I spent almost four weeks as an inpatient in a major teaching hospital during January and February this year. I am a full-time GP and I’m afraid to say I found the standards of nursing care at the hospital awful, worrying and at times verging on negligence and neglect.
I was admitted with septic arthritis in my left knee and due to the nature of the infection I was barrier nursed in a side room.
Just under a week after I was admitted to the hospital, at about 10pm one evening I felt a pop in my knee, which at the time had an open wound connected to a vacuum pump/drain. This was followed by bleeding from the wound and extreme pain, which I scored at 10/10 – the worst pain I had ever felt.
I alerted the nursing staff who gave me some oramorph for the pain, which took the edge off for about half an hour before the pain built back up to original levels. I was then told that as I wasn’t written up for any other analgesia I’d have to wait for any more oramorph.
Following the second dose, the pain soon built back up to an excruciating level, at which time the nurse contacted the on-call doctor who arrived about an hour later. At this stage I was in tears.
The junior doctor said he thought I must have ruptured a ligament, which I explained wasn’t possible as I hadn’t moved my knee. He then told me he wasn’t an ‘expert in knees’ and would speak to one of his more senior colleagues, and told the nurse in charge to ‘monitor the patient in the meantime’.
At no time did he do anything to address the obvious pain I was in. The next few hours were nothing short of agonising. I found myself pressing the buzzer to get attention and when none came for long periods I was shouting, screaming and begging for help as loudly as I could – something I never thought I would find myself doing on an NHS ward in 2018.
The nursing staff came in occasionally apologising that the doctor hadn’t actually done anything and making unhelpful comments like: ‘I hate seeing patients in pain.’ The pain was so severe I remember asking them to kill me or take my leg off. An orthopaedic registrar came to examine me and said he was happy that I didn’t have ‘compartment syndrome’ – the dose of oramorph was increased, which again took the edge off the pain for a short period before it once again returned to the previous 10/10 level.
This went on for the whole of the night. I told one staff member that if I had allowed a dog to suffer like this then I’d be prosecuted.
When the morning nursing staff came on it became evident that my pain and predicament hadn’t been handed over. A nurse popped her head in at about 8am, could clearly see I was crying and in obvious discomfort but rather than asking how I was simply asked: ‘Do you need anything for your bowels?’
This was obviously the last thing on my mind.
Soon before 9am, the usual ST3 doctor for the ward came to see me with her registrar – they sorted the situation almost immediately by administering IV morphine and setting up a PCA analgesia pump and within about 30 minutes pain was under control.
I feel extremely bitter that such action was not taken during the night and I was left to suffer extreme pain for almost 11 hours. In this day and age I can’t believe I had to shout, scream and beg at the top of my voice in the middle of the night on an NHS ward. I am an extremely quiet and proud person and feel aggrieved to have had gone through such a trauma.
As a GP, if a patient had told me this had happened to them I would have been somewhat sceptical and thought the story had been exaggerated - but believe me, this is exactly what happened and I feel it needs to be highlighted and investigated. I would be interested to read what was actually written in my nursing and medical records for that night.
If this can happen to a relatively young, educated, professional person who works in the NHS, what chance does an elderly/frail patient or one with communication problems have?
I appreciate that wards can be understaffed at times or staffed by relatively junior staff due to shortages, but this sort of situation should never have happened in the first place or should ever happen again.
Poor nursing care
There were a number of other instances in which I thought nursing care was substandard.
Nurse call buzzers were frequently not answered for over half an hour, often 45 minutes, and the longest time was 60 minutes. As I was in a sideroom, there was no way staff knew why I was pressing the buzzer - no-one even popped their head in to see what the issue was. I had no other way of contacting the nursing staff to alert them to what potentially could have been an emergency.
One morning I was given a bowl of water to get washed. As I was bedbound I was told to wash what I could then press the nurse call buzzer and they would come back and help me wash the rest of me and change my sheets. After pressing the buzzer, I was still waiting 45 minutes later in cold, wet sheets, semi-naked. In the end I Googled the hospital telephone number and phoned the ward through the switchboard to summon staff. The reason I was given was that the ward was short staffed.
After being moved between wards post op, I waited for the nurse call buzzer to be answered for 35 minutes to request analgesia on the day that my morphine PCA pump was taken down - it then took another 20 minutes for a trained member of staff to be available to administer the pain relief.
Food was another issue. We were given a tick-box menu to select for the following day. On several occasions I was brought a meal which I would never have chosen but on querying this was told that this is what I had selected. I started taking photos of my completed menus as a result. One evening I was brought a small piece of fish and several chips.
‘Where are my starter and dessert,’ I asked, only to be told I hadn’t ordered them. I showed my proof – a photo of my completed menu. ‘I’ll see what I can do for you,’ the nurse responded kindly. She never came back.
Being isolated and barrier nursed in a side room meant staff had to wear an apron and gloves just to come into the room. I personally feel it was an inconvenience for staff to come into my room, which meant I was at times neglected. Urine bottles would still be left on the side for hours at a time. I have photos of dirty swabs on the floor for several days as my room certainly wasn’t cleaned on a daily basis on one ward.
As I was on IV antibiotics, it was extremely rare for a nurse to come back to disconnect IV antibiotics three or four hours after they had finished running through - this added to my discomfort at being bedbound as it meant movement of the arm the IV was connected to was restricted.