Tales from the NHS

On Sunday (yesterday) morning at 7.30 am I went to get my smashed wrist fixed at Derriford. I got home this afternoon at 6pm with it neatly rebuilt and wrapped in plasters and slings and things. Some of it is a bit of blur, to be honest, but on this day when the media is full of NHS 60th anniversary stories there are some clear snapshots worth remembering.



Arriving on the appointed ward at the appointed time and finding I was first on the list for surgery (good) but my allocated bed was unmade, and what's more never got the promised pillows... Nobody had time or inclination to explain to Ron what was happening or how he could get in touch later. Still, the bed was sufficiently prepared for me to go down to theatre only about 30 minutes behind schedule, someone stuck a venflon in the back of my hand and the next thing I knew it was all over. I was in recovery in extreme pain, with a button to push for pain relief.



I pushed it a couple of times until the pain went away and was returned, somewhat woozy but OK to the ward, where I was instructed to keep my arm elevated in a pillowcase pinned to a stand beside the bed, but I got into a row for not having it high enough, or was it too high, or was it that the bed was being moved up and down? Yes, and the under elbow pillow never arrived, either. And moving the bed kept pulling my oxygen out of the wall, but a kind girl in green got a longer tube. I was OK, however, until told I could get out of bed for the toilet, sat up and felt, but wasn't actually, sick. I was still feeling a bit queasy when Ron arrived; while he was there dinner was also delivered but one mouthful of rice from the sweet and sour something made me very sick indeed - all the several pints of water I had drunk. After that I dozed and started to feel better about nine - by 10.30 I was starving! "There's cheese & biscuits, yogurt or banana in the fridge." "Yes, please!" "Which?" "All of it!". And I ate all of it, later, plus Jaffa cakes Ron had brought me.

At 3am I was due a dose of antibiotics which involved putting in a new venflon as the first one had dislodged. From about 4 am the lady in the next bed was awake but confused, calling for her daughter and trying to get out of bed. Nurses occasionally came and went (usually when I summoned them to her because she was about to fall and hurt herself), but basically I spent the rest of the night listening to her if not talking to her.

By 9 am I had been issued with a fancy navy blue sling and been told that the only thing keeping me in was paperwork. After about 2.30 pm, when I discovered that the cut off point for getting out depended on whether the pharmacy was still open for painkillers to go home with (5pm) I started mentioning my predicament loudly to every passing NHS employee, in the hope that one of them would do something. I finally got my marching papers at 4.30pm, but was not just made to feel but actually told that I was being 'difficult' - and indeed keeping the doctor who had to sign the release from two very sick patients elsewhere!

Well, all I can say is that this is the only way that works. Opposite me was a small, quiet, polite lady, slightly older than me. Very reserved, very well mannered, accustomed to accepting authority, broken ankle. She had been there since Friday night and had never been free from pain, had not been visited by a consultant or a physiotherapist (or her husband, but he was not allowed because he had the flu). She was not aware that she could make phone calls. She was not a happy lady, but not the complaining type, and I learned most of this while we were up in the night with the 'confused' lady. So I did a little complaining on her behalf, and some asking for stuff and pointing out deficiencies. The first thing was some proper pain relief (she was written up for liquid morphine, she had been getting paracetamol), so she got some strength and some sleep, and by the time I left she had also been seen by physios etc and an ambulance had been ordered to take her home with a zimmer frame.

By contrast, on Monday afternoon a lady was wheeled in, complete with husband holding her hand, after some elective surgery. Confident, outgoing, greeted with a smile, people running round fetching her things, two physios walking her up and down the ward within ten minutes of arrival, etc.

And the 'confused' lady, who was being treated like a naughty, forgetful child but seemed to me to be mostly dehydrated, had apparently been fine apart from having fallen and hurt her leg some 10 days earlier. But was getting worse each day.

I have nothing but praise for the clinical part of my treatment, but life on the ward was completely and utterly shambolic and disorganised. It was a big, rambling, mixed sex trauma ward, although within the individual bays it was mostly all male or all female. There was no one in overall charge at any time, and although there were a lot of staff about it was impossible to know who to talk to. 'Uniform' in any meaningful sense, is totally absent. They all wear cotton tunics except the ones with nylon coats, of course. All conceivable styles and colours. Uniforms should identify roles clearly. Doctors are like sixth formers at the end of term; dressing up because they can, with absolutely no regard for hygiene or practicality. There were at least two competing regimes in the 8 beds Icould observe from my own, with two different drug rounds, observation and tidying lists. My bed was never properly made in the first place and not once did anyone attempt to tidy me up, but then once I was awake I was on it rather than in it anyway, more comfortable sitting crosslegged than trying to lie down. I had my temperature taken twice in ten minutes once, by two different nurses. I had the little clip put on my finger and the BP machine started with the cuff wrapped round the stand, not my arm. Because there was no control, no continuity, non assertive patients were ignored. Lies were told to shut people up (particularly the 'confused' lady) because that was easier than dealing with the situation. I heard a (presumably senior) member of the nursing staff tell my consultant that I hadn't been sick at all (because Ron had held the vomit bowl, emptied it and replaced it for me). She also said I was imagining the lack of oxygen supply, because a junior, greener, altogether nicer member of staff had gone and got a longer piece of tubing (possibly also because it was the senior nurse's constant fiddling with the height of the bed that caused it to come out the second time). I said never a word - what's the point?

I could go on, but I won't. Sadly, my experience is far from unique. I can see ways to improve the service, but the basic premise is now, sadly, flawed. And about to become a constant factor in my life, it would seem - Ron and I now have GP and an outpatients appointment each in the next week...