Care Opinion

Awful care for 48hrs in A&E / excellent care in A3

Posted By distraught wife

"Awful care for 48hrs in A&E / excellent care in A3"

About: Accidents & Emergency / Phone First Antrim Area Hospital / Ward A3 Respiratory

(as a relative),

Sorry this is going to be a long one!!!!

My husband had covid and on the last day of isolation he deteriorated.  Our GP advised us to ring the 'call first number' at AAH.  We were given an appointment for assessment at the covid rapid assessment unit.  The doctor and nurses that seen to my husband at this stage were very helpful and explained everything well.  We were told after a chest xray that things were bad - he had pneumonia and would need admitted for IVABs and steroids.  I was grateful for the explanation, an d was scared for him as left him and went to get him an overnight bag.  On arrival at A&E again, a nurse came to take his stuff and explained which antibiotics etc he was on which was great.

However, that is where I can honestly say the good care ended for the rest of the 48 hours he spent in A&E awaiting a bed on the ward.  
To cut a very long story short I feel he was treated extremely poorly.  He text me to say his oxygen mask was changed but wasn't told how much oxygen he was requiring.  He sent me a picture and as a nurse myself, I knew from it that things were pretty bad.  The following morning he said it was changed again and again sent me a picture.  You can imagine how worried I was not being able to visit and my husband not being able to give me any details.  I rang for an update.  I was told the nurse was busy and to ring back in half hour - fair enough.  I rang back and was told this time to ring my husband for an update as they were too busy to talk to me.  I find this greatly unacceptable as my husband wasn't told anything and his oxygen levels dropped every time he removed his mask. 
After a further hour or so of worry and anxiety, I rang and asked for a senior nurse - they answered and again told me to call my husband.  I explained that he didn't know anything.  I asked how much oxygen he was requiring and what was the plan.  The nurse told me that they didn't know as they were in charge and not looking after him.  I had to beg them to find out for me.  I found this extremely unacceptable communication with a worried family member.  
The same thing happened the next day when I again rang for an update - I was told to ring back and then told on the 2nd call to ring my husband as the department was 'mental'.  I don't feel I rang too many times - once a day i feel is acceptable (had my call been answered!)
  
Aside from the terrible communication from staff in a&e, basic care was missing.  The first full day, he wasn't given any lunch despite me being told on the 2nd phone call that he was eating lunch and was talking on the phone - lies as he couldn't speak with the mask on and couldn't manage without it.  About an hour later he txt to ask me what time lunch was usually at?  This is not acceptable with any patient but especially a diabetic patient.  I had to inform the nurse in charge about this when talking to them so that he would be fed! 
I have since found out that all his meals were left on a tray on top of a bin lid at the entrance to his room.  Apart from disgusting hygiene, this resulted in him having to remove his oxygen mask, make his way across the room and carry his tray back to his bed.  He needed to put his mask back on for at least 5 mins prior to eating as he struggled to breathe.  
As I said before, he was in a&e for 48 hours and was never once offered assistance or equipment (ie a basin) to get washed or even a dish to brush his teeth.  This I believe is very basic nursing care and in my opinion on this occasion it was extremely poor / absent.  I understand that we are in the middle of a pandemic and the NHS is really struggling (i work in the thick of it too!) but the lack of such basic care such as providing food and hygiene is a disgrace.

Thank goodness my husband eventually got transferred to a ward (A3) where his care and the communication from staff was excellent.  I only needed to ring the ward once during his stay - on the evening he got admitted.  The nurse who was looking after him was busy with their patients but the nurse who answered the phone got all the information needed and provided me with a comprehensive update on his care and the plan.  My husband was also very well informed of what was happening and was therefore able to update me the rest of the time until discharge.  Once on the ward he started to recover fairly quickly.  He was well fed and given assistance as and when he required.  A massive thank you to the staff on the ward for their diligent care and attention given to my husband.  They made the end of his hospital journey much more pleasant than the start of it.

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Responses

Response from Cathy McCoy, Clinical Service Manager, Acute Medicine, NHSCT 3 years ago
Cathy McCoy
Clinical Service Manager, Acute Medicine,
NHSCT

Submitted on 19/01/2021 at 14:27
Published on Care Opinion at 14:27

Dear Distraught Wife,

My name is Cathy McCoy and I am the clinical service manager for ED in Antrim.

Please accept my sincere apologies for your husband’s long wait in ED. As you are aware, the hospital has been under immense pressure recently resulting in long delays both for admission to the ward and also delays for patients waiting in ambulances.

Whilst I appreciate that the staff are under immense pressure, communicating with patients and their families has never been so important. Staff should be involving patients in their care and communicating with them when carrying out any interventions. This was unacceptable and I apologise. I’m sure your husband was already anxious and that this only heightened his anxiety and yours.

It is unacceptable that you were told to contact your husband for an update regarding his condition. Patients are vulnerable and are quite often very anxious. ED can be a very daunting place. I know that having been a patient myself, I don’t always absorb the information correctly to be able to pass it on, and in this case communication was lacking totally. This as you say, caused both you and your husband anxiety. It does not meet our values and I will ensure that this is brought up at team briefings and with the medical team. It is very difficult for patients and families at present due to the ongoing pandemic which has resulted in restrictions on visiting, so it is imperative that we try to improve communication with worried families at this time.

I am appalled to here that your husband’s food was left out of reach on top of a bin. This is totally inexcusable and again I will be raising this at safety briefings to ensure this doesn’t happen going forward. Maintaining hygiene is a fundamental of nursing care, as is providing adequate nutrition to aid recovery. I know you say that these are the ‘basics’ of nursing, but they are also some of the most important. Again I can only apologise for the poor care that your husband received.

I would be very grateful if you could contact me directly to discuss this further via email Cathy.McCoy@northerntrust.hscni.net

The staff in ED have requested that a Family Liaison Officer be offered to ED to keep families updated during these difficult times. We are awaiting a response to this request. I will keep you informed of the outcome here.

Again, my sincere apologies to both you and your husband for this poor experience, but please rest assured that this will be shared with the team so that they are able to reflect on their practice and learn from it.

Best Wishes,

Cathy

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