"Inpatient Experience"

About: Derriford Hospital / Colorectal surgery Derriford Hospital / General surgery

(as the patient),

I was an inpatient or nine days, following an operation for a Hartmann's Reversal and significant abdominal hernia repair.

I Woke up after the operation in Stonehouse Ward bed H1. I was uncomfortable to find myself in a mixed gender bay and no member of staff discussed this with me. I did not feel comfortable with this. Machine alarms / alerts were left unattended for long periods and the constant bleeping prevented me from resting, despite me and other patients asking for them to be dealt with in a timely manner.

Two days later, I was  moved to Stonehouse bay F3. I noticed that a number of nursing staff were coughing and were not wearing masks. I raised this with a senior nurse who advised that staff were not required to test for Covid and were not required to stay at home if they felt well enough to attend work. I was alarmed by the response given that patients are likely to be in a vulnerabl state, either recovering from surgery or generally unwell. I later discovered that the hospital sick absence monitoring and sick pay policy encouraged staff to remain at work.

Three days later, the consultant advised that I should remain in hospital until I  opened my bowels and in any event I did not feel sufficiently recovered. At 13:50 I was advised that I would be moved to Postbridge within the next 30 minutes, although I did not understand why. This did not happen until 18:30 and I had already cancelled my husband’s visit due to uncertainty of where I would be.

I did not have dinner in Stonehouse due to the move and when I arrived at Postbridge, only sandwiches were available. I understand that Postbridge is intended to be an admission ward along with a day case and recovery ward rather than for inpatients with no discharge date. The constant comings and goings of outpatients meant that it was not restful for patients remaining on the ward. There are no windows and the air conditioning is very noisy; not a pleasant environment for an inpatient. The ward was unable to support my dietary needs of light meals, offering mainly soup and sandwiches, jelly and ice cream or heavy meals.

The next day, only one nursing staff was on duty through the night despite 8 overnight inpatients and one discharged late in the evening. I believe that the maximum ratio is 1:6. No observations took place through the night.

The next day, I woke with a high temperature and tested positive for Covid which I believe I had acquired from nursing staff in Stonehouse. Despite their lack of taking precautions to avoid infecting me, I was put into isolation and masked, whilst full Covid procedures were activated with staff now wearing masks, and PPE. I did not receive any breakfast and was later moved to an ensuite room in Meavy Ward.

I was advised that it was too late for breakfast and too late to order lunch. Instead I would have to see what sandwiches were left at that time. I was offered and accepted a tuna sandwich which unfortunately included sweetcorn which I cannot eat. My meal was therefore only ice cream. The evening meal was again soup and sandwich with heavy wholemeal bread. At 22:30 I was woken by 2 porters who told me that they had come to move me back to Stonehouse, where an isolation room was set up. Fortunately they kindly helped me to pack up my belongings but I was unhappy at being woken late in the evening to be moved yet again.

I stayed in the room in Stonehouse until my discharge. Nursing staff who came to the room were in full PPE. The bin for removal of the PPE was placed near the window furthest from the door of the room. This was bizarre as staff had to walk across the room to remove their PPE and walk back across the room without PPE to exit. I took it upon myself to move the bin next to the door to assist the prevention of Covid spreading.

Acquiring Covid with the persistent coughing after abdominal surgery definitely hindered my recovery and was quite painful.

When I was discharged, I asked for assistance to get me to my husband's car as I  had pain in the area of the operation scar and could only shuffle. This was denied by the nursing staff and I was told that my husband would have to get a wheelchair and push me himself. This was most unsatisfactory and lacked care.

Overall, the nursing staff in every ward that I was moved to worked incredibly hard but they appeared to be overstretched and unable to deal with patient bell calls and machine alerts in a timely way. I do not feel that sufficient thought and care had been given to my dietary needs, care and safety. I feel that being moved 4 times in 8 days was excessive, unsettling and prejudicial to my recovery.

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Responses

Response from Alison Stanton, Complaints and PALS Manager, University Hospitals Plymouth NHS Trust last week
Alison Stanton
Complaints and PALS Manager,
University Hospitals Plymouth NHS Trust
Submitted on 16/09/2024 at 19:11
Published on Care Opinion at 19:11


picture of Alison Stanton

We would like to express our gratitude for your feedback regarding your stay at Postbridge Unit. Senior Sister Overnell has looked at the issues you brought up. Firstly, I want to sincerely apologise for any inconvenience or distress that the multiple ward changes may have caused you.

Regretfully, the hospital has been in a particularly busy period, filling all of the escalation and inpatient wards to capacity. There were multiple ambulances in the car park (waiting to bring patients in) and other hospitals were requiring support too. Therefore, it was decided to transfer as many patients as possible from the Emergency Department to inpatient areas in order to maintain the safety of all patients, both inside the hospital and while waiting in ambulances. These moves help to create a safer environment for not only the patients, but the nurses, doctors and staff looking after them. All patient movements made, especially in the evening, are closely examined and risk assessed to ensure they are absolutely required. The patients chosen were assessed by clinicians within their wards and treatment plans were made to keep them safe.

In your case, after consulting with the site manager and your surgical team, it was determined that you were a level 0 and the team agreed to your continuing care on Postbridge. Additionally, the Postbridge unit's staff have received a great deal of training in multiple specialities within surgery. I hope this can reassure you as to why you were moved to Postbridge.

Postbridge unit specialises in both day case surgery and a twenty-three-hour unit that tends to patients who need to stay overnight for additional observation and monitoring before returning home the following day. The two 6-bed sections in the Postbridge facility are set aside for patients who stay for 23 hours. This can vary based on need, but not our staffing levels or the overall number of patients we can take on (12 patients altogether). We often have a staff-to-patient ratio of one registered nurse to six patients during the night shift, with also an HCA to support with observations and other varied tasks. Within 12-bed wards, these are standard and secure numbers. In the event that an issue arises, the nursing staff can bleep their seniors with the trust for guidance or assistance.

I'm sorry we were unable to accommodate your dietary needs. We take great satisfaction in providing our patients with a variety of hot and cold meal alternatives. In addition, if these are not suitable, we always try and liaise with our housekeeping staff to always meet dietary requirements. Many patients also make advantage of Derriford's outside amenities, which include the level 7 Greenbank restaurant, the level 6 Warrens café, and the M&S shop that is connected to the main entrance.

Please do not hesitate to get in touch with our surgical matron Sue Johnson or Senior Sister Julie Overnell, if you feel you would like more help or to talk about this in more depth.

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Update posted by MrsBcolor (the patient)

Thank you for your response which although detailed, did not mention what changes may be made to improve patient experience. I absolutely understand and sympathise with the incredible pressure the NHS is under and therefore maybe it would be better not to ask for patient feedback as the resources to make improvements are not available to you.

I am disappointed that there was no response to me having caught COVID from nursing staff, nor was there any mention of how this may be avoided for future patients.

The response regarding my dietary needs avoids the fact that I was not offered any alternative other than sandwiches when I arrived in Postbridge and when I arrived in Meavy. Therefore I did not experience the 'great satisfaction' that you refer to.

Thank you once again for responding and I do hope that better resources become available to you and your colleagues in the not too distant future.

Response from Alison Stanton, Complaints and PALS Manager, University Hospitals Plymouth NHS Trust last week
Alison Stanton
Complaints and PALS Manager,
University Hospitals Plymouth NHS Trust
Submitted on 17/09/2024 at 12:29
Published on Care Opinion at 12:29


picture of Alison Stanton

Thank you for responding.

If you would like a more detailed response, please do get in touch with the ward manager or PALS as suggested previously, as we are unable to post confidential information on this site and as you need more details from us, it would be better for direct contact so the ward can obtain your personal details.

Many thanks

Alison Stanton

Patient Experience

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