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

[Skmo1]

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???

Oramorph Concentrated is 100mg/5ml and so ten times the concentration of the one everybody is casually dismissing on this thread. Mistakes have happened where people have confused the two. In my mind I still don't understand why Oramorph is not a proper controllled drug when 5ml of it is 10mg morphine whereas one tablet of MST can be 10mg and is controlled. Threads like this especially don't help in making people respect it. They even have MST 5mg which is controlled.

In my mind I still don't understand why Oramorph is not a proper controllled drug when 5ml of it is 10mg morphine whereas one tablet of MST can be 10mg and is controlled.

Bioavailability. Eg if you swallow 5ml of oramorph your body doesn't absorb even 5mg.

Also this might highlight why the 2 aren't mixed up, along with the fact that one is kept in the CD cupboard and one isn't.

It’s a controlled drug in paediatrics. At least in all the trusts I’ve worked in.

How is your daughter today OP?

Wow! Just wow..... YANBU

Most hospitals now only take children up to 16 on a children's ward. We had this with my daughter when she turned 16 and was in for a bad infection she was put on an adult ward.

YANBU!! I am a senior paediatric nurse and in the NHS hospital I work in all children Under 18 are admitted to the children's ward unless unsuitable ( mental health etc). She is still a child and should be cared for as one. Definitely get on to pals and make it clear what you're unhappy about. As far as I'm aware, oramorph is a controlled drug in every hospital, so this is serious and should be taken seriously! Best wishes to your daughter x

That really isn't the case though, especially not in Scotland where the OP, and I, am.

If she's under 18 she can choose Wether to go to an adult or children's ward. Tell her not to touch the Cannula!

Not here!

On my ward oramorph is still a controlled drug.

Leave feedback on the Care Opinion website as well as raising your daughter's situation with the ward sister.

op I don;t think anyone is accusing your DD of lying...but it is perfectly possible to be very VERY confused when on morphine, particularly the first time you take it.

I had a hospital stay when I was 16 that involved morphine and I thought there were people waiting to visit me who lived in the TV...and also that I had broken my arm (I really hadn't). All of this, plus a huge amount of raving and ranting and throwing my bed covers off randomly all got recorded in my notes as 'patient seems a little confused' - which makes me think my response to morphine wasn't all that unusual.

I think its reasonable to question your DD's understanding of the situation - and that really isn;t the same as calling her a liar!

I was left oramorph in a syringe when I went down to neonatal when DS was born. Another patient (I'm hoping patient and presuming not a staff member) took it.

I remember DD been given it for the first time on the kids ward age 13. She started rearranging the furniture in the hospital room, she was on a different planet.

16 seems so young for an adult ward. I hope she gets sorted soon it must be so worrying for you.

All trusts are slightly different.
I am a Sister on a Paediatric Ward and we only accept children under 16 unless they are under the care of a Paediatric Consultant or have complex needs so your daughter would have gone to an adult ward. Some hospitals have an adolescent unit but they are usually the larger trusts or hospitals rather than district generals although we are trying for a better service for adolescents

When the oramorph was given the nurse should have explained what it was and asked name/dob/allergies and checked against the drug chart. I wouldn’t necessarily check the name band if the patient/parent could give me the details.
Oramorph is no longer a controlled drug in the majority of trusts so doesn’t require signing out but we still double check it against the prescription/check dose with 2 nurses, and the nurse should have stayed until it was taken. Sometimes if parents are struggling to get a child to take medicine, I will return after a few minutes to see if it was taken but that wouldn’t be the case here.
It sounds that there are some definite poor practice happening that should be addressed...you can ask for the Nurse in Charge or the Ward manager...and they will be able to address your concerns or complete a verbal complaint form.

Hope her stay improved and you got your concerns addressed.

It is unfair to tar the entire NHS with the same brush though as there are plenty of nurses who are trying to do the best that they can with limited staffing, resources and time. Unfortunately, there are always going to be slipping of standards and staff that are not as interested in doing the best by their patients.
We do welcome negative feedback although it is not nice to hear but it is the best way for us to address it and try to improve our service if we can.

I’m pretty sure that oramorph is a controlled drug everywhere.
It’s hit and miss where I am. Some nurses checked my Id and asked my dob, whereas some just handed me the syringe and walked off.
When I’ve had it on prescription I’ve had to sign in the box and fill out a (small) controlled drug form when collecting.
I would contact pals with your concerns, I e heard they can really help. Good luck OP and i hope your dd is ok.

Many rules have been broken here including the Nurses code of conduct. I am sure ypur daughter did not sign up to self administer her medications and the nurse should have observed her taking it. The filthy state of the ward is a clear case of neglect and a serious cross infection risk. In the first instance you need to speak to the modern matron in charge of the surgical units or the assessment unit depending on where your daughter is and ask for a copy of the hospital complaints procedure to raise your concerns. This is obviously accepted practice on the ward so no point going to ward sister first.

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).

I'm sorry this just cannot be true

She is still underage even if they put her on an adult floor. That must have been scary for your daughter (I have a 16 yr old daughter and she has serious issues with anxiety too) and I'm sure it was hard on you too.Hopefully she feels better soon.
And I would absolutely make formal complaints about ALL of the issues.
Good luck to you both❤❤

Except 16 is a strange in between age. Old enough to get married, have a child, and work full time, young enough to still legally be considered a child.

We managed to stay with my Mum 24/7 when she was in for several weeks so can be done for adults too if needed. I would say at 16 in that state the ward should be grateful for any assistance even for one patient.

Lots of the tasks you are talking about are more like orderly/assistant tasks rather than nurse so it maybe they are short on those so medical stuff takes precedence but how hard is it to take two sick bowls to the disposal place.

I work for the NHS and I love the NHS.. BUT... This is not acceptable. YANBU. Please speak to the patient liaison service at the hospital. Sometimes they are called PALS. This does merit a complaint.

Except 16 is a strange in between age. Old enough to get married, have a child, and work full time, young enough to still legally be considered a child.

I agree. Despite the posters who’ve shared that their sixteen year olds have MH issues and would struggle to cope on an adult ward, the majority of sixteen year olds would cope fine on an adult ward with visits from their parents! At sixteen I and most people I know were traveling across the country alone for events and going on nights out, sure it’s frightening to be ill but i’d say it’s the exception rather than the rule for a sixteen year old to be suited better to a child’s ward, and even then only if it’s related to being mentally unwell.

Glad someone has finally picked up on the fact there are different strength formulations of liquid morphine and the rules around being a CD and how it’s administered differ between formulations and even trusts and local areas. 10mg/5ml Oramorph is not a controlled drug according to the BNF.

Definitely YANBU. I would contact Chief Executive of hospital and complain or Head of Nursing at the least. If you really want to stir it up and you have a local newspaper contact them and give story to them. I would not let it go. Basic nursing, care and cleaning being overlooked.