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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To be furious after tonight and feel the NHS is not good enough

125 replies

DespairingofNHS · 31/12/2013 23:52

My mum is in hospital with a chest infection. She's bedbound and has little mobility after suffering from a series of strokes over the last several years. She can speak but has absences, forgets she's talking, eating etc. She needs help to eat and make sure she's eating enough.

I arrived at the hosp. tonight at 7pm and a tray of food was sitting next to her, untouched, cold and still sealed. It was clear no attempt had been made to get her to eat or even to take the film lid off so she could try to feed herself. I asked to speak to a nurse who advised that the doc had decided at mid day to put her on nil by mouth. I had to ask a series of questions to find this out, nothing was willingly volunteered. Apparently they were worried about her swallowing. I asked what the plan was and they said they were waiting for the SALT (I had to ask what this was - speech and language therapist) to come by. When I asked when that would be they said 'tomorrow or the day after'. I said 'so your plan was to let her go potentially 48 hours without food or drink?' the nurse said 'well no one ever died from not eating for 48 hours'. She advised me that mum had eaten loads yesterday including lots of chocolates fed to her by the nurse (wtf - she's diabetic), This begs the question why the next shift decided she couldn't swallow to the point where she shouldn't be fed. She can be a bit absent and forget she's eating/sit with the food in her mouth. This had been communicated to the next shift as 'she's refusing to eat'. I asked why they didn't intubate or put her on a drip. not procedure apparently! why didn't they consult us? because they have 55 patients on the ward and can't check with people's families about treatment...or deciding to starve them.

Needless to say I requested the doctor to come and attend - the doctor assessed her and saw that my mum was able to swallow liquid fine. BY the time we finally got her some food it was gone 9pm and my dh had to stay to feed my mum personally while I took dd home to bed.

I am furious that this could happen and that if I hadn't visited (some of the patients on the ward had no visitors at all) they would have happily left her with no food or water for 48 hours till the SALT could attend after the bank holiday!

Partly I'm writing this to remember it accurately later. But I also really want your thoughts and advise on how to properly complain about this in a way that ensure it gets dealt with. The nurses and docs simply said 'we've only just got on shift'. Nothing was written in the notes to say why the nil by mouth was put in place or even that it had been (the ward manager showed them to my dh although said he wasn't really supposed to). Their response was simply to hand us a complaint form...we had to ask them to sort her out some food. I have no confidence the same thing won't happen again tomorrow. I feel like they unilaterally decided to put her on a Liverpool care path and let her die. She just has a chst infection and is not terminally ill. I am shocked by the lack of care and compassion and feeling very scared about getting old one day and having to be entered into this NHS system.

OP posts:
CheeryCherry · 31/12/2013 23:56

Can't help you but I'm shocked at this treatment, how awful. I understand that wards will be short staffed at the moment but surely food and drink alongside meds is the top priority?
Hoping you have a better experience tomorrow, and hope she gets better soon.

saintlyjimjams · 31/12/2013 23:59

My mum is a nurse & I know she would be appalled (mind you she was told she was 'old fashioned' for saying patients should come first & was put on disciplinary after raiding concerns about patient safety).

I think you should complain. To PALS definitely - but you need to complain to her consultant as well. Unfortunately I think it is quite usual these days for patients who cannot feed themselves to be left unfed :( I would also ask them whether she HAS been put on the Liverpool pathway & if do why. I think you should also complain to the head of trust (or whatever they're called these days) & copy to the head of nursing & your mp & counsellors.

Sorry this has happened. :(

goshhhhhh · 01/01/2014 00:02

This is shocking. Refer to the Francis Report when complaining. You can also find out if they have a history of this type of complaint or if it is a one off.
Hope things get better - if not I would be inclined to ask to talk to the Director of Nursing or equivalent.

lisad123everybodydancenow · 01/01/2014 00:04

This reply has been deleted

Message withdrawn at poster's request.

ancientbuchanan · 01/01/2014 00:10

It's appalling.

We have faced similar uphill struggles over food with my DM in hospital, when she wasn't eating. I had to email both hospital ( ward, pals) and gp to say that by their action they were pre empting other action, I was not happy and wad raising concerns.

And we had to get people to go in and feed her.

Mind you, I had to do that with FIL 25 years ago too.

VegasIsBest · 01/01/2014 00:22

Terrible. To back I tomorrow and complain. Not to PALS who'll be shut due to bank holiday but to whoever is in charge. And good luck.

TheMaw · 01/01/2014 00:42

This is really awful. Definitely complain, sorry I don't have any more advice.

Poppyhat · 01/01/2014 01:09

Nothing you have experienced surprises me at all !
And that's a shocking statement.
My ds was admitted into hospital a couple of years back ,and because the children's ward was in a hospital a few miles away ,and my son was almost 16 they decided to admit him to an adult ward ,but I stayed with him ,in a chair ,by his bed for most of the night.
I cannot tell you how bad things were in that ward !
I sat and observed for hours .
I saw patients buzzers being ignored.
Patients wailing in pain ,being ignored .
One elderly lady put on a commode ,and left there unchecked for over half an hour .
One lady soiled her bed , and I had to inform the nurse ,who took ten minutes to attend to her .
One lady suffering dementia tried to get into another patients bed ,I had to guide her to her own bed .
This was one ward ,one evening.
I am now very afraid for myself or any of my family being admitted to hospital .:-(

ApocalypseMeow · 01/01/2014 02:08

Terrible treatment. Sorry you and your mum going through this but not surprised. My poor mum was admitted to hospital four years ago. Her treatment in intensive care was great but when she was briefly on a ward her care was awful. She went into hospital as her usual self but her surgery and medication made her confused. The nurses on the ward ignored her, refused her a sick bowl when she was anxious to have one and told her she didn't feel sick, left her without clothes and bed sheets when she was being changed as they had forgot to go back to her and many other things. I fully believe they contributed to her further decline and eventual death at only 56 because of their poor care. Complain, we did and got an apology and a promise that practices would be reviewed. Won't change things though Sad

PassTheSherry · 01/01/2014 02:15

OP I'm so sorry this is happening to you and your Mum - it sounds awful. Get names and take notes of everything you witness and are told. Unfortunately I am also not surprised by what you've said.

My Dad was admitted into hospital a couple of months back with severe breathing difficulties - heart failure. He is a man in his eighties and while he is usually fairly independent (lives on his own, goes out and about by himself etc), at that point he had deteriorated over a few days, to the point where he hadn't eaten for nearly two of them, and couldn't even get from his bed to the loo without a lot of difficulty. (He is very proud and had tried to cope by himself so didn't contact me until he was really ill).

He was admitted to A & E and they actually tried to discharge him home after 48hrs, even though his condition was much the same (very weak, unable to even sit up in bed for long, could barely walk to the loo, too breathless to hold a conversation, couldn't eat. The staff kept on referring to his condition as 'fine' - I was so shocked. It was as if we were looking at different people, and they didn't see what I was seeing. I had to repeatedly say that his condition was not normal, and that he would not manage at home the way he was, as he lived alone. It took about 6 conversations before they decided to admit him to a different ward. He was left with an empty drip stuck in his hand for hours after it was finished, so that when he absolutely had to go to the loo, which was difficult enough (no asked him if he could manage, or offered to help), he had to drag the useless stand around with him. When the nurse took the drip away, she said she'd be back to take the needle out of his hand, that the drip had been attached to, but it was at least another 2hrs before it was finally removed, after we had to flag her down to ask again. He was just left, mostly.

On the new ward I was told that they still intended to discharge him the following day, until I repeated my concerns yet again several times and mentioned 'unsafe discharge' proceedings. That seemed to do the trick and they stopped pushing for him to go. In the end he was in nearly two weeks before he was deemed actually OK to be discharged.

Had I not been there, it looks to me very likely, they would have dumped an old man back into his flat, who (at that point), had no appetite, could barely stagger 5ft, took huge effort to sit up in bed, and all he was doing all day was lie there in silence as he was too weak and exhausted to do anything else.

The staff were busy, definitely - there was a man in the next bed who was very poorly and I think they were concentrating on him, but how anyone can reasonably expect someone in my Dad's condition to cook, shop and look after himself at home is beyond me. Yet the way they kept referring to him as 'fine' and tried their hardest to free up the bed, made me feel almost bad for making a stand! I think the pressure on staff has got to the point where quality of care is compromised in a myriad of ways, especially when it comes to perception of what is 'fine' and 'acceptable' in their patients.

Sorry to rant on but the OP is right. It was certainly a traumatic time, and wake-up call about the state of the NHS now. I spent a few days being genuinely worried that my Dad was going to be sent home to die, had I not advocated loudly and repeatedly.

timidviper · 01/01/2014 02:20

It is shit. A friend of mine was admitted recently to the ward where she used to be a sister years ago and she was appalled too. Saw much the same as upthread, patients ignored when needing pain relief, general care neglected, etc. She complained and you should too

ohfourfoxache · 01/01/2014 02:24

Christ that is just awful.

Please complain. Loudly. First port of call should be PALS but there should also be a mechanism in place for submitting a complaint directly to the lead commissioning CCG (if you need any help finding out who this is then please feel free to pm me).

The safeguarding vulnerable adults lead should also be informed - either by whoever you submit the complaint to or, if you don't trust them to do it, contact them yourself. Again, if you need any help finding out how to get hold of them please pm me.

I really hope your mum is as ok as she can be x

Tableforfour · 01/01/2014 02:30

Terrible and you should complain but don't ask why they didn't intubate her or you will make yourself look foolish. Intubation is management of an airway for surgery or ITU and not relevant in this situation.

NearTheWindmill · 01/01/2014 02:31

This is of course exactly why the NHS is the national religion and the sacred cow. Because there is nothing wrong with it or the way it is organised - nothing at all if you want to ignore an animal with rampant foot and mouth disease which is creaking and failing towards death. PALS, MP, HOSPITAL TRUST BOARD. Contact them all and set it out as you have set it out here. It's all about diluted standards, poor service and slap dash, uncaring attitudes. The entire system has been inculcated with it.

But, has anyone else noticed that the two whistle blowers from Staffs have received honours. One hopes that means that sloppy, sub standard, care and fraudulent record keeping are not acceptable and that the centre will welcome complaints from professional staff from now on. The bit worry is that the poor standards have become embedded and too few within the system think that decent standards should be the norm. You know standards where people are treated with respect, dignity, care, sensitivity and where those providing care are properly monitored, properly trained and somebody makes sure they are able to provide care in accordance with guidelines and basic human conduct.

Slutbucket · 01/01/2014 02:33

I've been on wards and have created hell. I would ring a safeguarding helpline as this clearly is a safeguarding issue and they have the biggest clout. Also ring care quality commission. There is a big push on ridding the nhs of this behaviour so there is a massive crackdown. Ring PALS and also follow the complaints procedure. Time and time again u say that you don't need a degree in nursing to know that if somebody is not eating and drinking they aren't going to get better.

enyainaldis · 01/01/2014 02:48

Really feel for you. don't know what to say. how can people who purport to care have the audacity to put themselves in such positions where their lack of dedication has such consequences? I wouldn't dare pretend. I wouldn't want to be a nurse if I didn't think I had that basic NURSING instinct. i can cope with being a crap secretary but how do these people become so CRAP at doing what they are supposed to want to do.

I really hope you get the help you need. thinking of you.

NearTheWindmill · 01/01/2014 02:59

Before you complain, do a bit of research and find out how many of those on duty were HCA'S and how many were nurses. I think that's important and if you don't know the answer already ask yourself why you don't know it and why you weren't informed.

Iamsparklyknickers · 01/01/2014 04:28

IME the staff who encourage you to complain are the ones who agree with you and have tried to change poor practice and basically been bullied into shutting up.

The NHS's policies tend to have a flow chart to follow for complaints, the aim is to nip anything in the bud at the informal stage though which, imho, are abused into keeping things under the rug so to speak. Mediation meetings and a simplified plan of action such as staff training, apologies and a formalised plan of care are all things that would halt things at 'informal' resolution rather than escalating to a more detailed investigation.

Think logically - all those things (apart from the apology) should have happened anyway, reiterating them makes no headway to improvements, your mum should already have a care plan and the staff shouldn't require training to provide basic care or keep proper records - if it didn't register the first time what difference does a refresher make?

I know you hear a lot of stuff about over-worked clinicians, but frankly that's not a good enough reason to put someone at risk, out of the clinicians I know not one of them would put their patients at risk over bureaucratic requirements - I've seen them personally, argue their case in meetings with management, what you've encountered is a deeper cultural problem within that ward/hospital/Trust. I hate to say, but it does exist - in our NHS and public organisations across the world - it must be challenged but it doesn't reflect every corner of the service.

You can quite easily google the Trusts policies if you wish to quote them in your complaint. For impact I would cc in the trust's chief executive and the named consultant heading up the department your mum is under (again google) when you contact PALS.

You don't need to know the in's and out's of running a ward, but you do need to question the answers you receive and always ask for evidence of them acting within their own policies.

If they pull that mediation crap of "what would you like to achieve from this complaint" (I hate this btw) all you need to say is that you feel your mums care has been substandard and you want to see them enforce their own policies as well as the guidelines set by wider government. Do not be fobbed off with - staff training and an apology unfortunately it achieves precisely fuck all. People think they've got away with it or were justified in the first place, they certainly don't change or take it seriously.

rabbitlady · 01/01/2014 06:45

i'm not even surprised.
my mum is 79 and bedridden. the hospital tried to lcp her twice, the second time she was only saved by chance as the government said they now have to check with families and we'd already objected. after that the nursing home tried to lcp her, but the fuss i kicked up was sufficient to put them off.
now, my dad has to go in every lunchtime and evening to make sure she has been given something to eat. he provides yoghurt and pureed fruit for her - after a year in the home they still refuse to provide her with a yoghurt she can bear to eat or with decent soup (she can't swallow much).
they keep her clean, though. but they'd gladly let her starve to death. they resent giving her a drink and she can go without water for hours on end.
oh, and the bedridden who might ask for help are put on a corridor away from the main area, so no-one can hear them shout. my mum has a buzzer but often we find it placed out of her reach or disconnected. if she asks for help a hand reaches in and closes the door to her room, leaving her alone in the dark.

so yes, they just love to kill off the elderly and inconvenient by dehydration and starvation. its been going on for years, staff are habituated to it and trained in how to go about it. add in staff shortages and you have a perfect excuse for something they want to do anyway.

giraffesCantSledge · 01/01/2014 06:54

Total madness :(

giraffesCantSledge · 01/01/2014 06:55

Shame she isn't ina ward with my Gran - she is a former nurse with dementia and is desperate to nurse everyone - she would have happily sat for your with your Mum nursing her properly, the old fashioned way.

blahe · 01/01/2014 07:21

Rabbitlady - why have you not moved her to another home?

feetlikeahobbit · 01/01/2014 07:32

Rabbitlady please look into moving your DM to another home, the one I work in isn't like that. We'd have food/fluid charts in place and when a bell rings it's logged on computer and flagged up in head office if unattended 5 mins. Moving bells out of reach is a sackable offence.

LegoStillSavesMyLife · 01/01/2014 08:16

It's so sad. Two of my relatives have gone through this

GMIL: 90 in hospital didn't get food or drink for long periods.
My uncle 80: didn't get a drink 48 hours due to operating delays.

Thankfully my uncle is as fit as an ox with a constitution second to none and he bounced back, though was clearly aged by the experience. My GMIL did not,by the time she came out of hospital the severity of her dementia much much worse and she died shortly after.

oldgrandmama · 01/01/2014 08:34

OP, I am appalled but not in the least surprised ... I could relate how cruelly and uncaringly an extremely ill elderly relative of my son in law was treated but I won't. Please, complain, complain, move your mum if you can. How she's being treated is beyond disgusting.

For myself, being elderly, I am absolutely terrified of being dreadfully ill and thus finding myself in one of those charnel houses posing as NHS geriatric wards. So I've my own 'get out' solution ready - I'd sooner die in my own home.