Tuesday, 26 February 2013

... of Mice and Men

The journey to the hospital took nearly ninety minutes ... and when I got there, it took me nearly thirty minutes to find somewhere to park. That done it then took another thirty minutes to find my father.

He had been admitted to the A&E Department by ambulance, and was initially assessed and sent to the Minor Injuries Unit ... who then passed him on to the Major Injuries Unit. They decided to send my father for an MRI scan of his head and for some chest X-rays, after which he was allocated a bed in the Medical Assessment Unit. They only problem was that when I arrived I had to follow this trail to find him.

By the time I finally found my father had had the cut on his head sutured and dressed, and was lying on a bed attached to a saline drip. A nurse was trying to take his blood pressure, but the pressure cuff was leaking air, and after several attempts she had to try to find a monitor that was actually working. Eventually she found a functioning blood pressure monitor, and his blood pressure was taken and the results were recorded.

I then sat with my father for over an hour before an assistant brought drinks round for the patients ... but she was unable to supply the tea my father wanted in a beaker (there were none available) and he had to try to drink it through a straw from a normal china mug. This proved impossible for him to manage as he could not sit up.

Nurses regularly checked on my father's condition, but it was not until after midday that he was seen by a doctor. The doctor had no idea that my father had been admitted to the same hospital for a fall only five days previously or that he had been prescribed antibiotics for his urinary infection. There was also no record of the medications that my father was taking, despite a list having been given to the hospital on the previous Friday. After examining my father and looking at the results of the scan and X-rays, the doctor decided that my father needed to be given yet another antibiotic intravenously to combat the chest infection that he seemed to be suffering from. She also told me that she expected that my father would be discharged later in the day, but that this would be subject to approval by the relevant consultant later that afternoon.

As soon as my father had fallen asleep after his examination, I took a break to contact the members of my family and my father's care home to appraise them of his condition. Whilst I was away from his bedside, some food had been left for my father to eat ... but because he was asleep it was left to go cold and uneaten. I tried to get my father to eat something, but he found it too difficult as his false teeth had been left at the care home.

Just after three o'clock in the afternoon the consultant arrived to examine my father. I had to repeat everything that I had told the junior doctor earlier in the day ... even though she was standing there with the consultant. He decided that my father might be suffering from emphysema, but the fact that my father had not smoked since the late 1940s and had never been exposed to dangerous airborne particles seemed to indicate that this was unlikely. The consultant eventually decided that my father was not going to be discharged today, and would most probably be kept in hospital for at least two days.

As my father had not been admitted with any of the things he would need for a protracted stay in hospital, I contacted his care home and agreed to collect everything that he needed from them. I also used the break to eat a somewhat belated lunch and to have a drink (my first since leaving home).

On my return to the hospital I found my father was still asleep. His intravenous drip was checked and changed, and sandwiches were brought round for the patients. I managed to get an egg sandwich for my father as it was the only one on offer that he could eat without his dentures. After over an hour of sitting with my father, trying to keep him calm, I asked the nursing staff when it was likely that my father would be taken up to a ward, but I was informed that a shortage of beds meant that it was unlikely to happen until tomorrow.

By this time I was feeling very tired (and somewhat stressed), and as visiting time was coming to a close and my father was sound asleep, I left the hospital and went home. I contacted my brother, and he offered deal with the hospital and visit my father tomorrow so that I could have some rest and recuperation. After today, I certainly need it!

22 comments:

  1. God bless your patience Bob, the Corderys have had a hard station and no mistake.

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  2. Gadzooks! I'm sorry you and your father are having to go through all of this! Best wishes for a quick recovery!

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  3. Bob,

    My sympathies. I know how frustrating it is to deal with medical bureaucracy, and this was when I was a mere patient! My wife had to do what you're doing, and it was not pleasant.

    Sending positive thoughts your way (and to your dad)--

    Chris

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  4. What a time of it for you all!
    Take care
    Alan

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  5. Conrad Kinch,

    We do our best in trying circumstances.

    Sometimes I wonder how I manage to keep my temper under control ... but I do, if only for my father's sake.

    All the best,

    Bob

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  6. Fitz-Badger,

    Thanks for your best wishes.

    Yesterday was one of life's trials, by which we are tested. I just hope that my father will be out of the hospital and back in his care home very, very soon.

    All the best,

    Bob

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  7. Chris,

    Many thanks for your kind comment.

    I am a reasonably well-educated, articulate person who has had years of experience of working in and for bureaucracies ... and yesterday I was finding the situation more than a little difficult. I pity the poor person who does not have my life-skills and experience; they must find the whole thing totally confusing and frustrating.

    All the best,

    Bob

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  8. Tradgardmastare,

    It has been rather trying ... but at least I have the support of my wife and family to fall back upon.

    All the best,

    Bob

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  9. Hi Bob,

    Thoughts as ever with you and yours - dealing with bureaucracy is certainly one of life's trials and no mistake.

    Get some r and r today to be ready for the inevitable next round!

    Very best wishes,

    DC

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  10. David Crook,

    Thanks for your best wishes.

    When it works (i.e. the systems are used properly, proper up-to-date records are kept, users read what is in the system before making decisions, etc.), bureaucracy can make life so much easier BUT inefficient bureaucracy makes things far, far worse. Yesterday I saw the latter at its inefficient worst. The hospital does have a very sophisticated computer system ... but no one seemed to be reading what it had stored on it. Instead they were using paper forms and scraps of paper in cardboard files. No doubt at some time in the future the contents of the files will be transferred to the computer system … but too late to have been of any use to the frontline practitioners and their patients.

    I did not sleep very well last night (which is hardly surprising in the circumstances) and the cold I began to come down with on Sunday has progressed to the 'head full of cotton wool, bunged up nose, and earache' stage. I had hoped to fight a wargame today, but somehow I just don't seem to have the mental energy to do so as yet. Perhaps later today I might do.

    All the best,

    Bob

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  11. I empathise completely, but will give you the other side of the picture just for balance.... my wife is an NHS sister in an A&E department... yes they have a very expensive computer, but it fails regularly and the backup when it is down is the bits of paper you saw... if the computer is working the printer isn't so they can't print off records they need... and the back up is, you guessed it.... their computer support is business hours only - no good if it breaks down overnight.... in addition when it is working it is slow - there aren't enough nurses, so they tend to ignore the computer because it just means they can't hit their (time driven) targets... she gets very frustrated too.... :o)

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  12. Steve-the-Wargamer,

    Point taken. Having worked in a target driven/obsessed environment and having taught database design to students I can understand your wife's frustration.

    I have no complaints about the medical staff who were dealing with my father, but the management of the hospital is appalling. Why spend money on a computer system that does not work FOR the users? There should be 24-hour IT support available and a budget for the regular replacement of equipment. The outlay would eventually save time, effort, and money ... and provide a better overall service delivery.

    All the best,

    Bob

    PS. Sorry for slipping into 'management-speak' in my reply, but old habits die hard.

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  13. Not at all - I understand completely... unfortunately, it appears increasingly these days that operational decisions are being made by bean counters rather than the professionals...... I still commiserate with you on your current issues.... I hope the situation improves.. and quickly.

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  14. Steve-the-Wargamer,

    Absolutely bang on about the bean counters.

    The problem is that they never realise that - to carry the analogy forward - you have to plant beans so that they can grow into plants that will yield you even more beans. Investment for the future is always the better option than cost constraint today.

    (I seem to remember that there is a parable in the Bible about this, but I doubt if that would have any impact today in a multi-faith society!)

    My brother tells me that my father has settled into his ward, but that he has been taken off the IV he was on and does not seem to be either being rehydrated or given antibiotics ... both of which were part the course of treatment the doctors said yesterday that they were going to follow.

    All the best,

    Bob

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  15. Bob
    What a hard day you have had hope your father is more comfortable now

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  16. Johntheone,

    It was a long, grinding sort of day for me ... but my father seems to be a bit better today. We are hoping that he will be allowed home by the weekend, but if he does not make a quick recovery he may have to stay in hospital until next week.

    All the best,

    Bob

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  17. If it's any consolation Bob I once did the rounds of 4 hospitals in the one day.

    My work duties took me to various teaching hospitals in Edinburgh and in some of them I visited both my father and my mother and my sister while I was there.

    I'm not sure if that was a 'blessing' or a 'burden' to be able to do that in one working day.

    I hope your father improves soon and gets back to his 'normal' routine.

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  18. Jim Duncan,

    Four hospitals in one day; I find it difficult enough to cope with one! (I have an acquired aversion to hospitals; I spent nearly five years in and out of hospital when I was a child ... and the memories are not pleasant ones.)

    My father was fairly normal today. By that I mean that he was fairly normal for someone who has dementia, and who drifts between different (and sometime conflicting) 'realities' most of the time. He is eating and drinking ... but not really enough ... and is on an intravenous drip so that he can be rehydrated and given a course of antibiotics that should clear up his chest and urinary infections. He has also been referred to the physiotherapist in the hope that they can find a solution to the problems he has standing up. With luck he should be back on his feet in about a week … but who knows what will happen then?

    All the best,

    Bob

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  19. In recent times, my wife and my daughter have had to spend time in hospitals - one public the other private. For all the efforts the successive fat head Governments of this country have made to depreciate our health services, I'm bound to say they would have to become be a lot worse to equal what you have described.

    You have my sympathy, for what it's worth...
    All the best,
    Ion

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  20. Archduke Piccolo (Ion),

    The NHS used to be something that people in the UK could be proud of ... but the truth is that it now seems to be a very expensive and over-managed system that is not always run as well it could or should be. It has major problems with PFI (the Private Finance Initiative) and 'targets'.

    It is our bad luck that my family seem to be particularly poorly served by NHS hospitals.

    South London Heathcare (the 'Trust' that runs three local hospitals near where I live) is the first in the UK to go into administration because it had massive debts and could not pay the charges due to the private company that has the Private Finance Initiative.

    Queens Hospital, Romford (the hospital my father is currently in) has been criticised by the Care Quality Commission because of its poor levels of care, especially within the A&E Department. It has currently not achieved four of the five national standards for care as laid down by the Care Quality Commission.

    Every time I visit these hospitals I feel that the staff are doing their level best, but are hampered by the need to meet the needs of management and not patients.

    A bit of a rant - for which I apologise - but that is the way I see things being done where I live.

    All the best,

    Bob

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  21. Bob,

    Sorry to be so late but I'm only just catching up on the week's blog reading today.

    Needless to say, your account strikes a nerve here, and I have more than a faint idea of what you've been going through.

    Needless to say, you're in my thoughts and, dare I say it, prayers.

    Be strong. Do what needs to be done. And know that in the circumstances no-one could possibly have done better than you have. (Of that last I have no doubt)

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  22. Dr Vesuvius,

    Thank you for your very kind words and thoughts. Having gone through something similar yourself so recently, you understand what it has been like for my family and I.

    We will continue to try to do our best for my father.

    All the best,

    Bob

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