Any nurses or hospital staff about? Desperate Help Needed!

[carocaro]

Need advice, so please read if you can, tried to keep it brief.

My step dad is in hospital with a broken femur. He has primary progressing MS and has not walked for 7 years. He was due to have an ileosomy but he broke his leg days before. He now has 2 bed sores that are not getting any better. He his not getting any rest in hospital and is going down hill rapidly. At home he is all set up with equipment and bed etc to come home.

He wants to come home and will be able to rest and get better at home, the district nurse agrees, but the hospital cannot seem to make a decision. There seems to be the competitaveness between departments to 'be right' and my poor mum is stressed, upset and tired of being told different things from different people and also being 'told that person/that department' is wrong.

The PALS service are quite frankly fucking useless and have been no help in anyway at all, they cannot even remember my mums name or even call her back afte 10 calls!

They don't even read notes, stupid physio, said he needed to get out of bed and walk around the wards to get use back in his leg, he has not walked for 6 years, it's on his notes. Really WTF is wrong with people?!

I know I am clouded bu emotion, but he needs to get home and someone needs to grasp the nettle at the hospital, but who would that be?

What can we do? No one seems to know!?

Sorry your step dad is ill. I will try to help a bit if I can. Why is he waiting for an ileostomy? That may make a difference.

Bedsores are nearly always preventable but given his problems they might occur even with great care - is he on an electric fancy mattress and has tissue viability nurse seen him for the sores?

If his nutrition is crap it will affect the healing. Sometimes people go home with an electric mattress and the DNs can arrange it.

Apart from the Drs arguing, what does your step dad want ? Would going home now and coming back for ileostomy work as a plan? They probably don't want to operate while he is so compromised.

If PALS aren't helping, escalate to a formal complaint now. They are usually good but it sounds like a complex situation and he needs a solid plan first IMHO.

How long has he been in hospital?

I presume he has a care package already set up at home?

The fractured femur , is that sorted now or is he on traction?

The hospital may have valid reasons for keeping him in although ime as community nurse they usualllly send people home too early.

Is there some meds or treatment he is having that the district nurse service can't provide ?

Thanks so much, to answer:-

He is on an electric fancy mattress, but due to the MS he canot move himself about, they are supposed to do this every half hour but they don't and no one did anything over Easter as no staff!

At home there is a fancy electric mattress, hoist, commode wheel chair and other stuff, just waiting for him.

There is a care package in place, they just are waiting for the hospital to say he can go home, which is what my Mum can't get an answer from onyone on.

The food is vile, but my Mum takes all his food in everyday, he has been eating very little, but better now.

Not on traction now, just in a cast.

Tissue viability nurse - no idea, I will ask my Mum.

They say they can't do the ileostomy now, until her is better.

No more meds than usual, which they can't even get right in hospital, they keep forgetting, his MS meds etc, my mum has to chase them everyday.

He wants to go home, but they said if he signs out AMA, he won't get any help at home, which he has to have!

So who above PALS should my Mum contact at the hospital?

Is it like each depart for each condition won't communicate properley to each other about what is best overall - is there someone that should do this?

Thanks again, it is such a difficutly situation and not understanding how things work make it even harder. I really appreicate it.

Yesturday they did not change him properly after her had a poo, he tried to sort it our himself, got poo under his finger nails, asked for a bowl of soapy water to clean his hands and was left for five hours until my Mum came in, in that time they expected him to eat his lunch with filthy nails.

No wonder infection spreads in hospitals.

If I were you I would ask for an appt with his Consultant and ask what is stopping him from being discharged.

If there is quarelling between depts is there two consultants involved in his care?
Where abouts are his pressure sores ?
Tissue viabilty nurse usually get involved if staff need advice on how best to treat a wound.

Thanks, there are four consultants invovled it seems, and they are only bothered about their own bit eg: MS, ilestomey, borken bone and bed sore.

His pressure sores are on his cocyx and hip bones on his back.

My Mum has not heard about any treatment or advice about a tissue viability nurse - so she is asking when she is going in today to visit. I will also say to her to ask specifically, what is stopping him from being discharged.

Thanks again, so very helpful.

Well the orthopaedic consultant will prob be the one controlling the ability to discharge I would guess .
I'm guessing his MS is being managed as i would be at home and the ileostomy is postponed anyway.
The consultant to do with bed sores has me stumped to be honest? Is he on a medical ward for other problems?

Well I would say the thing to remember is your dad is not in a prison. He can leave at any time and the hospital would have a duty to provide transport and services asap if he makes that decision.

All the other reviews from differing consultants can be don on an outpatient basis, but will take longer and could be difficult for him to attend. It's worth him considering this when deciding what to do.

District nurses are great at managing sores and can get advice from a tissue viability nose if needed.

So sorry your step-Dad is going through all this.

Reading it from a completly non-medical point of view, how old is your Mum, and what is she like under pressure?

Could you go in and talk to those involved (with SD permission) and see if you can cut through the red tape?

You need to make an appt with consultant and ask what are the medical issues keeping him in and what are the plans.

Make an appointment to see the ward sister if there is no medical reason for him to stay in hospital and ask what they feel are the barriers to discharge and plans.

Good luck

Thanks all again so much. He can now go home, but as it is a complicated discharge he it will take a few days. Pressure sores can be cared for by district nurse team. I am sure once he is home he will feel better and start to get some rest and get to some sort of better, even if the end is in sight, at least he will be at home.

That's good news ..at last.