"Variable care depending on the ward and day of the week"

About: Norfolk & Norwich University Hospital / Older people's healthcare

(as a relative),

Staff attitude

Staff attitude

My father was unexpectedly admitted to Norfolk & Norwich University Hospitals as an emergency and, after the initial assessment, he and the family were told that his prospects were not good, and that a 24-48 hour period would be an expectation for his survival. 

Last Wednesday afternoon, a really good End of Life conversation was held with the family by a consultant, who professionally and sympathetically confirmed that care would be moved from treating the multiple conditions to palliative care going forward. Because of this, unrestricted visiting hours would apply, and whenever the family wished to visit, they could. 

For the hospital operational convenience, my father has been moved twice since that conversation - on the first occasion his notes did not follow his bed, and he himself was being asked whether he had been given his anti-coagulation tablet (given the prognosis, delirum due to kidney failure is present at times, and this uncertainty could be very risky - when the nursing team should have been able to see from the hospital notes what had been given when). 

However, it is the second move which has had the most profound impact on both patient and family. On moving to Loddon ward the unrestricted visiting continued for the first 2 days, but yesterday something was said which caused doubt that this was to continue today. On further enquiry this morning, the ward sister confirmed that the particular ward that my Dad was on did not allow unrestricted visiting, (even though that had been confirmed by the previous hospital consultant). When pushed for the rationale of going against the consultant, the ward sister explained that this is because the ward consultants need to be able to have full ability to hold confidential conversations on a bay of 6 patients. 

This need for confidentiality is ABSOLUTELY understood - but does not get away from the fact that the unrestricted visiting could apply on other days (when the family were asked to step outside the bay to allow confidentiality to be maintained), but not today as, quote 'today is a different day' i.e. a Monday, when the consultants make their rounds!!!....

So, a very caring and understanding consultant of the hospital can give a short term palliative care patient, who may have a very limited number of days left to live, a commitment for unlimited visiting from his loved ones, but because that patient moves wards, for hospital convenience, and because of the fact that today is a Monday (!!) that is not applicable in the eyes of the ward team.....

How very sad that, in 2019,  this part of the NHS is worked for the convenience of the ward consultants, not the wellbeing of the patient lying in his bed, or his family still coming to terms with the End-of-Life situation.....