My relative returned a PSA of 6.56 some weeks ago, so my training, (45 years a nurse) told me I needed testing. I persuaded the GP nurse practitioner to allow the test. The result came back as 19.25, a repeat was 19.48 so rapid services kicked in, I had an MRI incredibly quickly and it showed further tests needed, so a biopsy was arranged.
The paperwork said “make sure you are available on the phone for the 7 days after the biopsy” it did seem incredibly fast. Ten days later no results so spoke to GP, who agreed that the 7 day message was nonsense. Eventually I was informed that the biopsy was indicative of confirmed prostate cancer and an urgent appointment was made for me to meet a consultant for results and planning the direction to go forward.
I consented to robotic surgery and was told a referral was made in early July to the continence team to prepare me for the surgery and advice re interventions post op. I never heard from them and was delighted that the lovely [name removed by moderator] from Southend, was incredibly helpful in sorting things out, she informed me that the team had booked an appointment to ring the next day (without discussion with me) so I cancelled my plans and waited….and waited!
When I got back to [name removed by moderator] she said that she looked on the database and could see a further appointment was booked for the am of 11/08/22, I did inform her that they would have to wake me during my surgery as that was the day my surgery was already booked! I must, at this stage say that [name removed by moderator] was being helpful as she is cancer support not part of the continence team!
I had on a number of occasions sought to contact the continence team, but there is no possible direct communication with them all calls have to go via the local council “hub” who very kindly passed on numerous messages, without helpful response from the team.
At this stage, 45 years a nurse, 23 as an operational matron covering 6 hospitals I knew the paths to follow to escalate. My complaint went to [name removed by moderator] Head of Integrated Community Teams. Her very early intervention resolved my issues with the continence team, and she has instigated her own internal investigation of the service failures and I look forward to working with her in the future.
My admission was booked and I arrived as instructed at Southend Hospital at 0700 on 11/08/22 on the surgical admissions unit. For reasons of clinical need of first on the list, I didn’t go to theatre until 1430 nor did others on other lists. I had to ask for fluids as I had been told not to drink from 0300.
I awoke on Princess Anne ward around 2230 that night. I make no observations about bed management challenges, but the man in the six bedded bay to my left was clearly not an acute post op patient. He was non verbal and spent his entire nights banging his cup on average every 10-15 minutes all night on his bed side table, this had a massive impact on post op patients attempting to recover, my calculations being I got around 90 minutes sleep overnight.
Staff were of varying standard from superb to blatant abrogation of registered nurse duties. On the positive side was [name removed by moderator] a HCSW who clearly has a deep passion for her work and wholly committed to her patients. She plans to undertake nurse training and I told her I believed that she would be a wonderful nurse. On the negative side, the night staff on the second night were noisy disengaged and failing miserably in their duty to undertake wards rounds overnight. The man in the bed opposite to my right had had significant surgery and his analgesia of IV Paracetamol was not, in any way, reducing his pain score of ten. The staff eventually came to see him and said all they could give him was further doses of the medication that had no impact on his pain. They went away and came back with the paracetamol and hung it through the same giving set he had just had another drug (not fluids) infused through (I can’t comment on compatibility, but it did seem to not be best practice). Later on he was still in pain and the nursing staff answered his buzzer and when he said his pain had not reduced at all they told him there was nothing they could do! I have to confess that at that stage I intervened in what I saw was poor practice and insisted they contact an on call Dr, who was, eventually called, prescribed an alternate analgesia that resolved his issues.
I had been kept in another night due to unresolved severe pain, initially they thought it might be cramps due to air inflation for surgery so after asking the nurses at around 2000 for Peppermint I eventually got it around 2300. No one came back to see if I was still in pain or settled, meanwhile I got no sleep due to the percussion obsession of my neighbour. My buzzer had dropped so I couldn’t move easily so I couldn’t call staff, they did see the other other but never spoke to me.
On a couple of occasions they did visit the noisy male but did nothing to intervene with his noise making. By 030 ish I lost patience as I could hear loud chatter from staff down the corridor so I rang switchboard, as I used to work there, and asked to speak to site manager, switch informed me that they were at an emergency, but would get then to ring me asap. Soon afterwards a nurse turned up and seemed genuinely surprised I had an “issue”. The nurse seemed totally unaware of the reason why I had been seen by the team and kept in for an extra night! Clearly either didn’t listen at handover or less likely it wasn’t handed over. I pointed out that the expectation, on the handsets was that they did regular ward rounds and now around 0300 or so, no one had said anything to me since 2300 despite the fact I had been continuously awake and they had only come in twice to the man in pain and a couple of times to percussion man.
The nurse, rather than address my pain sought to explain workload, staffing and deny my observations on their frequency of visits. Eventually I focussed her back on my need for analgesia and she went off, some extended time later I got my oral analgesia and functionally that was the last time we interacted prior to them going off duty.
Whilst I was, I think, justifiably angry with the “care” offered over that night, I am also mindful of the superb care from [name removed by moderator] also the daytime drinks and meals lady was a breath of fresh air.
My discharge was a bit haphazard, nurse handed me a bag and disappeared with no seeming interest in asking if I wanted to ask any questions nor telling me anything about the contents of the bag. I fully accept that post op when I arrived home I had zero interest in reading the reams of paper! Apparently my daughter did a chat with a nurse and did get some guidance
The phone call from the enhanced recovery team was very helpful and informative, but equally a welcome unexpected surprise, as I was unaware of their existence.
What worried me about the overnight experience was that, without my intervention that patients pain would have continued untreated, that is unacceptable.
There is much to learn, I was in the very fortunate position that where there were gaps, and yes there were a number, I had the background to join the dots, my concern is that few patients have my knowledge of where to go to get information.
Director of nursing and I had a long productive chat, watch this space
8 weeks post op PSA less than 0.01 saw my surgeon couple of days ago who was delighted that I was ahead of recovery expectations.
Edited by moderator 09 Oct 2022 at 08:25
| Reason: Hospital staff names removed