26th April and i expected the charts to be done etc immediately.

Mum was agitated and needed something around 10pm and it was not written up....in fact the old chart with everything on it was still in place......in fact the night nurse came in the room ....after an hour and a half....and thought he was giving IVs and seemed surprised not to find a cannula.

If you agree a pathway....do it immediately!

Mum died at 11pm after some hasty Morphine.

The doctor obviously thought he was right...i was wrong and that mum would still there in a fortnights time.....he :humoured: me in other words.

That is very bad care and when something is agreed it should be implemented immediately.

Mum died of Urosepsis.