NHS in crises - the patient

[HospitalStayNHS]

I’m experiencing a very mixed bag of services this week due to being very ill and ending up in two a&e departments (I live in two areas) and being admitted in one.
I’m writing at 1.24am as the very full ward has an 84 yr old patient possibly suffering some form a dementia, obviously I am sympathetic but having suffered almost fatal sepsis (first a&e didn’t pick this up), I could do with some rest and she is constantly pressing her buzzer and yelling out. Could she not be moved to a private room?
The NHS is clearly in total crises. The service I’ve received from second hospital has been wonderful but 8hrs in recovery, due to lack of beds then onto this noisy ward won’t make anyone better.

Dh had this he was in for surgery and the poor chap next door has no idea where he was or why and was up all night. Had to have a nurse sat with him all night. It seems so unfair on him and the other people trying to recover.

A lot of confused dementia patients are at high risk of falls. Ideally, they need 1:1 care. Unfortunately, there are never the staff to facilitate this.

When I was a student nurse I had a placement in a dementia ward and it was horrendous. One particular patient ended up being there for over 12 months (because the family refused to source a nursing home - they thought the NHS should pay for their family members' care, despite there being nothing medically wrong with them) and would fall multiple times a day. I remember one shift finding a lady lying on the floor with a deep laceration to her head. She had climbed out of bed, fallen and hit her head on a sink.

Incident reports were constantly being fired off, but nothing changed. Staffing could have been increased, but no, too costly. It was the most depressing placement I had and put me off ever working in elderly care.

The ironic thing, while I was there the NMC visited the ward to inspect its suitability as a good learning environment for students. On the day in question, I had never seen so many qualified and student nurses on shift, we were tripping over each other. The same thing would happen when they knew the CQC were going to visit. Overstaffed wards, which reflected a false reality of the day-to-day working environment.

As a student, I was asked to speak to the NMC and give my views. I told them the truth, that the ward was massively understaffed, compromising student training and patient care. Nevertheless, they still approved the ward to continue having students. That was my first realisation that the NHS was badly run and completely corrupt.

I was in a similar situation a couple of years ago OP. I am sorry to say I was so bored just lying there I regarded it all as entertainment.

I've had hundreds of hospital admissions over the past 30 years and it's never been any different.

People age and get dementia, older people can get infection based dementia, or dementia due to anesthesia.

Sometimes if able the best way to stop the shouting is to talk to them and calm them down. Not easy when you are unwell yourself but easier than listening to someone be very distressed all night long.

And Ivor it's awful to admit to but yes I agree I've had some very funny memories from some of the dementia patients who have been my room mates.

Just to put a few misconceptions straight.

1. i don’t think she’s a lesser patient than me, anyone reading my posts will see that.
2. I am grateful beyond relief to have received the care I’ve had and continue to receive.
3. Greedy NHS executives are to blame, not the hard working staff on the ground.
4. Listening to a distressed lady until gone 4am thinking she has snakes and bears in her bed is not entertainment!

Obviously you’ve never had a family member with dementia in hospital.

My friend whose dad was hospitalised after a fall had to sleep in a chair next to his bedside because the nursing staff said they couldn’t handle him due to his dementia.

At mealtimes my mum used to get out of bed and hobble on her broken hip to another lady’s bedside to take the cover off the plate, unwrap the cutlery and place them into her hands and then she would start to eat. This is basic dementia knowledge that everyday tasks become confusing however the nursing staff were oblivious and when Mum mentioned it their response was ‘we don’t have time to feed her’ despite that not being required. Prior to Mum’s assistance they were claiming the lady was ‘refusing to eat’ and talking of inserting a NG tube.

Do not assume my family experiences nor what I do for a living
Nothing obviously about it

I completely agree.

My husband took him to a&e on wed evening was given fluid and pain killers via drip in a waiting room and sent home being told virus 10 hours later.

The following day he was worse. He didn't want to go back so had an appointment with a 111 GP who called an ambulance as he was meeting red flag sepsis signs. We got to hospital at 5am and treatment for sepsis started. He had a ct scan and was admitted but still no bed so was sitting in a chair from 5am friday until 3pm yesterday so 34 hours.

Hope you feel better soon.

OP, I feel sorry for you. Being in hospital is horrendously and frightening and a grave condition such as sepsis must have been terrifying.

I was in hospital for heart issues a couple of years ago and on a temporary ward when admitted. I remember wondering if I would make it, how to tell the children and being scared on a high dependency mixed ward.

There was also a lady with dementia there (no idea why as she was maybe the only one without lots of equipment attached to her). She was constantly shouting and walking around, it made me even more exhausted and frightened than I already was.

i think OP is getting a hard time here. She is exhausted, possibly still scared and cannot sleep. She is allowed to have a moan about that.

OK, I’ll ignore your ignorant comments about NHS managers and shareholders (WTF?) and sympathise with the shitshow in which you find yourself.

At the moment the best we can expect is good clinical care. Peace and quiet is a pipe dream. Make good choices at the ballot box.

My advice, from when DH was in your position, is to order yourself some ear plugs and maybe headband ear phones, and download some audiobooks and podcasts, preferably boring droning ones, that can help you drift if not actually sleep.

Being angry is not helping your recovery (although being angry is a good sign, if I recall….) - you need to zone out the rest of the ward and focus on your own little world.

The ignorance is astounding.

There are very few illnesses which prevent a conscious person typing on their phone.

So the NHS prevented you from dying from sepsis, and you are complaining about your accommodation. You are clearly on the road to recovery!

I do get it though - I have been there.

The NHS is underfunded, has low capital expenditure and is clogged up because our social care system is screwed. However, it’s admin fees are very low (1.9%) Until we have investment in new hospitals and properly funded social care, it will continue.

And likely someone else is in that private room now.

I hear you OP, many new-build hospitals are all single rooms but from a nursing point of view this must be harder to manage. It's all very well saying dementia patients should be on a separate ward but that's not what happens. A patient who breaks their hip is on an orthopedic ward, if they have dementia that's not what they're in hospital for. Very few dementia patients are in hospital because of the dementia - they are there because they have some other condition which needs hospital treatment.

Having said that, it IS hugely disruptive for everyone else, my dad had dementia and was very very shouty and agitated in hospital because he was away from everything he recognised. He was in a single room (everyone else was too) but having that sort of patient on the ward is still disruptive.

I hope you're feeling better soon OP.

That’s the joke, @DadJoke …

Ah, I get it. It wasn’t obvious to me you were satirising a viperish comment rather than just making one.

It's not safe to have a lady with I presume severe dementia out of sight in a side room on her own. How distressing that would be for her, and she is also at risk of climbing/falling out of the bed and getting a serious injury. She would need to be watched closely which is why she is in a bay.

How awful of those midwives to be helping new mums breast feed their babies. The sheer audacity of it all, those babies wanting to be fed and those mums for trying to meet their needs. Just awful.

I understand your concerns but private rooms are very scarce. My daughter who has been a doctor for three years now has struggled to get rooms for peoole who are dying to give them and their family some privacy.

She does her very best but the service is on its knees.

The NHS is a public service that we all pay for, we’re allowed to complain about it. OP didn’t say anything bad about the lady with dementia, that’s you projecting.

Hospital is a place where you receive medical care, part of that care is aiding recovery, which sleep is a very important part of.

She's a patient just like you.

In a private room (which are usually for those either dying or needed to be isolated because of infection) the staff couldn't keep watch on her if she were to need help as if she's so confused she wouldn't be able to summon help herself

where we are the (very few) private rooms are for people who are actively dying or very infectious - eg. Someone who has got norovirus or Covid and is a risk of spreading it to the rest of the bay.

I found this out when I was out on a ward with mothers and babies when mine had sepsis and was in NICU and I was recovering from a serious complication. I was told I wasn’t infectious so nope.

But also - the staff need to be able to see this patient and monitor her closely I imagine, which misty be harder in a private room. She is also extremely vulnerable.

My Dd at 16yo was very poorly, nearly died and was admitted to a ward where she spent 5 days. There was an elderly lady in the bed opposite who had dementia and would sometimes try to stand up on her bed.

after a couple of days when Dd was feeling a bit better she would do and sit at times and talk to her. Or buzz for the nurses if she was worried she was going to fall off the bed. I’m not saying it’s right that another patient had to help like that, but Dd was happy to and I was proud of her compassion. Obviously not all patients will be well enough themselves to help like that.

But this is a major reason a dementia patient can’t be kept in a side room, they need to be somewhere more visible. Nurses, etc are in and out the bay and keep more of an eye on them and other patients may also call for help. In a side room she could fall out of bed, crack her head open and be dead on the floor for an hour before she’s found!

Also the side rooms will be for the dying (if you’re lucky), the infectious.