To call A&E where my sister is an insist they find a fucking heat pack for her sore back...?

[GayByrne]

Ok, gotta make this quick, bedtime and all.

Sister has mental health problems and is an alcoholic. She started a binge on Fri and had 5L vodka and God knows what prescription drugs, tramadol, codeine etc. Anyway, she called on Tues having lost two days and mum had to call an ambulance for her as she was out of it, crying uncontrlably, thowing stuff around, shouting, saying she wanted it to end etc.

So she's taken to A&E, put on a drip and librium and is currently there in observation detoxing and has spoken with the mental health team etc. We actually think that this episode could be the catalyst to getting her the help she so desperately needs.

To say that some of the staff haven't been supportive of her or willing to lessen her discomfort is fair. She has been judged for coming in as she did, i.e. alcoholic who od'd, albeit accidentally. She's had to fight for lirbrium even though she's shaking, throwing up, headachey, trembly inside, anxiety through the roof...when the alcohol nurse saw her she was so cross that she'd been denied librium and made a point of putting it on her notes the amount she can have within any 24 hr period. For the record she's well within that limit, well within it - so she's not taking the piss.

So she's obviously addicted to codeine etc and has a terribly bad back, that's how the addiction started. They won't give her anything for it, fair enough, but two nights in the hospital bed is killing her back and they've just told her they can't get a heat pack or V pillow for her...this is a big hospital.

AIBU to call them (I am 3 hrs away, was there today after driving overnight to get to her but had to come home for kids, husband going away with work etc). Can I ask to speak to the ward sister and insist that they try, at the very least, to help her out?

Thanks, could really, really do with some advice. My sis in vulnerable and unable to express herself as she normally can at the moment. I wish I was able to be with her right now.

This is all so distressing.

Incredibly distressing for you and your sister. Yes I think you should ring, and be nice but insistent about this. I think the way you put it at the end there 'vulnerable and unable to express herself as she normally can' is the phrase to use.

Thank you Joan, I so appreciate your reply. I will do that when the little ones are in bed, 15 mins.

Even if it is a huge hospital they won't have heat packs or v pillows. They are just not the kinds of things that hospitals have.

They're not allowed to use heat patches or hot water bottles. It's against H&S.

I work in a large hospital ,we do not have V shaped pillows and heat pads are banned ,can a family member take something in for her ?

YANBU. But I'd be careful and tactful in how you phrase the call and don't treat them like the bad guys.

eg "Sorry to bother you, DSis has called me saying she's not allowed a heat pack... I know the state she's in at the moment so just wanted to check if she's got that right or has misunderstood ... She's always had a bad back so if there's any way you could find one it would really help, I know you must be really busy and she's not the easiest to deal with right now"

It may be that the back pain she has now is as a result of damage to her internal organs, which could affect what the staff can do to ease it.

Ah cross posted with more knowledgeable people.

Is there anyone nearby?

Yes you are being u.

Even if heat packs are allowed in her hospital, it's not up to you to diagnose, prescribe and tell medical staff how to treat their patient.

There may be sound medical reasons why she can't have a heat pack- do you know if she has a temperature, for example, or if one of the drugs she's on has skin or temperature side effects?

The most you can do is point out she's in pain and ask if there's anything they can do for it.

Sorry Gay, I work in a hospital, heat packs and hot water bottles are against regs (May burn someone who is unable to express the pack is uncomfortable or unable to take it off) and v pillows just do not exist anywhere (I've worked in 5 hospitals across 3 trusts in my career).

This doesn't mean they can't do anything though. They need to encourage her to mobilise (safely) to stop stiffening up, and ask the medical staff to review her pain relief options. If her back hurts she needs medication and if she is addicted to opiates she needs a proper detox not just cold turkey at a time she is under other pressures. It must be awful to be far away from a family member in need of support. And for you.

Heat packs won't be allowed and I doubt very much they have any v pillows.

Can someone take one in for her?

Years ago, my Ex was in hospital and was feeling cold so I took in a hot water bottle the next time I went. It was confiscated because of H&S but also because it would give a false impression of his temperature. I was cross.

I was cross about the H&S business but had to give in over the temperature element.

When my late DH was in hospital and was cold, I took in two extra Lanaircel blankets (the sort with holes in them). The hospital, a large one in the biggest Berkshire town, didn't have enough ......

To echo the above, heat packs and v pillows just don't exist in NHS hospitals. She needs a joint review from the pain and alcohol team but no chance at this time of night.

Hospitals do not stock heat pads or V pillows. It is also unlikely that she will be prescribed any painkillers such as codeine without the approval of the psychiatric team given her multiple addictions.

And if you asked me to find you a fucking heatpad in person I'll call security and have you evicted from the hospital.

Generally speaking, being rude and abusive is not a successful strategy and suggesting staff are incompetent doesn't make them want to help you.

Thanks everyone. I should have thought that of course heat packs wouldn't be allowed. I did think that perhaps V pillows would be available though.

I think I'll still ring but just say that I have heard from her and she really is in pain and if there was anything they could do I'd be super grateful.

My mum is close by but she has my niece tonight so can't go out again. She could phone her friend who is a GP and is coming to see her today. That's the only friend that she has left really. She lost the rest of the gang along the wayside. Addiction is a truly, truly awful affliction. I am so sorry for her. She just wants to be normal.

Thank you all for your replies. I truly appreciate you taking the time to give your opinion.

ps - I would never be rude to the staff, my mother is a nurse and if she found out (and she would - it was her training hospital!) she'd eat me alive!

I doubt they would have V pillows, however if they have three pillows she can make a V pillorw, oftem do it for patients suffering with back pain.

Kundry, I wouldn't use that tone as I know it wouldn't help with the ultimate aim. However, some staff are uncaring and incompetent. I think recently it was called "compassion fatigue" in the summing up of a serious case review...yet another one!

She doesn't want codeine or anything like that. She knows that this is the point where this all has to stop, she could have died.

If staff are uncaring and incompetent then name them individually and stop assuming that everyone is automatically like this.

It is incredibly difficult to treat pain in patients who are addicts - have the Pain Team been involved?

You'd be lucky to have a normal pillow provided round here! We sometimes make do with rolled up blankets instead...... V pillows definitely non existent in the nhs. The nhs is very stretched. If the staff appear to lack compassion it's because they are overworked , underpaid, and probably haven't had a break during their shift.

Could try asking for something like ibuprofen gel or deep heat, might help relieve some of the pain. Really important to keep mobilising and avoid lying on bed for long periods.
Would monitor if things improve with the alcohol nurses input, but say something if this does not get better.
Hope things improve for dsis soon.

Thanks guys, I will give them a call and see if they can have a chat with me. I have a greater idea of what to say now, thanks.

I'd just like to point out, without getting into a titfortat thing, that I did say in my OP that "some" of the staff were uncaring. And this remains our understanding of the situation. I understand that the staff are overworked and underpaid - I saw enough of the shite they put up with last night as I sat with DSis until 2am. Having my mother as a nurse and tons of nurses and medics in the family means I have heard how awful it can be on the wards. But this isn't my sister's fault - she has worked since she was 16 for the same company until recently. She has earned the right to be treated with respect by the people who are Health CARE Professionals.

Thanks for the tip about the Pain Team, I will certainly ask about their involvement. I understand that it's going to be bloody complicated to manage her back pain bearing in mind she's an out and out addict! But simply saying to her that she has to put up with it isn't good enough, is it? As an aside, this is what a nurse said to her yesterday with regards to the cold turkey detox she was going through when DSis asked for librium. The Alcohol Nurse said she was disgusted and that's when she noted on her notes that she could have up to 250mg within a 24 hr period.

Anyway, I am rambling. I'll let you know how I get on, shall I?

Totally agree that she has the right to be treated with respect and I think they should get the pain team involved.
Has she got a diagnosed spinal problem - are neuro/rheumatology involved?
If you have encountered uncaring staff then then there are channels to communicate this.

YANBU except apparently about the heat packs if people above are correct. It is negligent to leave a patient in pain when there are any alternatives that the patient would accept and they will have baths, maybe a TENS machine, at least bloody paracetamol which is not addictive ffs. I'm afraid that having had friends who self-harm, medical professionals do sometimes moralise with patients and do not try hard enough to alleviate suffering in those they see as 'having bought it on themselves' (e.g. refusing anaesthesia to stitch self-harm wounds) which is incredibly wrong and needs to be addressed- this is probably the problem here as not all pain relief is addictive so there are options for detoxing addicts.

Yes Wood which is why the Pain Team should be consulted as to the best form of pain relief.
Often staff are at a loss as how to help addicts - it is very complex and expert help is needed.

I am not sure about the availability in all hospitals but when I had severe pgp I wad given steroid injections into the muscle area which helped massively.

Perhaps discuss this with the nurse when you call.