The invisible patients

I had been essentially bed bound for 5 days, catheterized, cannulated and weak as a new born, in a ward for the elderly which I will call ‘ward A’, when the first senior nurse I had spied came into the 4 bedded room in which I lay. She chatted and giggled for ten minutes or so with the nursing assistants, who all stopped what they had been doing. I couldn’t hear much of what was said as I wasn’t wearing my hearing aid, but I picked up the gist that it wasn’t work related. Then, picking up her paperwork, and after a cursory glance through each of us patients as though we were invisible, the senior nurse departed again.

Five days earlier the highly professional doctors and nurses in the Emergency Department and medical assessment unit saved my life. I was diagnosed with sepsis secondary to pyelonephritis, given iv fluids and antibiotics and admitted initially to the medical assessment unit. There I was cared for by a pleasant final year nursing student, who told me her name and explained that I would be transferred forthwith to another ward for on-going care. Sadly, that was when things took a downhill turn.

If I hadn’t had anything to compare it with (see below), I might have thought that the care I received in ward A was the best on offer. On arrival I was left in a metal wheelchair in a corridor for 2 hours, with nowhere to rest my head other than a table-top and the body of my husband standing next to me. I’m 61 now, but I was by far the youngest in ward A, and I wondered if that played a part in some of the nurses apparent perception that I didn’t need any help- even though I was acutely ill, apparently rambling at times, and receiving intravenous antibiotics for the antibiotic resistant e-coli bouncing around my circulatory system that I had acquired in another hospital after a routine cystoscopy. Each morning I was expected by the night staff to get out of bed and sit in a chair with no pillow for 2 hours even though I was septicaemic and unable to support my own weight, while I waited for the day staff, a couple of whom chewed gum all the time, to ‘come and do the beds’. After 2 days I rebelled and crawled back onto the bare mattress but they didn’t come any sooner and left me until last. While lying there I heard the lady in the next bed who was barely conscious referred to as a ‘bed-blocker’. Then I refused to get up altogether at 6.30 am and my increasingly stained sheets were left unchanged for 3 days while the dressing on one of my bilateral cannulas, left in for almost a week, began to discolour and smell.

Neither the nurses nor the ever-changing doctors who visited each day introduced themselves and I couldn’t read their name badges as I didn’t have my glasses with me. I gradually learned which nurses to ask if I wanted something, and which ones would ignore me or get inpatient if my request didn’t fit with their all-important routine. Two of the staff nurses and one of the untrained nurses showed me considerable kindness- they told me that they had been hospital in-patients too and knew how important it was to be provided with information. Another left me for 2 hours in acute pain. Three days into treatment I was mistakenly given my medication orally rather than IV, but even this didn’t warrant a conversation with the lead nurse. When I made my first unsteady foray out of the room and down the corridor, fortunately without falling, I couldn’t resist a cynical snort when I saw a poster all about ward A’s dedication to providing high quality patient centered care.

Halfway through my stay, as I began to recover I was transferred to another ward, which I will call ‘B’. I was immediately greeted by the senior nurse who expressed horror at the sight of the tube hanging from my arm and insisted on its replacement. This was a surgical ward, and it was quieter, but only at first, and it soon filled up completely with post-operative patients and quite a few people as disabled as those I had shared a room with before. Everyone there introduced themselves with ‘Hello my name is’. I became visible again- as a person who was sick and needed care and assistance. Each day my bed was remade and I was able to get back into it if I needed, as I was still utterly exhausted. This was the NHS that I recognized but it felt as though I had been moved to a different hospital – not just to another floor. The mattress was even more comfortable (this was not a halo effect- my lower back no longer required a supporting pillow!). I was assured that beds were the same, yet it seemed to me that the people most at risk of pressure sores were sleeping on the oldest and most worn in the hospital. I also realised that the floor of ward B, unlike that in ward A, which had caked on dirt by the side of my bed, was actually clean.

I hate to criticize the NHS. I spent my life working in it, and I do believe it is the best health care system in the world- but I don’t think that means we should assume that all of its failings are related to lack of money and understaffing. I’ve worked in and researched health care long enough to know that isn’t true. From treating NHS employees with mental health problems who were bullied or excluded by managers and staff cliques, I know how much culture and management play a part in how effectively a unit operates, and how leadership style is crucial. That I only once saw a senior nurse in my time on ward A- and I and my fellow patients were invisible to her, was, I believe a contributing factor in why ward A was failing to provide the care it aspired to. In ward B the senior nurses were regularly seen around the unit and were approachable to patients and relatives.

After 2 weeks, I was discharged home where I am still slowly recovering. My bruises are disappearing and my desire to do something to change things has returned in force. I’m not good at being invisible- it’s a life long problem. I will be writing to the Chief Executive of the Hospital Trust … and also suggesting that if any of the Board are in doubt about the state of the beds in ward A they should be invited to spend a night (or two) in them.

7 thoughts on “The invisible patients”

  1. Oh my God!

    The horror of Ward A is simply revolting and unacceptable…what a total nightmare. I can’t tell you how sorry I am that you of all people—you who have helped countless suffering souls–
    you had to stay there. 😦 Ward A makes Dante’s Inferno look good!

    I’m so glad you had a drastically different experience in Ward B. I think your idea to write the letter to the Chief Executive of the Hospital Trust is an excellent one. True justice would be putting all of the Board Members in Ward A for a week or two!

    I’m grateful you’re doing so much better!!!!!!

    1. What a well expressed account of your experience. I hope you and your husband can put this episode behind you and move on with greater strength.
      Soft skills are often the greatest gift a person can have (& use).


  2. So glad you are getting better, but what an awful experience. Anyone who uses the NHS should rightly protect it, but with aims to improve services, call out poor treatment as annd when it happens. I
    Get well soon, you have been missed. xxx

  3. Truly shocking and dangerous- I hope the Trust C.E. acts on your complaint. If people with your senior health experience are not actively heard and listened when making factual critique what hope is there for the rest of us?
    The very best for your recovery.

  4. Your experience sounded exactly the same as 2 wards my elderly relative experienced. One was an elderly care ward (like your ward A) and the other a woman’s surgical ward (your Ward B). She said the same as you. She had been really apprehensive about having to go back to hospital after her experience on the elderly care ward but said she actually enjoyed her stay on the surgical ward! Like you she said it seemed like a different hospital.
    Now my other elderly relatives are worried that some day they might be admitted to the Elderly care ward and we are forewarned we will have to fight for them.
    It does sound as if you were on an Elderly care ward but not sure what you were doing there at 61. But care should be as good as anywhere else.
    My relative was actually afraid of some of the nursing assistants. It really isn’t good enough. Do we stop being full human beings after a certain age? I could never understand how staff can see a patient looking exhausted and uncomfortable after being ‘sat out ‘ for ages and not want to do anything.
    I hope you get a meaningful response to your letter and that you continue to recover steadily.

  5. Twelve years ago my grandmother had a stroke and was admitted to hospital. Over the next 18 months she spent over 4 months in hospital, the longest period being her first stay (3 months). The horrors we witnessed have not left our family. They were a result of not just a lack of resources but of hospital bred bullying of the elderly. I kept a diary and was determined to take the complaint to the highest authority but my family was concerned that my grandmother would bear the brunt of any complaints and so I dropped it. We are still haunted by it. When my mother was recently told she would need to be admitted (after an infection to her burst hernia wound failed to respond to oral antibiotics), we both cried “Not to the elderly care ward please!” Fortunately she wasn’t, and she received great care in a specialist ward, but my God were we all afraid of the alternative.

    Happy to lend my voice and time to your quest of making the invisible, visible.

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