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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:
Orlande · 17/12/2018 09:58

NewYoiker - maybe you need to consider that your patients might not know anything about iv drugs, don't know anything about flushes or anti sickness medication, and would have no clue about the significance of the colour of a syringe? Especially not at 16?

Original poster
Skmo1 · 17/12/2018 10:01

NewYoiker

I completely understand what you are saying but:

  • She’s never been in hospital before
  • She has only ever had morphine on the A&E ward when admitted yesterday
  • She has no idea what goes where or otherwise

If the very first time she had morphine she saw it goin through the cannula, she’s asked for more pain relief, nurse has come to give her another syringe, with morphine, no matter the colour (as she wouldn’t have a clue about colour codes) then walks away, I don’t understand why she WOULDNT think it was to go in the cannula. As I mentioned before thank god she did have the sense to ask and didn’t just go ahead and do it or we could be having a whole different conversation here

OP posts:
BertBox · 17/12/2018 10:07

NewYoiker - you’re assuming patients have a certain level of medical knowledge. I’m 48 and have never stayed in hospital - if I were feeling dreadful, and was handed a syringe of medicine, of course I would think it was to administered in the exact same way I’d already seen - why wouldn’t I? Why would the colours mean a damn thing to me?

OP, I hope your daughter is feeling better and is home soon.

Lostandinsane · 17/12/2018 10:08

@ItWasOneTime
Ah, was the Oramorph deffo in a purple syringe? I must have missed that bit (skim reading), my mistake!

Motoko · 17/12/2018 10:10

NewYoiker
I've been in hospital plenty of times, and had IV morphine and Oramorph. I had no idea about the syringes being different colours, so why would OP's 16 year old? She was probably in too much pain to notice the colour of the syringe her morphine was administered in at A&E.

You're assuming everybody has the same knowledge as you. In a medical setting, that's a dangerous assumption to make.

cuppycakey · 17/12/2018 10:13

Welcome to Tory NHS Sad

EdtheBear · 17/12/2018 10:14

I'd say 16 is adult and should be in an adult ward.

In my local hospital the childrens ward seems to be segregated by age not sex or gender. Is it really appropriate for 16/17 males and females to be sharing rooms?

Sidge · 17/12/2018 10:16

All the people shouting “OMG you must contact PALS” - do you realise there are layers of management to go through before contacting PALS?

If you have concerns on a ward, ask to speak to the nurse in charge. They are the feet on the ground and can investigate and manage a situation or concern practically. Then you may escalate to Matron and beyond if necessary.

PALS are a support service, they’re not a complaints handling team. However they will assist in directing concerns and complaints, and guess who they will contact first? Yes, the ward manager...

gamerwidow · 17/12/2018 10:19

Maybe it's just me but I'd never do self IV administered drugs in hospital
Yes but you’re not a 16 yo child. How is she or any other non HCA supposed to know purple syringes mean oral and other syringes mean IV.
As an adult I wouldn’t expect to administer IV medicines but if she’s only ever seen the syringes administered via a cannula how she going to know this one is different.

FruitCider · 17/12/2018 10:20

Oramorph is not consider a schedule 1/2 controlled drug in England, Scotland or Wales. It is not required to be written in a controlled drug register, it does not need 2 nurses to complete the checks and 2 nurses do not need to sign the MAR.

HOWEVER there has been a drug error here as the nurse signing it off the chart needed to witness your DD swallowing it before marking it as "fully administered".

ditavonteesed · 17/12/2018 10:20

Can I say just one thing to put your mind at rest a purple syringe would not in any way fit onto a cannula, there would be no way to put the oramorph through a cannula if it was in a purple enteral syringe they are completely different attachments. As for everything else, speak to the ward manager if you are worried they should be able to help you. And I hope your daughter feels better soon.

gamerwidow · 17/12/2018 10:23

PALS are very much a complaint handling service amongst other things and it is not poor advice to complain to them. Yes they may triage the complaints to the ward manager or similar rather than deal with them personally but that triaging of complaints is part of their rule.
It is not up to patients to know the complaints process it is up to PALS to signpost them to the correct information.

woollyheart · 17/12/2018 10:36

Why is everyone so focused on whether a rule has been broken or not?

I amazed that anyone would expect a 26 year old to know any of these rules, processes or practices.

Surely it is simple care and kindness to check with a patient so they know what you are giving them, and whether they know how to take it?

woollyheart · 17/12/2018 10:36

16 year old, not 26!

abacucat · 17/12/2018 10:38

All sheets in hospital beds are supposed to be changed daily. I am very surprised that is not happening as anywhere I have been in in the last few years has done this as part of the routine.

woollyheart · 17/12/2018 10:54

Having known some people training as doctors and doing their training in hospitals, it seems clear that hospitals are quite different places at weekends and overnight.

Those of you pointing out that rules are always adhered to in the hospitals you have worked in , have you ever been an emergency patient going in over the weekend?

From doctors I have spoken to, there may be only one or two doctors covering non-emergency wards overnight. Most of the nurses in the hospital seem completely unaware that the reason the doctor doesn't come immediately when summoned is because they are covering so many wards with continuous multiple demands for medical help coming up.

Maybe in this case, the nurses were under similar pressure.

Otterseatpuffinsdontthey · 17/12/2018 11:08

@ woolyheart
With reference to the 3rd paragraph of your post:
Inaccurate.
Patronising.

NaiceShoes · 17/12/2018 11:13

NewYorker I find your attitude frightening and quite frankly arrogant. Why would anybody know that the colour of a syringe means anything? Were you born with this knowledge or were you told in your nursing training? She was left with the syringe with no instructions. Why would she think 'oh they wouldn't possibly expect me to self administer IV medication so it must be for me to swallow instead?' Your line of thought makes less sense than what OPs daughter thought. You aren't the nurse in the OP are you?

mumsastudent · 17/12/2018 11:19

seventh sorry but bull: had a 17 year old with mh placed with adults & that was really bad & know of others in same situation. If there isn't enough space in childrens ward/or they consider 16 as adult than into adult wards they go - in general hospital & mh

Shepherdspieisminging · 17/12/2018 11:22

This reply has been deleted

Message withdrawn at poster's request.

Original poster
Skmo1 · 17/12/2018 11:28

Just also found out from speaking to my daughter at the time and the nurse just now there that at 7.30am this morning she asked for pain relief. Nurse said yeah, no problem. Still none at 8.30am after having asked again twice, Crying at the time as she was really sore 😔 nurses again, yeah no problem. 9.10am still none. I said Really, do I need to phone up and ask them to giv u pain relief?? Obvs jokin (half) lol. She actually said that to the nurse! Lol 😆 funnily she had her pain relief within 5 mins of this!
I completely understand that nurses have so many patients they need to go round administering medication, blood pressure etc and they are completely understaffed, overworked and underpaid but leaving her for 2 hours when she’s repeatidly askin (yes being a pest lol).......am I just being a worrying mum or is there a pattern emerging?

OP posts:
Otterseatpuffinsdontthey · 17/12/2018 11:36

@ NewYoiker
If you are a Registered Nurse - I suggest you read/refresh the NMC's Code of Conduct. Perhaps pay particular attention to administration of medicines, and accurate documentation.
You should also be well aware of the term "act or omission".

ItWasOneTime · 17/12/2018 11:46

@Skmo1 have you asked to speak to the ward manager yet?

sweeneytoddsrazor · 17/12/2018 11:58

@skimo1 2 hrs does seem like a long time but as you say they have to do lots of other patients and cant just drop everything the minute someone asks. I guess if its at a time when they are going round giving out scheduled medication then she might have to wait.

sleepylittlebunnies · 17/12/2018 12:03

Having to wait that long for pain relief is unacceptable. Did she ask a nurse or a HCA, sometimes on shift changeover there can be delays but I would expect a drug round to be taking place either at the end of the night shift or the start of the day shift anyway. I’m sure it’s not the case here but I have been asked by a HCA to get analgesia for a patient in agony and when I go they are fast asleep snoring, I don’t wake them up for it and if they wake later and complain that they’ve been waiting I apologise, explain and get it for them. When giving oramorph I either hand over the purple syringe or pop it in their mouth and it’s automatic to tell the patient that it’s liquid morphine to swallow. Years ago it was a 2 nurse check and would frequently be delayed as trying to find a second nurse who wasn’t busy was rare.

Woolyheart I think all nurses are very aware that there are only 1 or 2 doctors we can call overnight and that they are run off their feet covering far too many patients and areas. However when our professional judgement and policies state a doctor is needed then we have to try our best to get the doctor to come.

The trust I work in puts under 18s in children’s ward if in education and adult ward if in work. Unless the bed situation dictates otherwise. I’m an adult nurse but have offered young patients to have a parent stay especially on their first night.