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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

to Expect rules to be followed by nurses while my daughter is in hospital?

203 replies

Skmo1 · 16/12/2018 23:27

My 16yr old daughter got taken into hospital by ambulance this morning with severe stomach/abdominal pains. A&E, cannula in hand, pain relief (morphine through the cannula, then admission to ward and all very quickly! fantastic. As she is 16, shes in adult wards rather than children’s. She was very apprehensive about me not being able to stay over night with her plus she has anxiety, which brings on panic attacks about things like that! She phoned me at 8.30pm & told me she’d started feeling sore again & asked the nurse for a morphine top-up, (on docs request) nurse told her 5mins it would b with her. Nurse came back, alone & handed her a syringe filled with clear liquid & walked away! My daughter didn’t know what to do. It’s her first ever stay in hospital and also her first ever time having morphine. First time she has saw morphine was when she was down in A&E and the doctor put it straight into her cannula! She was a bit puzzled as to why SHE was GIVEN a syringe full of morphine, then left to her own devices. It’s very lucky she’s a bright girl & thought to ask before She whacked it through the cannula & it’s very very lucky she did ask as it was actually ORAL morphine, she was supposed to swallow it! So, shes got talking to a couple of women on the ward....as u do! One woman had blood and other bodily fluids all over her bed sheets from her admission on Fri. They havent been changed, at all. The same woman & another had violently vomited on Fri night and both their sick bowls are STILL sitting on their tables that go over the bed.....tonight (Sun).

So much for the hospital being vigilant in staying clean to Reduce the risk of patients catching superbugs like MRSA etc!! And also breaking controlled drug procedures completely to the point of negligence!

Am I being over the top???

OP posts:
TheLittleDogLaughed · 17/12/2018 04:21

I had a grim stay in hospital a few years ago. I had a gastro problem and was put in a side room in case I was contagious. It had its own toilet. I was asked to produce a poo sample in a plastic bowl and leave it on the side in the toilet. I did it the first night in and it was still there when I left after 2 nights there. I kept asking the nurses to take it. Also I was told to be nil by mouth but got v dehydrated as they kept leaving my drip to run out and not changing it. Didn’t have my sheets changed once. In the end I discharged myself.

dalmatianmad · 17/12/2018 05:05

Sorry you've had this poor experience.

I'm an A+E Sister. Oramorph is not a Controlled Drug. It does not need 2 nurses to administer it. The nurse should have checked ID and allergies and observed your dd taking it. IV Morphine should only be given if all other analgesia has been tried. It can depress the respiratory system and knock your breathing off.
The cardboard vomit bowels disintegrate after a certain time so it's very doubtful they have been there for 2 days. At 16 she should be on a paediatric ward. Its not appropriate for her to be on an adult ward.
What part of the country are you in op?

vinegarqueen · 17/12/2018 05:17

I think daughter should be on a peadiatric ward or private room, OP. It must be pretty terrible. No-one on here has called your daughter a liar, btw, but obviously you will need to make sure what drug she was given (morphine v oramorph) as even if she was given morphine at first they might have changed it while you weren't there. Oramorph can be given to self administer and whilst it isn't good practice just to leave it there, it's certainly not illegal. With regard to the soiled bedsheets I would also take a quick look for yourself if you can. If it is true then it is awful and you need to go to PALS, but your poor daughter may have had some things exaggerated to her by the women in the adjacent beds - you don't know if they are confused and your DD, being unused to an adult ward, is taking what they are saying at face value.

SimplySteve · 17/12/2018 05:18

Disgraceful OP.

Also, Oramorph has a far lower bioavailability than IV morphine. It takes 30ml of oral morphine to be equivalent to 5ml IV morphine. It also tastes shite and takes ages to work, unlike IV which is seconds.

HoppingPavlova · 17/12/2018 05:32

It would not be usual for 2 people to have to sign for the Oramorph.

Make a PALS complaint about unhygienic bedding if you have seen this yourself. I’m really struggling with the vomit bowl situation. Unless the patients have brought in their own vomit bowls out of the Ark, which seems highly unlikely, I don’t really see the standard cardboard bowls holding vomit for days, it wouldn’t be in the bowl but would be ALL over the place.

SimplySteve · 17/12/2018 05:41

It's normal in my trust for two to sign it off. (Midlands PCT).

Notveryadventurousname · 17/12/2018 06:09

When my 16 yo DS was admitted, he was given the choice of adults or children's ward. He chose adults and luckily was put in his own side room...great for recovery but quite lonely. But later found he would have had more 'support' on children's. ....longer visiting, teen worker, games etc. He says he would have opted for children's if happened again. If she is likely to be in for a while, is it possible for your daughter to ask for a transfer to children's? I would say she needs to ask, otherwise they may think you are trying to influence her (something nursing staff are obliged to consider).

NicoAndTheNiners · 17/12/2018 06:17

I can totally believe it. My 17yo was recently an inpatient (also on an adult ward btw, no choice) and while I would say that overall the care was good drugs were left in a pot at the bedside when I know as a HCP myself that the nurse should see them been taken.

Dd said to me that she wasn't going to take her painkillers one time and I had to tell her that she had to because they'd now been signed for on the script.

She was also cold the first night she was there, we asked for a blanket for her 3x over a space of 90 minutes and no blanket came. As I left for the night I tucked her in with her dressing gown and coat on top of her and asked for a blanket again as we left. Each time we're promised one and she didn't get one till 7am. A nurse even came and woke her for obs and drugs at 4am and would have seen she had her coat on top of her and didn't think then to get her a blanket. So I can even believe it about the vomit bowls.

SlowlyShrinking · 17/12/2018 06:21

Which drugs are treated as controlled can vary from trust to trust, and even from ward to ward within the same hospital.

cariadlet · 17/12/2018 06:35

It seems to vary from trust to trust what happens to 16 year olds.

My dd was in hospital for an operation at the beginning of October. When we went to the hospital for a pre-op visit during the school summer holidays, we were given leaflets for the children's ward that she was going to stay on. Unfortunately, the wait for the op was longer than anticipated and it happened just 2 weeks after her 16th birthday so she ended up on an adult ward.

As a 16 year old she had to sign all the consent forms herself and had to walk into theatre herself (if she was younger I could have stayed with her until the general anaesthetic took effect). The leaflet about the children's ward explained that a parent could stay overnight, but this wasn't possible on the adult ward.

I have to say, although I was disappointed that she ended up on an adult ward, in every way our experience was brilliant: the ward had side rooms for every patient so plenty of privacy, rooms cleaned daily, beds changed daily, flexibility over visiting hours and lovely staff.

Dimsumlosesum · 17/12/2018 06:43

How she is treated and what she will experience will def differ between Trusts. Some have way, way more funding than others, be in better areas in others, it's a very unfair lottery about what kind of care she will get, unfortunately.

8FencingWire · 17/12/2018 06:50

OP, what colour was the syringe?

Zevitevitchofcwsmas · 17/12/2018 06:54

They didn't even tell her what it was though let alone supervisee her having it!

Op definitely try and speak to someone urgently.

Zevitevitchofcwsmas · 17/12/2018 06:56

Moving sick bowls and clearing beds is basic training. Training that should still be upheld. How is that affected by funding? Unless nurses are being used who not actually nurses with noise training!

lostandconfusedd · 17/12/2018 06:58

Tbf when I've been in hospital and bled on the sheets, I didn't want them changed. That very well could be the experience here. Not everything is as simple as nurses neglecting people Hmm

OhTheRoses · 17/12/2018 06:59

If my dd were in hospital and distressed I wouldn't be on MNet. I'd be on my way to the hosputal to make sure she was being properly looked after. Adult ward or not. And if not and if I found others in bloody beds surrounded by congealed sick bowls, there'd have been merry hell by now with the hospital manager having been called.

It's time we all stopped being grateful for sub optimal care. Ifthe dd had exaggerated I'd still be there because clearly she needed me and must ave been feeling vulnerable.

gamerwidow · 17/12/2018 07:00

It’s not acceptable and you should ask to speak to the Matron urgently and then write to PALS. No Matron worth anything would be happy for this behaviour to be going on under their watch.

FestiveLemur · 17/12/2018 07:05

The policy for signing out oramorph varies from trust to trust, but that is irrelevant.

When nurses administer medication, they sign to say they have administered it to the patient. This means watching them. It also means assessing competence and ability and assisting if necessary to get the drug into the patient. It doesn't matter if the drug is morphine sulphate or vitamin b co strong. The procedure is the same. The signature means the same.

What worries me (aside from the fact that IV administration of oramorph is a serious incident) is that this nurse is giving out meds, signing to say they have been taken, and not checking. How many people who are old, confused, blind, exhausted etc have their medications lying in front of them on tables? (Hopefully, this isn't the case and the nurse just assumed that as your daughter is young and able, she was able to manage, and focussed on the more needy.)

It absolutely IS worth reporting. The nurse may need support and management. Learning from incidents in the NHS is what makes us stronger and safer. While unpleasant for the nurse, as a single incident, it won't "ruin his/her career". It will prevent him/her from making a worse mistake in the future.

YearOfYouRemember · 17/12/2018 07:16

My 17 year old is currently in hospital and he is in the adolescent ward. H and I have taken it in turns to stay. No way would we have left him. He's really poorly.

We've had great care but we've also had protocol lapses. The night shift nurse hasn't once asked him to show his bracelet and asked him if he'd had certain meds. I wasn't sure as hes on a lot. He said yes. The chart said no. She offered him some. It felt a bit casual and I told her she should know what drugs he's had and he can't be expected to know given how ill he is

I hope your dd is soon okay but I'd be asking firmly for her to be moved off the adult ward.

allthegoodusernameshavegone · 17/12/2018 07:21

Putting a 16yo in a children’s ward is un necessarily taking up a child’s hospital bed. The standard of care she is experiencing is poor and should be reported, but she does need adult care.

ILovePierceBrosnan · 17/12/2018 07:23

There are different versions of morphine.

Some are controlled drugs. Some are not.

Either way the nurse should have established what your daughter knew before walking away.

LittleCandle · 17/12/2018 07:36

Those saying the OP's DD should be in a children's ward as she is 16 - it depends where the OP lives. In Scotland, you are legally an adult at 16 and routinely placed on an adult ward.

cousineddie · 17/12/2018 07:51

Was also going to say in Scotland it’s quite normal for 16+ to be on adult wards , I was first admitted to an adult ward at 14 for surgery . Worked on an adult major surgical unit with HDU and we routinely took teenagers from age 14-18 although in most cases it was height and weight dependant iirc.

Also been given oramorph dozens of times in two different NHS boards and it’s definitely not a CD in either . One nurse and DOB/ID band check as with all meds but I was given it in a wee cup both times .

Whitescarf · 17/12/2018 08:02

In my trust oromorph isn't a controlled drug and a single nurse can measure and administer it. The oromorph should have been in a purple syringe however (which I think is now nation wide), which is an enteral syringe for anything given orally or through a PEG site etc. These syringes won't physically connect to a cannula, which is the safest way to ensure it's not admistered incorrectly.
The nurse should have checked your DD's drug chart against her wristband to make sure it was the right patient and make sure she knew how to take it correctly.
If the vomit was in the cardboard sick bowls, there's no way it would have held up for two days, they're really not that sturdy.

What i'd suggest, is speaking to the nurse in charge or ward matron and expressing your concerns on what you've seen. They'll be able to tell you if the oromorph is a controlled drug or not in that area, and what will happen with your complaint, whether that be nurse training on medication administration or infection control etc.

Hope your DD gets better soon

Seacow87 · 17/12/2018 08:25

Oramorph is lower on the CD register than IV morphine or MST. It can be administered by a single nurse. However she should have ensured your daughter knew what to do, and took it.
With regard to the other concerns. I would speak to ward sister / charge and if not call the hospital and ask to speak to infection control team and report your concerns. They will be taken very seriously.