"Poor wound care"

I was recently admitted to ward 18 at Wishaw General hospital, with an abscess that wasn't healing despite high dose antibiotics. I was greeted and checked in by a lovely charge nurse who was not only friendly and professional but during her shift she explained everything about my care really well and answered any questions I had. I couldn't fault her in any way and wish I could have thanked her before she finished her shift.

In the early hours of the morning I was visited by a surgeon, who examined me and advised that they could cut, drain, clean and pack the wound under local anaesthetic. I agreed to the treatment and the same charge nurse sat with me throughout the procedure, talking me through everything that was happening. The surgeon explained that they had referred me to the district nurse who would visit me at home over the next few days to re-pack and re-dress the wound. The surgeon said the consultant would see me in the morning and I would be discharged in the afternoon. All good so far?

The consultant came to see me in the morning (just after my breakfast had been delivered). The surgeon who had performed my procedure was among the many people (around 10) stood around my bed. This surgeon started to brief the consultant about the treatment I had been given me. Before the surgeon had finished speaking the consultant had ripped off the dressing, including all the packing in the wound, had a quick look at the wound and said it was all fine, before turning to leave. I was still asking questions about the wound dressing and aftercare as the consultant was leaving and before I knew it was gone. I had to ask a nurse 3 times before a dry dressing was eventually put over the wound (by this time my breakfast was cold too). At the same time I asked about the wound being re-packed and was told that a surgeon was due to see me before I was discharged and that they would re-pack it. While I waited I looked at my care plan in the folder at the foot of my bed. It was written (typed) in several places that "wound to be packed with aquacel and mepore to cover" and that district nursing services were required.

A junior doctor came to see me in the afternoon and said the particular surgeon was now unavailable and I could go home. I asked who would re-pack the wound before I went. He told me that the consultant didn't think it needed to be re-packed and to come back if I experienced any pain or hot red skin on the wound! I said that this was what I was trying to avoid and hence the question about the re-packing... The advice that the consultant was apparently now giving was significantly different to the advice the surgeon had given me and also what was written in my care plan. He said that the consultant was senior to the surgeon and that this advice was fine.

A nurse came to see me and told me she had made an appointment for me to visit the district nurse in 2 days time (not for the district nurse to visit me the next day as I had been advised previously).

I gave up having the discussion about whether the wound should be re-packed and I accepted the discharge advice I was being given and went home. However, I was concerned because the advice was so conflicting, so I called the district nurse myself when I got home and asked whether they would expect the wound to be re-packed. They said they normally would and asked me to come and see them later the same day. When I went they seemed surprised that the wound was still seeping a lot. They had to clean it out again and re-pack it. They also wanted me to come back the next day and the day after that to have the wound re-packed and re-dressed. This is in line with the original advice given by the surgeon and written in my care plan - and in complete conflict with the consultants advice...

I'm left wondering why the advice differed so significantly between 2 professionals and ultimately why basic wound care was so lacking at this hospital - even after me directly questioning it several times.

Whilst I appreciate the wound I had was minor compared to some, it was nonetheless very painful. I eventually got the wound care from the district nurse that I should have received from Wishaw General. But I shouldn't have has to go the lengths I did to get it - it should have been a given.  

Shame on you NHS Lanarkshire - I expected better...