To ask to speak to a doctor ?

[3smallpups]

Not in an aggressive way , just does it seem like a reasonable request ?
my brother has been admitted to hospital with what is clearly alcohol related liver disease. He is in no fit state to advocate for himself , rambling and barely conscious . Having been there for several hours today , there was no sign of a doctor on the ward at all. The head nurse was able to answer some questions but only to say that his bloods were all over the place and he’s waiting for a scan.
i have a medical background and it’s pretty obvious what the diagnosis is, without the scan and I know that there’s lab work that can be done to establish prognosis etc, which hasn’t been done .
i know that basically the only chance of a positive outcome is steroids started early , but I feel they aren’t going to do anything till they have done a scan ( likely not to happen over a bank holiday weekend ) and it will all be too late.
if this was my husband , I’d be laying in the corridor until they found me a doctor to speak to , it’s that important . But I sort of feel
as it’s my brother , I don’t have the authority? But I am his next of kin, our parents are dead and he is divorced .
actually just writing this out makes me realise that I need to stand up for him.

He needs you to speak for him! My late db was an alcoholic and he was always put on withdrawal meds if he was admitted. Our parents, particularly dm (retired nurse) was his main spokesperson though he often resented her getting involved. When ds(23) had sepsis almost 2 years ago I couldn't believe how difficult it was to find a doctor in a&e. I truly believe he would have died if dd1 had not advocated for him (she's a doctor).

Do they know he's a heavy drinker, why was he admitted to hospital.

hope he’s better today and getting correct management 💐

I have experience of someone with a similar illness. I’m not sure how it is with weekends or bank holidays, but in that hospital the doctor did rounds once a day and if you are very insistent they might let you sit on a round. It’s not during visiting hours and they are not very happy about it but as NOK you deserve to have some actual info. I went with the NOK to take notes, and in order to get permission to come in she had been very assertive and not taken no for an answer.
I know everyone is very busy but it’s like getting blood from a stone sometimes and it’s stressful when the person is urgently ill. I was NOK for an elderly relative and was told she might not make the weekend. When I came in the next day I asked how she was doing and was told she was “very poorly” 🤨 which didn’t really mean anything given the circumstances

Unfortunately not has no legal right to medical info without the patients consent but staff do try and share information when they can

OP you sound great and I hope things improve.

In the medium term, I would consider getting Power of Attorney for both health and finances in case it’s needed.

This is the level of care we've experienced for the last 20 years, it's frightening and neglectful when not even drinking is aided. I fought for FIL who had gone in with delirium to have an IV drip because he was out of it and convulsing. He'd not drunk or eaten anything for 48hrs, just things put in front of him. The drip helped loads and am not medical trained at all.

Please get him some more attention if able. So pleased for your brother he has you, I really hope they listen to you fast.

Impossible if he lacks capacity, you'll need to apply for deputyship or the court of protection

Dm was fast tracking a Power of Attorney when db died. It was very difficult because though he had given written consent for dm to deal with his medication etc the surgery kept on wanting to speak to him. By this time he'd had a tracheostomy and was unable to speak.

I am talking about when he hopefully gains capacity.

Db was an alcoholic and spent time in hospital. The nurses were great but I was rarely able to speak to a doctor, and the nurses were unable to change course of action. Db unable to advocate for himself. I wrote a letter to the doctor and left it with the ward sister. I think it helped, I was able to explain my concerns and I n is from the nurses that the doctor read it and took it seriously

Doctors in hospitals especially on a weekend are rarer than unicorn shit

When my husband was deathly ill (like 3 times had to be shocked back ill) the useless morons went on the ward once a day spoke to him for 2/3 minutes then went off again

I caught one of them at the nurses station on Grindr which he's allowed to do but not when he's getting paid to work

The only time they materialised was when he flat lined then they all came out of the woodwork

Thanks all
am reading and absorbing
he is getting worse not better
yesterday he could be roused anough to be spoon fed , they dumped a sandwich on his tray table for dinner ! He can’t even chew. I made an egg custard for him and brought in a protein yoghurt. It’s the best I can do as can’t bring anything soft and hot as I asked if there was a microwave and was told no .
today he can’t even be roused to swallow
have put formal complaint in to nurse who is escalating it to the one doctor that seems to be on duty this weekend.
i have threatened formal escalation, whilst stressing I realise it’s not the nurses fault at all .

OP, it very much is the nurses’ fault, for not recognising his deteriorating condition and taking action.
It being a weekend is irrelevant.
It’s frightening to think that this is an example of hospital care.

Next of kin doesn't really give you any authority over his care of you don't have POA. It sounds like no one has questioned his capacity. I think over a weekend on most wards the medical team will be busy fire fighting and family updates for someone not in immediate danger and with capacity will be a very low priority. He's in the best place and they have to prioritise caring for the patients over discussions with relatives.

We don't know if the nurse did or didnt escalate this, you can bleep, record MEWS , ring consultants secretaries till you're blue in the face sometimes. If he's deteriorating qnd unrousable then he needs an urgent review.

I’m not asking for authority over his care , I’m asking for him to have some care .
it seems to be that the consultant didn’t start specific liver treatment on Friday because he was awaiting a scan
he has gone home and not here till Tuesday
scan still not been done
his condition is deteriorating and he can’t advocate for himself as practically comatose , I suspect he has hepatic encephalopathy.
the nurses are now also concerned, now I have pointed out that he can’t even swallow properly any more , they do t have authority to make a treatment plan . They have asked the doctor but it seems that there are only two doctors working in the whole hospital today and they are busy in an and e . That’s what the nurses said ( unless they mean that there are two doctors for the hospital part and they have gone to help in a and e )
as for fire fighting , it’s not the patients fault if the hospital is not staffed adequately. Are people expected to sit quietly in a corner and die because it’s a bank holiday weekend ?

And he doesn’t have capacity , he can’t speak ? A person practically unconscious surely does not have capacity ?

My gods, the NHS. Local Pharmacies can get you nutritional shakes that may help that you could take in. But honestly words fail me at what the NHS has become. I really feel for you OP. I see it from the privilege of having Swiss healthcare.

one tip I learnt when you do get to speak to someone, say you want it written in the notes that you asked for x,y or z and it was refused. I’d also make a sign for his bedside table that says „this patient needs assistance with feeding and drinking, put the hospital logo on it and place it there.

document everything. Hugs

I really feel for you! Once late db was hospitalised after a bad fall and immediately started on detox treatment. He was hallucinating and told doctors he had no family. It took dm 3 days to track him down.

I know , it’s so scarey , it terrifies me getting older or ill.
i bought some protein yoghurts and shakes but now he can’t open his mouth for the spoon or swallow properly .

What age is he and what’s his life outlook from here? Does he have a serious chance of living a semblance of a decent life from here?

Does he have a chance of getting and staying sober? Does he want to get clean and try to live a reasonable quality of life without alcohol? What’s in his life worth fighting for?

Which hospital is this, there must be more than 2 doctors on duty. There will be a&e, on take, itu and theatre doctors on duty in addition to the medical and surgical cover.

He is 56 and a functional alcoholic , has a flat and a lot of friends .
i don’t think it’s up to me to push euthanasia on him if that’s what you are suggesting

That’s his call to make , if he wants to stop drinking and turn his life around that’s fabulous, not my decision though.
but def not my decision to say oh well , it’s his own fault , he is an alcoholic and his life isn’t worth fighting for !
im pretty sure if i had asked him a week ago , oh by the way , if you fall ill and get taken in to hospital , is it ok for them to stick you in the corner to die ? He would have said no !

Well you would think that wouldn’t you ? That’s why I think maybe the nurse meant there are two doctors covering all the medical wards but they have been dragged in to an and e ?
there certainly are no consultants or clinical teams etc
I suspect that the doctors that are here are fairly junior as well .