Sunday, October 20, 2013

From Bad to Worse

   Things are not well with Les. The last two days have been hell for me but especially for Les. His Hep lock (cannula in Brit medspeak) delivering pain meds started blocking up on Thursday night/Friday early am. I was told nurses flushed it numerous times, still by the time staff shift changed on Friday AM Les still had an unfunctioning cannula in his hand and NO PAIN MEDS IN HIS SYSTEM!
   Finally a bright nurse on the am shift realized the problem and put in an emergency call to the registrar on duty (Brit medspeak for doctor) but she didn't wait for him and pulled the old cannula out and installed a new one. By the time I arrived at 2 pm Friday Les looked tired and overwrought but was getting some meds into his system.
   Saturday I was really worried because he had not tried to call or text me during the day. When I arrived at hospital at 2:45 pm he looked like death, grey-faced, sitting in a chair with his eyes closed, a vomit pan in his lap. He in fact vomited twice that morning bringing up nearly 2 cups of liquid and he feebly whispered that the registrar on duty told him if it happened again they were going to put a feeding tube down his nose which scared him. Les was experiencing searing pain again so bad his diaphragm was spasming and sounded like he had hiccups--each spasm jarring him with yet more pain. It took me and Kev two hours to get it all sorted. Thank the Goddess for my daughter-in-law Joanne and my step son Kev. Without them I would be lost.
   Les didn't have an adequate amount of pain meds in his system and he was in so much pain he was vomiting from it. The anesthetist angrily apologized and said " I'm sorry, this isn't right; no one should suffer like this." Damn right and I am--as a foreigner who has had 8 operations in U.S. hospitals and not a single day of pain in any of them--pissed off, frightened and totally dismayed.
   This is what I've seen and experienced to date: nursing staff are oblivious to what is actually occurring with their patients who are stacked 6 in a ward with no privacy or peace and quiet at all; one nurse had the gall to suggest that Les was experiencing "some wind (gas)" and could not be bothered to look after my husband until I insisted on talking with the doctor. The physician finally arrived and when he said "Jump" by god that nurse finally got off her ass and did what she was told and got onto what Les needed--hours previously.
   Les was sitting up in bed, in a hospital gown bunched up around his waist-- uncovered because it is way too hot in the room, no fans or air conditioning of any kind, or any way to control the heat. He was vomiting in front of an audience of other patients and their visitors--eleven strangers all told, and the guy in the next bed over had the gall to complain to his wife about Les "Kicking off again."
   The NHS is a system which fosters benign neglect of patients who are lucky if they survive a hospital experience over here in my opinion. So many things have gone wrong from the evening of his first day in "enhanced recovery" there isn't room to list them all.
   I am a frightened foreigner watching the one I love suffer in an antiquated system. Trouble is, this system is all Brits know. Americans comparing U.S. hospital care sound like over privileged, whiners but I tell you this for a fact: U.S. Health care is some of the best in the world--what we get for what we pay is worth every penny--even bankruptcy. We don't know that until we see what goes on somewhere else.
   In the U.S. it is standard for there to be no more than two patients to a room; hospitals are quiet zones and staff are expected to behave professionally. Nurses come around and take vitals once every hour and they check the machines delivering pain meds to ensure they are working and the patient is getting the meds properly.
   As far as I know, not one nurse did this for Les yesterday. He felt ill, has had NO SLEEP in over 24 hours and so he forgot to press the button on the pain med machine. The hospital is so noisy it sounds like a cocktail party is ongoing--staff raise their voices and call to one another from room to room, stand in the doorway discussing other patients, and behave more like keepers at a mental ward, dispensing pats on the back and tea from a goddamn trolley but very little actual medical care from what I can see. 
   It wasn't until Kevin and I showed up and began questioning what was going on with my husband that anyone took notice and started doing what they were paid to do. Yet I am only allowed to be there during visiting hours. I HATE THIS!!!
   Hospital care in England is like some third world country by comparison with America. If I become seriously ill over here I want my family to find a way to get me back to the U.S. Please, please don't leave me here!!
   I am worried sick about Les who has been allowed to fill his stomach with greasy, fiber heavy foods he hasn't eaten in months (beef casserole, mashed potatoes--broccoli, sugar heavy puddings) before his intestines were functioning properly first. And the food at Watford Hospital I am told is microwaved!!! There is no nutrition in microwaved food at all which is why my oncologist told me flat out not to eat microwaved food ever again. Microwaving heats food but it also kills all vitamins and enzymes and destroys the minerals in the process.
   How can Les be expected to recover enough to come home when he gets no quality rest, his pain meds are not being properly monitored, he has no privacy and the noise level is so bad sometimes I have to cover my ears to think; he is allowed to eat whatever he wants but not offered what his body actually needs to begin quality functioning, and he is offered microwaved food with no nutrition. I am so scared for him--that he won't make it back home where I can take care of him like he needs and deserves.
   I am frequently treated over here like a demanding foreigner and ignored or dismissed with hostility. I am exhausted, scared and I feel so isolated and alone. I miss my country, and my daughters and my son-in-law Ben terribly. He is a medical surgery technician and my youngest daughter is a trained Certified Nurse Assistant. I could use someone with medical knowledge on our side...

15 comments:

  1. Hi,

    Deadful treatment. yes hospitals have reached an all time low - been there and suffered the consequences!.

    Hope things improve, sadly hospitals don't have Matrons who ruled the roost with 'rods of iron' anymore.

    Boat OK.

    Mike

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  2. Jaq
    I am sorry this has happened, I must say this has never been my experience in a hospital at all nor that of my Mum who was cared for beautifully before she died. The doctors of this county have fought tooth and nail to stop the government from reducing spending to the NHS. In this country a nurse has to get a doctor to sancion everything although from their experience they have a lot more knowledge than the doctors from a nursing point of view. I hope Les is doing a lot better now you have kicked up a stink,so big hugs to you both, Carol BV

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  3. Jaq,
    I would have to agree with you that what happened to Les is unacceptable. The Registrar shouldn't have to tell someone to take action. My assumption is the nurse directly reports to someone other than the Registrar as these days most hospitals are "managed" by a non medical manager who is managing a financial budget.
    What happened was an "Incident" (an unwanted and unplanned event). In a quality organisation all incidents are reported and investigated to ensure remedial action is taken to prevent a re-occurrence. However from all the other information you've provided I suspect this doesn't happen at your hospital. It is therefore likely nothing will happen to change the "Culture" at the hospital until there are a number of very serious incidents resulting in a change of senior management.
    The lesson I take from your post is.....If I need major medical treatment, I'm going private!

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  4. Dear Jaq,
    It is so hard to be the onlooker when someone you love is so poorly. I just hope today will be a better one for both you and Les.
    Our love and prayers go with you,
    Karen

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  5. Oh, Jaq, my heart is aching for you and Les as I read this. As a fellow Yank, I have wondered about the real state of NHS care here, and your words are frightening.
    But the worst is Les' suffering and all because of indifference. You are his best advocate and I know you do all you can to make sure his care improves. Is it possible to bring food in for him? Can you insist that you be there more of the time? And insisting at top volume, if necessary?

    I am one of your anonymous readers, but have followed your blog for almost a year now, as we began our own journey to life on the canals. Your words have educated, amused and moved me, but never more than today. I wish I were miles down the canal, just to be able to sit with you or do more to
    support you. I am keeping you two in my thoughts,
    sending you all possible strength.

    Valari on NB "Stardust"

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  6. Oh Jaq I am so sorry you are experiencing this awful service, I really am gobsmacked and so angry at the way patients there are being treated (or not treated)! Not having experienced hospitals as an inpatient it is difficult to believe that things could be so terrible. For goodness sake don’t give up, keep ranting at the staff, make them aware of the situation regarding Les and get something done. My thoughts are with you both and I really do wish that there was something, anything that I could do to make the situation easier for both of you.

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  7. Hi Mike,
    Thanks for keeping an eye on our floating home.
    JaqX

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  8. Hi Carol (Blog Virgin),
    I hope things are better at other hospitals. I agree nurses often have more independent knowledge of patients than do doctors, and a couple of the nurses have been good once I showed up, introduced myself and they knew someone loved Les and was watching. But for the most part it seems they draw a salary no matter how they perform their duties. We have to resolutely hold parliament and the government to the fire and make them understand that if they are gong to have an NHS it msut be properly and adequately funded. We must demand it!

    I'm happy to hear your mum received good treatment.
    JaqXX

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  9. Tom and Jan,
    I agree with you that private insurance may be helpful but will it guarantee better quality care? I hope you never have to find out my friend.
    JaqXX

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  10. Hi Valari,
    I hope we do meet up some day soon. I'd love to sit and have a cuppa with you. I will be sure to watch out for your boat.

    We are moored an hour and 10 minute--2 bus ride away from Watford. I am going to try cooking something for him later next week and see if I can get it there still hot enough to eat.

    I have asked for longer hours but have been told no exceptions--2-4 pm and 6:30- 7:30 pm only. I catch the morning bus into Watford and then the one to the hospital to be there at 2 pm and come back to the boat each evening to run the engine and top up the batteries, clean house, wash clothes, work, and generally keep our home fire burning.
    Thank you for following our blog. Take care!
    JaqXX

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  11. Thank you Carol. This is all such a shock to me. I will keep advocating for Les, and hopefully this will be behind us soon.
    Love JaqXX

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  12. Sorry to hear Les is having such a tough time. As one or two other people have said, this isn't always the case in NHS hospitals, a couple of people close to me have had exemplary care (from both doctors and nurses), in a few different hospitals, over the past year or two. That isn't much comfort though, when you're having to deal with one of the bad ones.

    If you have further problems, it might be worth contacting PALS, who are the Patient Advice and Liason Service. There's more information on their website.

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  13. Oh Jaq this is disgraceful. I am near Watford at Cassiobury heading your way. Do you want to move the boat closer to Watford? Ask and it will be done.

    This is not the way all hospitals operate. The JR in Oxford has always been very good to me. having had six ops there in the last six years.

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  14. Jaq & Les,

    Keep getting better and increase the love to 'off the scale' it will get you through, but you both know that.

    I feel I have to respond to defend some of the health service, I know how dedicated my wife is to improving the outcomes of stroke patients.

    http://news.bbc.co.uk/1/hi/uk_politics/5403798.stm The link is to a BBC story in 2006 reporting David Cameron saying the health service is safe in our hands. He is a liar and his party is doing everything to generate a crisis in health care and it will be privatised so those who can afford it will get the best and the rest will suffer. Not too different to how I understand the American system works or did work before it was recently changed, but that is under such attack now for the same reasons our Health service is? The poor committed (they are the majority)of hard working staff take the brunt no pay rise for three years, change of their pensions, no training budgets, shift changes imposed on them - 12 hour shifts on a busy ward anyone? Sorry it a rant and I am doing it on your blog Jaq, sorry. I know Les will get better, he has the best carer and the best medicine. Nev NB Percy

    PS. At my wifes hospital such instances of poor care are flagged by a IR1 form that triggers an investigation. The purpose is to ensure learning is the outcome and what happened to Les does not happen to others.

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Jaqueline Biggs