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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

Disgusted with the GP.

256 replies

Daisymae15 · 10/08/2021 19:27

This is not a bashing the NHS thread we are so angry with the GP.

My Mil 92 is in a nursing home last Thursday she had a minor stroke the home called the GP and all she has done is send aspirin, wouldn't visit.
Yesterday she had a fall, banged her head, shoulder and back. Not injured enough to call an ambulance.
The GP was called yesterday and was supposed to phone, as of 7pm tonight she still hasn't rung. When WE phoned the surgery told that she is on the list to be called.
The home are frustrated at not being able to give anything stronger than paracetamol. We are frustrated because of covid we are not allowed to visit.
(Someone tested positive on Saturday so they have gone back in lockdown)
We feel as though the GP is hoping she dies so she doesn't need to bother. DH has spoken to the home and they have said that they are worried about her, she is in a lot of pain, very depressed and not even got dressed today. Last night she slept in a chair as she couldn't lie down.

As I have said I'm not bashing the NHS as in the last year I have had breast cancer and my treatment has been first class.(Not under the same surgery)
We can't change surgeries as each home in town has an allocated practice.

Is covid to blame or is it possible that she is a shit GP.

OP posts:
EspressoDoubleShot · 10/08/2021 21:11

A home cannot compulsorily impose DNACPR that’s clinically and morally inappropriate . It’s a multi disciplinary team and family discussion . If this is not your wishes then write to the home manager,keep a copy and ask for a meeting to record your wishes formally in care plan and get a copy . Let the GP know the decision too It really must not be applied as a blanket rule . Individualised care not an institutional blanket rules
*report the home to CQC link regard DNACPR

The home should have called ambulance following the fall they shouldn’t have delayed

LemonRoses · 10/08/2021 21:11

If a ReSPECT form has determined the ceiling of care, an ambulance will most likely not transfer to hospital for most things. A home calling an ambulance to transport a frail elderly patient against a clinical decision isn’t acting in their best interests. They are not providing good care by so doing.

Most nursing home residents would be offered a natural and dignified death rather than a ham fisted resuscitation attempt and inappropriate transfer only to die on the journey or with strangers in a busy accident department. Resuscitation on a frail 90 year old is futile.

whataboutbob · 10/08/2021 21:12

The local CCG will have a safeguarding officer (adults). If you still have concerns you can contact them.

frumpety · 10/08/2021 21:13

Yesterday she had a fall, banged her head, shoulder and back. Not injured enough to call an ambulance

Who made that decision ? was the fall witnessed or was she found post fall ? Did someone hear her fall or was she found on the floor ? if it wasn't witnessed how would anyone know if she had any loss of conciousness ?
She has had a diagnosis, and been medicated for a TIA, all done anecdotally. She has a potential head injury, reduced movement as a result of a fall, increased pain, vague episodes and she has been prescribed slightly stronger pain relief that being honest won't get to the home until at least lunchtime tomorrow.

LemonRoses · 10/08/2021 21:14

@EspressoDoubleShot

A home cannot compulsorily impose DNACPR that’s clinically and morally inappropriate . It’s a multi disciplinary team and family discussion . If this is not your wishes then write to the home manager,keep a copy and ask for a meeting to record your wishes formally in care plan and get a copy . Let the GP know the decision too It really must not be applied as a blanket rule . Individualised care not an institutional blanket rules *report the home to CQC link regard DNACPR

The home should have called ambulance following the fall they shouldn’t have delayed

Entirely inaccurate. Nobody imposes anything. You can’t impose what isn’t offered. It’s similar to trying to consent to insisting on antibiotics for a cold. You can’t consent because it’s not on offer and not appropriate. You can and should discuss why and what the best course of action is though.

Relatives cannot consent for another person about anything without an LPA.

DamnUserName21 · 10/08/2021 21:15

The fall was only a recent occurrence and have the home have been trying to arrange pain relief. There is no safeguarding issue for that.

As for the 'blanket approach' to DNR-there is no proof of that. Just hearsay that ALL the residents have DNRs.
Having worked in nursing homes, it is very, very unusual to find residents with DNRs in place without their knowledge and even consent of the resident and family (even though the latter is not required).

@lemonRoses, most nursing homes do not have stock medications. All medications are named and prescribed and cannot be transferred to another resident. Only time this recently changed was with morphine during shortfall last year.

VaccineSticker · 10/08/2021 21:15

“A resident in a nursing home isn’t going to be a top priority because they have professional oversight already. The elderly person at home would take precedence. The person with chest pain would take precedence.”

@LemonRoses huh?A person in a care home has a professional oversight? Since when has a carer become now a nurse or a GP?
A mini stroke is beyond a carer’s expertise.

God, I really hope I never need a care home.

EspressoDoubleShot · 10/08/2021 21:15

Contact your local authority MASH team multiagency safeguarding hub this is a safeguarding issue

Coffeegirl87 · 10/08/2021 21:16

There are so many issues here OP, I'm so sorry you're going through this.

  1. There should not be a blanket DNR policy. It is a clinical decision made in the best interests of the patient by the clinical team and should be discussed with relatives.
  2. DNR means do not resuscitate. I.e if her heart stops beating don't start jumping on her trying to restart it. While her heart is beating it has no bearing on her care.
  3. TIA in a patient who does not have a care plan to manage at home = 999 ambulance not GP. If the paramedics feel non-conveyance is in best interests they will have a conversation with the GP.
  4. Fall with head injury on a background of aspirin -= 999. Ditto re conveyance discussion.
  5. Uncontrolled pain following the above = 999. Again non conveyance is a discussion with crew and care home.
LemonRoses · 10/08/2021 21:17

@DamnUserName21

The fall was only a recent occurrence and have the home have been trying to arrange pain relief. There is no safeguarding issue for that.

As for the 'blanket approach' to DNR-there is no proof of that. Just hearsay that ALL the residents have DNRs.
Having worked in nursing homes, it is very, very unusual to find residents with DNRs in place without their knowledge and even consent of the resident and family (even though the latter is not required).

@lemonRoses, most nursing homes do not have stock medications. All medications are named and prescribed and cannot be transferred to another resident. Only time this recently changed was with morphine during shortfall last year.

Most really do have stock, but not of CDs. Those that don’t can pick them up from an OOH pharmacy.
bellabride · 10/08/2021 21:18

I'm wondering how you could possibly know the DNAR status of all the residents in the Home?

LemonRoses · 10/08/2021 21:18

@VaccineSticker

“A resident in a nursing home isn’t going to be a top priority because they have professional oversight already. The elderly person at home would take precedence. The person with chest pain would take precedence.”

@LemonRoses huh?A person in a care home has a professional oversight? Since when has a carer become now a nurse or a GP?
A mini stroke is beyond a carer’s expertise.

God, I really hope I never need a care home.

The person is in a nursing home. It’s in the name. They are required to have appropriate numbers of registered nurses.
isadoradancing123 · 10/08/2021 21:19

Nursing home should have called an ambulance

AwaAnBileYerHeid · 10/08/2021 21:19

"Just to say all the residents have a DNR in place."

How do you know this? Has the home given to you the confidential medical information of all the residents in the home? If so, this is a serious breach of patient confidentiality.

I hope your mil gets the treatment that she needs. I would perhaps call in the morning and speak to the home manager.

DamnUserName21 · 10/08/2021 21:19

@lemonRoses,

I've worked in two nursing homes. One a well-known chain. No stock meds-they even frowned upon PGD medications/. I don't speak for all nursing homes but don't assume they all this capability.

Marcee · 10/08/2021 21:19

@ICantFindTheBuffet

No advice from me, the other posters have that covered. I just want to send my well wishes to you, your MIL and your family. Terrible she's being left to suffer.
Same Hope you get her seen
EspressoDoubleShot · 10/08/2021 21:21

Lemon
I’m saying there doesn’t appear to have been adequate discussion with client or the family , if the adult appears to lack capacity then there can be a MCA . It has not been formally explored or appropriately recorded

If it’s recorded as DNACPR then it has It has been imposed. care home records that will potentially travel or be verbally related will show that there’s DNACPR

Reallyreallyborednow · 10/08/2021 21:21

is on the phone to the home now.
Just to say all the residents have a DNR in place

DNR is not Do Not Treat.

The issue is someone has been left in pain without adequate care. At the very least she should have decent pain relief.

There should be a mechanism to access that, whether it’s GP or home. I’d be complaining, loudly. Gp and the home protocols need changing so if this happens again the resident can be made comfortable.

reesewithoutaspoon · 10/08/2021 21:23

A nursing home is only required to have 1 nurse on duty for legal reasons. The bulk of the actual care is done by carers

MorganKitten · 10/08/2021 21:24

DNRs must be signed by family or this is worked out when you create the care plan. Ambulances are called at the care homes discretion.

godmum56 · 10/08/2021 21:24

Are you in England? You absolutely can change your GP
www.citizensadvice.org.uk/health/nhs-healthcare/nhs-patients-rights/

Pixie2015 · 10/08/2021 21:29

With or without a DNAR anyone in pain and can’t walk like they could before a fall should be in AE getting an X-ray. Has your MIL declined an AE review.

Redcart21 · 10/08/2021 21:29

From that you’ve said, I can’t see where the GP is at fault? They would have assessed the situation and advised if an ambulance was necessary or not. For the TIA, I agree she should have had a medical check.
The GP would have had a long list of patients to call, all of which would have thought themselves a priority. There are too few GPs and too many citizens, they can only do so much and so the wait for a call back shouldn’t really be an issue sorry.

tintodeverano2 · 10/08/2021 21:29

You should be angry with the nursing home as they should've called for an ambulance, even more so as she hit her head!

Did she go to hospital following the TIA?

frumpety · 10/08/2021 21:29

Is she in a nursing home or a residential home ?