"Surgical Observation Unit at Edinburgh Royal Infirmary"

About: Royal Infirmary of Edinburgh at Little France / General Surgery

(as the patient),

After a lot of surgery, I developed acute stomach pain in the middle of the night, taken to A&E by ambulance and treated for four days in the Surgical Observation Unit, attached to A&E. The ambulance arrived at 3am.

All I remember is the stomach pain which had been building up all day. It had become intolerable.

I also remember my darling husband begging me not to go back into hospital. It was my third visit and this time, he reckoned I might not be coming back.

In my heart of hearts, I agreed with him - but that sentiment was easier for me to bear. The pain was so bad I no longer cared.

My recent hospital stay marked the culmination of two years of orthopaedic surgery, of hospital admissions; of intensive physio; of effort and more effort – much of it to no avail.

After a childhood disability and several years spent in a wheelchair and on crutches, things were coming home to roost. Call it the start of old age, call it whatever you like. It has arrived but it has overstayed its welcome. It has not been a welcome guest.

I had both hips replaced in the past two years.

Thousands of people in the UK have hip replacements every year. Some are very fit and have over-indulged in sport; others are decrepit and worn out. A few have aged with disabilities from childhood. I fall into the latter category.

Most noticeable to me is that the NHS has changed dramatically over the years. It is awash with problems: budgets, superbugs, waiting lists and staff who are stressed to what seems like breaking point.

On the day of my first hip replacement, I had to report to the same Edinburgh Royal Infirmary at 7 am. I was escorted to a room to wait but my husband was sent away.

What they don’t tell you is that everyone scheduled for morning surgery is called at 7am. You have no idea where you are on the list and are given nothing to eat or drink.

It is like waiting in a hot airport for a very cheap flight and you feel so alone.

Nor do the medics give you anything to calm you down before surgery. Despite having had a lot of operations in childhood, I was shaking like the proverbial leaf when they wheeled me towards the knives.

In the Sixties, I had bones repeatedly re-set, pinned into position so my legs turned out instead of in. If I wasn’t in a wheelchair, I was on crutches or walking with sticks.

However, back then, a visit to hospital for an operation was a calm, leisurely affair. You were admitted the night before surgery and tranquillised. These days that is probably considered too costly.

Not once did I ever suspect these things would return to haunt me. A friend once said to me: “I suppose your legs are behind you now”. While I thought the comment was hilarious at the time, I agreed with the sentiment.

But I was wrong.

In the past year, between hip replacements, I had, for the first time, to visit Accident & Emergency at the RIE, with a related orthopaedic problem.

It wasn’t a happy experience and I wrote critically about it.

It was a Friday evening with the usual weekend crowd of drunks. The waiting room produced that inevitable clash of strangers forced together by accidents and illnesses, in inhospitable surroundings, with a shortage of staff; all a recipe for disaster.

I waited for three hours to be seen.

However, patients like me, who come through the main door on foot don’t see the ambulances next door delivering people, who have, for example, been in a car accident or are ill to the point of death.

I was taken, very quickly, to the Surgical Observation Unit and told I probably had an ulcer or abscess on my pancreas.

This unit deserves publicity. It deserves awards. It is the best ward I have ever been in as a patient. It is A&E’s hidden treasure, the place to which ambulances screech and hurtle.

It is not an ordinary hospital ward. There are no meals; no visiting times – people can come in when they wish.

Sadly, the patients didn't talk. People were curled up, moaning; too sick to see; too ill to chat. Everything happens in hospital, after all. You’re born there, you may die there, you have children there and you are ill there. You see everything in here; every disease and accident. One morning, I woke up to see a man in handcuffs opposite, accompanied by a policeman.

The nurses are dedicated, caring and incredibly direct yet sensitively so.

They have to question every patient, about their lifestyle, about how much they drink; conversations inevitably heard by the other patients. Many are in denial, vastly under-estimating their consumption.

They will be referred from this centre of excellence to other wards for treatment.

If there was a model for the NHS to follow, this Surgical Observation Unit has to be it – a classic example of nursing as it once was and should always be – regardless of the bean counters.

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Response from NHS Lothian

Dear "Nicky Murray"

We would like to thank you for the valuable feedback and the very thoughtful and personal way in which it was written.

This has obviously been a long and emotional experience with ups and downs and we welcome the opportunity to learn from the negative aspects of patient care while passing on the praise for the positive ones. Feedback of this nature is vital for us to learn and develop as a health service.

We wish you good health and recovery for the future.”

Stuart R Wilson

Director of Communications and Public Affairs

NHS Lothian

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