"poor standards of care at A&E RAH -"

My father attended OOH GP service based on RAH campus at 8pm after consultation with NHS24, for acute urinary retention and bowel disorder. He was in extreme pain. My father has chronic pain due to osteoarthritis, osteoporosis, lumbar spondylosis resulting in poor mobility. OOH GP confirmed above diagnosis, and we were informed my father was to be admitted for possible surgical intervention. GP informed that no beds available in RAH, and after consultation with bed manager on QEUH informed no beds there either. Inverclyde agreed to take my father who was by now in extreme pain and distress - Inverclyde is 25 minutes from RAH. QUEH is 10 minutes from RAH. A "blue light" emergency ambulance was arranged - after 30 minutes and no ambulance arrival we were informed that Inverclyde were now refusing to take my father due to an arrangement whereby they were closed to GP referrals! Time now 10. 30pm - no pain relief for chronic and acute pain and no intervention treatment for acute condition!

A porter arrived and bundled my father onto a wheelchair, ran him through corridors which were not even lit, to take him to RAH A&E. He was dumped in a corridor which was lined with other patients on trolleys. No information from nursing team, who were overloaded with patients. No eye contact from nursing team. I asked a nurse what was happening. She said my father had to be triaged. I explained he had been, by the GP and had been accepted by the surgical registrar on call. She said it didn't matter - everyone has to be triaged. I asked her to approximate the length of time - even how many patients in front of my father, explaining to the nurse I required this in order that I could assess whether he should remain nil by mouth or whether I could administer his pain medication to him, She said she couldn't estimate this. I reiterated that he has ongoing cardiac issues and she could see the distress he was in. She did nothing to help and walked away. Due to the acute bowel condition my father required toilet facilities - only toilet available was in this corridor with patients lying watching him enter it frequently. The toilet was dirty with blood on the toilet seat. There was a complete lack of dignity and privacy afforded to my father. I witnessed a staff member passing patients on trolleys who had been there for some considerable time - many elderly and alone - taking cups of juice to other staff members. Not one cup was offered to either patient or relative! !

The corridor was extremely hot. After approx. 45 mins my father entered the triage "room/corridor". This room/corridor had a door leading directly to the a&E reception which a nurse used as a short cut whilst my father was being triaged. She made no apology, in fact she didn't even acknowledge his existence. I closed the door after her and the curtain. Again no respect for privacy and dignity. My father was still in extreme distress with pain. The triage nurse took his obs and immediately recognised that my father required immediate intervention - he found a side room and he arranged for my father to be catheterised. Whilst waiting outside in the corridor I witnessed nurse after nurse, dr after dr, walking past patients on trolleys - no eye contact, no kind word, no reassurance offered, in fact no communication. These patients were elderly, some alone.

The portering staff hurled patients around on trolleys and talking over them, all witnessed by the nursing team who seemed to do nothing to stop it. On entering the room my father had been catheterised and was less distressed - a mere 3. 5 hours after being told he required immediate intervention! ! ! He was lying on a trolley with no blanket/cover and no pillows. Due to his chronic pain and arthritic conditions he should have been offered pillow support. He required to use a commode, after which the nurse didn't offer him toilet paper or hand washing facilities - I did it for him when I found this out. By now he required his prescribed medication for breakthrough pain - I asked the nurse. 25 minutes later I went to look for the nurse and asked again for his analgesic. The nurse informed me "yes he's written up for it" and then walked away. I waited to see if she would return - no apology for the delay and no confirmation she was getting it for him. She then did return and gave him the medication - she did not check to confirm his identity by wristband prior to oral administration. A student nurse entered to take my father's BP, she didn't explain to him what this would entail - as she stuck the saturation probe on his finger again without explanation. A poor reflection of her training so far! The laminated sign on the door said "active Care @ " - no time written in! ! The FY Dr who attended my father was patient and explained the next steps to him. The surgical registrar came in at around 3am and apologised for the mix up with the referral. The last nurse involved in my father's care was great, she took her time and she conversed with him and us. This made a world of difference to us. By now it was 3am - 7 hours after we were "rushed" around to A&E. It saddens me and shames me that I am part of the same profession - I am a trained nurse with 20+ years experience in the acute sector. I watched a department and service which was clearly under severe pressure. I and my family watched my father experience hours of pain, distress, lack of dignity and privacy which is an experience I will never forget and which has left my father traumatised.