"Lack of Dignity, Respect, concerns over DNR"

About: University Hospital Wishaw

(as a relative),

My Father and mother-in-law 90 and 88 respectively were scheduled to be discharged after both having been in hospital since Christmas. There was a large care package arranged for them to enable them to be discharged and safe to be at home. On the Monday morning the hospital beds were delivered to their home and other essential medical equipment. After I had arranged their rooms I drove to the hospital which is only five minutes drive from their home,to see how they were and to give them outdoor coats for their return. On route the pharmacy contacted me for some information and advised that their medication would be with them shortly. I went to their ward to find the beds already stripped. and I subsequently found them in the discharge lounge, the time being 11.25am and they had been transferred from the Ward at 11.00am and 11.15am.

I didn’t stay long in the discharge lounge with them as I presumed as their medication was on the way they would be home shortly.

I went back to their home and prepared for their arrival, but at 3.30pm my husband called to say the ward nurse had been in contact with him and advised that his parents were now in the discharge lounge. Eh! No they’ve been there since before 11.30. He called the nurse back who confirmed they had been transferred at 11.00am and the ambulance should have been there to take them home at 1.30pm.

I called the patient liaison office at the hospital and said that I thought this was totally out of order, the time now being after 4.00pm. The person said they’d find out what was going on and call me back which they did promptly to advise the ambulance would not now be there till 5.30. I expressed my concern that two vulnerable patients were being treated with anything but dignity and they then said they would try to escalate a quicker response

I made my way back to the hospital and discharge lounge and after parking arrived at about 5.15. Goodness I was met with a very sad sight indeed. My father-in-law was slumped over the arm of his chair, propped up with a pillow, my mother-in-law was looking extremely distressed and when I asked if she was all right, she replied that she had had an ‘accident’. The discharge nurse confirmed to me that they had been there since 11.00 am though they had had lunch and dinner. I asked the nurse if she could take my mother-in-law to the toilet   The ambulance crew then arrived at 5.45. They had no knowledge of any previous times and indeed had only just recently started their shift.

I waited on the nurse returning and the ambulance crew then helped my in laws into the ambulance, I made my way back to their house and the ambulance crew then assisted them into their beds,  finally they could relax and this would now be 6.10pm some seven hours after leaving their wards.  I feel that they were certainly have not been treated with dignity they deserve.

I also want to write about a serious concern over the DNACPR (Not for Resuscitation) form and procedures.

I was taken aback on picking up my father in law from the discharge lounge the ambulance crew opened a letter lying on the table to see it was a Not for resuscitation form.

I knew it very unlikely my father in law would have agreed to this and on closer inspection of the form have found a few discrepancies.

First of all this form completed was I believe obsolete at the time of completion

The patient or any relative had not been involved in the decision to agree to DNACPR and my father in law confirmed that he had had no discussions about this matter. There are no sections on the form marked to say this has been agreed or discussed with anyone.

The reason given on the form is noted - CPR is unlikely to be successful due to: Frailty, Age. I cannot believe that ‘age’ is a relevant reason.

The form was initially signed by a junior doctor on my father in laws admission when I doubt any observations as to his frailty could have been borne out.

I await your comments on this serious matter

Responses

Response from Faith McCrea, Service Manager, Emergency & Medical Services, University Hospital Wishaw, NHS Lanarkshire

picture of Faith McCrea

Dear apusfg46

Thank you for getting in touch and I am so sorry to hear of the concerns you have in relation to the care and discharge process for your father and mother in law. Please be assured that we would wish to look at this further and I would be grateful if you would be able to provide us with further information.

I would appreciate if you could contact Yvonne Ross our Patient Affairs Manager on 01698 366558, with more information. As soon as we have this detail we will be happy to look into this with the relevant clinical areas to ensure patient centred care is being delivered.

Kind Regards,

Faith

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