"Everyone is trying very hard but better..."

What I liked

The Emergency Department was improved from when my mother was admitted in 2008 when it was appalling. This time the staff were polite and caring. The doctor was especially polite and pleasant. It was nice to see that chairs had now been provided for relatives and they were not expected to stand for hours whilst waiting for their relative to be seen. It was reassuring to be acknowledged by the doctor rather than ignored which happened in 2008.

The department was unusually quiet for a Friday evening but it still took approximtely 5 hours for my mother, who was a trolley case to be processed through the dept. I couldn't help thinking that the delays were poor time management since my mother only had a blood test and one chest X ray in all that time. Once the patient is put in a cubicle they become very abandonned and if after many hours they need a bedpan or commode it is very challenging to try and get any attention of any kind. 'Getting blood out of a stone' comes to mind. Everyone just seems far too busy to attend to a patient's needs. It is clear that the needs of a lone elderly patient would be completely ignored. As usual we were told that there were no beds available to accomodate my mother. Patients know that is par for the course in the NHS these days but it all adds to the stress of being ill and makes the patient feel like a terrible inconvenience. Transfer to the ward was quick and efficient one the decisions had been made.

What could be improved

Access to a member of staff for such things as bed pans during the long wait whilst in the cubicle could be improved.

Once on the ward,communication all round appeared to be very poor. My mother is very hard of hearing and found it very hard to understand the questions of the doctor. I visited regulary every day but no one sought to clarify anything with me, consequently wrong assumtions were made and my mother had absolutely no idea about her treatment or drug regimen. Staff changed constantly so there appeared to be absolutely no continuity of care. Trying to access someone who knew anything about my mother was extremely challenging. Trying to speak to a doctor seemed virtually impossible. More worrying was that the communication between the nurses and doctors seemed very fractured as if they existed in two separate worlds. This can lead to unecessary errors, in patient management

It was disconcerting to find that my mother, who had been vomiting copiously could not be washed properly the next day because the ward had no hot water for 24 hours.

It was not unusual to see patients press the buzzer for toileting needs and wait half an hour for a response. Then, once on a commode wait endlessly to be taken off. The long waits for attention caused some patients to be incontinent in their beds.

Anything else?

The staff I encountered were always polite. It was clear from their comments to each other that they were not particularly 'happy' and I suppose that will show itself in the care the patient receives.

I was satisfied with ward cleanliness although bags with vomit soaked laundry left at the end of the bed during visiting hours are not a good idea.

It clearly stated that visitors should not sit on the beds yet there are no where near enough chairs for visitors so they all end up sitting on the beds. I saw a bed stripped and changed because a patient was being transferred to another hospital. That patient's relatives arrived, all sat on the clean bed. They subsequently went home and the contaminated bed was then used for a new patient.

It is very difficult for an outsider to differentiate between different types and grades of staff which makes it very difficult to know who to approach when seeking information. I am an excellent communicator on all levels and am very confident but I found trying to communicate successfully very challenging..............elderly people or those with lesser communication skills wouldn't stand a chance.

A frail elderly patient with little or no mobility needs access to the nurse call button. I invariably found my mother's nurse call trapped somewhere under the bed. Ensuring that this is available to patients who need it should be a priority, surely.

Things have improved since 2008 but I fear that there is still a long way to go.