"Patient Feedback Report: Experiences During Hospital Stay"

Purpose of Report: This report outlines my experiences as a patient at FSH, highlighting areas of concern regarding care decisions, treatment actions, and staff interactions. The intent is to provide constructive feedback to support improvements in patient care and safety. I request a formal investigation into these matters and a written response from the hospital.

Introduction

I was admitted to FSH with a small bowel obstruction. Over the course of my 3-week stay, I underwent two surgeries and encountered several distressing incidents related to surgical decisions, post-operative care, and staff interactions. While I am grateful for the medical interventions that addressed my condition and am now recovering at home, these experiences raised significant concerns about patient safety, dignity, and communication. I believe a review of these events is essential to prevent similar occurrences for future patients.

Chronology of Key Events

• Admission and First Surgery: I was admitted with a suspected small bowel obstruction. Surgery was performed to investigate possible bowel necrosis. Upon inspection, the bowel was found to be healthy, but lesions and scar tissue were identified as potential causes of the obstruction and were removed. During this procedure, a perforation occurred in the healthy small intestine, necessitating a bowel resection. The decision was made to close the abdomen without inserting abdominal drains.

• Post-First Surgery Complications: In the days following the surgery, my abdomen became increasingly bloated and distended, causing extreme pain. A few days later, I experienced pain rated at 10/10, which culminated in an emergency second surgery to clean the abdominal cavity due to a rupture in the suture line. This resulted in intestinal fluid leaking into the abdominal cavity.

• Second Surgery and Immediate Aftercare: Following the second surgery, I required drain dressings to be reviewed and changed on Ward 7B. During this process, I informed the attending nurse of my significant pain and discomfort from the recent operations. Despite my requests to stop after 10 minutes due to increased distress, the procedure continued for an additional 20–25 minutes. Subsequent attempts to raise concerns with another nurse were dismissed, with comments attributing the pain to surface-level issues (e.g., related to body hair) rather than internal 

I was required to measure food intake and output (stool and urine) due to the nature of the surgeries. This involved frequent reminders to staff to collect and remove samples, often resulting in multiple containers accumulating in the bathroom, which was degrading and undignified.

Additionally, solid foods were introduced shortly after the first resection, which was concerning as surgeons later noted vegetable matter in the abdominal cavity during the second surgery.

• Several incidents with nursing staff left me feeling concerned for my welfare. In one case, I formally requested that a specific nurse not treat me again. Other concerns were reported to the clinical psychologist during my stay, as documented in her notes.

Specific Concerns and Questions

1. Decision Not to Use Abdominal Drains After First Surgery:

The choice to close without drains is questioned, as it may have contributed to the undetected build-up of fluid, leading to the suture rupture and second surgery. Could drains have provided earlier indicators (e.g., through fluid markers) to prevent the rupture and subsequent abdominal contamination? A review of this decision-making process in line with hospital protocols would be appreciated.

2. Rapid Introduction of Solid Foods Post-Resection:

Introducing solid foods shortly after the initial bowel resection appeared premature, as evidenced by the presence of vegetable matter in the abdominal cavity during the second surgery. This raised concerns about post-operative dietary guidelines and their alignment with recovery needs for bowel surgery patients.

3. Painful Drain Dressing Change and Dismissal of Concerns:

The dressing change procedure caused significant additional pain, and my requests to pause were not heeded. Follow-up discussions with staff were dismissive, minimizing the pain as superficial rather than acknowledging potential internal sources. This experience was highly distressing and left me feeling unheard. I raised this with the clinical psychologist, and her report should corroborate these details. Improved training on patient-centered pain management and escalation pathways for concerns is suggested.

4. Management of Output Samples:

The requirement to monitor and collect stool and urine samples was handled inconsistently, leading to delays in removal and an accumulation of containers. This process felt degrading and undignified, exacerbating the emotional toll of the hospital stay. Streamlining protocols for sample collection and disposal could enhance patient dignity.

5. General Staff Interactions:

Multiple incidents with nurses prompted me to request reassignment in one instance and report others to the clinical psychologist. These events contributed to a sense of vulnerability and concern for my overall treatment. A review of staff-patient communication and conflict resolution procedures may be beneficial.

Impact on Patient Experience

Physically, these events prolonged my recovery, intensified pain, and necessitated a second surgery. Emotionally, the dismissal of concerns, degrading aspects of care, and overall distress affected my mental well-being during an already challenging time. While the clinical psychologist provided valuable support, the cumulative impact underscored the need for more empathetic and responsive care practices.

Requests and Recommendations

• I request a thorough review of my case, including surgical decisions, post-operative protocols, and staff interactions, to identify any deviations from standard care and opportunities for improvement.

• Please provide a formal response within  30 days, addressing each concern and outlining any actions taken.

• Consider enhancements such as updated training on pain management, patient dignity in monitoring processes, and clearer guidelines for post-bowel surgery care (e.g., drain usage and dietary progression).

Conclusion

I am relieved to be home and progressing in my recovery, thanks in part to the skilled interventions at FSH. However, the issues outlined in this report warrant attention to ensure high standards of care for all patients. I appreciate the opportunity to provide this feedback and look forward to your response.