"You Must Advocate for your Person"

My Dad was admitted to A&E with UTI. He was not assessed by a medic until the following day. He was not fully assessed by nursing staff either, there are a number of concerns here; lack of basic healthcare provision; length of time for basic healthcare provision; lack of equipment necessary for safe, person-centred care; lack of clinical judgment and advocacy for the patient on the part of nursing staff.

My Dad was not granted access to any medication from nursing staff as he had not been seen by a medic yet. My Dad had his own medication and this same nurse advised my brothers they were not allowed to give this, as he had not yet been reviewed. I feel this is outrageous, the lack of clinicians should not have precluded him from taking his regular medication especially given the lengthy delay. There was no consideration given from any member of staff about the fact that there were 2 missed doses of regularly prescribed medication in this admission. This is unforgivable and should have been raised as a duty of candour event. This resulted in a loss of independence in feeding and hydrating himself; cut off from the outside world as he was no longer able to use his call buzzer or his mobile phone. Dignity out the window, fear skyrocketing!

Over 12 hours after admission I administered medication from his dossett box.  Unacceptable. Still no sliding sheets despite a variety of staff initials on the PUDRA stating changing of positions. A staff member asked if my Dad required full assistance, which means he had gone without their assistance until we arrived and would not have been able to eat or drink a thing - again no food and fluid chart to speak of despite being left to deteriorate to a point of requiring full assistance. This was a frightening time for my Dad, who was left lying in a room with the blinds on door/window closed and door shut despite his very clear and obvious deteriorating state! This was a very distressing time for our family, the staff member was unhelpful and did not seem to recognise any of the risks I had brought up to them. I had a conversation with another staff member who was able to scare up a medic and GM of A&E. 

Shortly thereafter my Dad was reviewed by a medic to discuss palliative care. This was made all the more frightening by the lack of basic care on offer at this time within A&E and ARU5. Poor care was discussed with other members of staff. They were apologetic for the lack of basic care from the beginning of our conversation. They advised that they would source a mattress (still had not been done 18 hours after admission) for a man who is completely bed bound with complex care needs.  A staff member returned to give teatime medication however this was the wrong dose and once again I was advised I couldn't give the medication from dossett box as it wasn't prescribed at this dose. I was increasingly fed up by the incompetence on show within this unit and gave my Dad his own medication. A third medication incident in less than 24 hours. I would like to think that these were each documented in their own right as per your incident reporting policy. 

The doctor returned later in the day to advise that a bed had been sourced in the neurology department despite this current illness was not in relation to his MS - at this point I would have taken healthcare from a back alley rather than the staff we had been dealing with in ARU5.  This was not sold to us as being a medical boarder because I know what being a boarder means -  lack of meaningful access to medical care which was at the absolute forefront of what my Dad required at this time. We were transported with a nurse escort to ward 67 at neurology which if you have not visited recently is like the land that time forgot. This ward is absolutely not the place to transfer an acutely unwell, potentially end of life patient. I was horrified when we arrived to see the dormitory areas and the restrictions on visiting when I was concerned about my Dad being at end of life. I was reassured when the nurse in charge spotted my Dad from the end of the corridor and immediately contacted her superior to advise them of this inappropriate admission. At this stage there was nothing she could do. We continued to request transfer back.  My Dad was admitted into a dormitory with 2 other men. Curtains hanging of the windows; lack of basic privacy and dignity. 

My Dad continued to deteriorate within a full dorm; no-one advocating for his privacy or dignity expect us.  Medics and nursing staff stated this ward was inappropriate for his needs. A critically ill; deteriorating patient was left languishing in a dorm in a ward which NHSGGC seems to have forgotten about. He was moved to a side room closer to nursing station at my continual request. He continued to deteriorate due to fluid overload and I am certain had I not been there and jumped up and down about this that he would have died on this night. Had to argue for a chest xray and senior review which showed fluid overload and required a change of course - scary to have to be this hypervigilant in the presence of so called professionals.  The staff here agreed that his acute needs were not what they were used to dealing with.  Nursing and junior medics did not recognise the deteriorating patient. However I will again state this inappropriate placement of my Dad led to unnecessary distress and suffering. 

Finally spoke with senior medic the following day and we're transferred to the excellent Ward 8D who were able to support my Dad back to his baseline and eventually discharge.