"Patient centred care and care compliance"

My family member was admitted to a single room on precautions. On arrival to the room, they were facing the window sitting on the side of the bed, their gown was gaping at the back showing an incontinence pad, yet they had clean clothes and pyjamas by their bed side, my family member is not usually incontinent. Their bathroom door was open and there were wet towels on the floor and pooled water. The bed was high, their legs were swinging and not touching the ground (my family member uses a walker and has a falls risk). Their walker was on the other side of the bed. They didn’t have access to their nurse call bell it was on the ground on the other side of the bed. My parent had no access to tissues to wipe their face and had not been offered a cuppa to go with their breakfast, my family member made comment they needed a cuppa to wash down the dry toast (they couldn’t open the condiments). Someone had styled my family member's hair into a mohawk, totally inappropriate for a person who likes their hair combed over. I cleaned the bathroom, set my family member up safely for breakfast and mobilising should they need to get up, and I went and made them a cuppa. 

My family member's IV, line and antibiotics were not labelled, I was there for 45 minutes and their IV pump was beeping the entire time as their IV antibiotics had finished, during this time we did not see a nurse. My family member had not had a complete therapeutic dose as the antibiotic was not flushed in a timely manner. They had no name band on their arms or legs, they have severe drug sensitivities and had been delirious on admission, so I found this particularly concerning. I had to go and find a nurse, no one walked past the door or popped their head in to check on them while I was there. I asked the nurse to put a name band on and to check their IV and line labelling and let the nurse know my family member's antibiotics had finished half an hour ago and needed a flush, I checked in with family and the IV, line labelling and name band had not been done by the end of the day.

The next day a graduate nurse was caring for my family member under supervision, my family was present, the graduate nurse was setting up to do a wound dressing, had the pack set up and was taking off the current dressing. The family member had been present when the team reviewed and was aware they wanted a specific dressing. The nurse started the wound care under supervision of another nurse and the family member questioned if they were aware of the plan, they both reported they were not, this resulted in the wound and dressing pack being uncovered for an extended period of time, it concerns me that notes and the wound management plan were not reviewed prior to starting the procedure (lucky family was there).

My family member was discharged on oral antibiotics, the IV was not removed prior to discharge, family realised when they got home. Plans for my family member's ongoing wound care were not clearly communicated to the primary caregiver, they were expecting hospital in the home to visit over the weekend as they had been told they were on daily dressings, however no one came, multiple phone calls were required to determine the plan for care. I believe the discharge plans were there just not well communicated.

Family commented that all of the nurses were kind and patient towards my family member. There was particular mention of how lovely and kind the discharge coordinator was (they couldn’t remember her name), the nurse remembered the family from the previous visit last year.

My concerns are the level of person-centred care, lack of compliance with procedure and unclear discharge communication. I don’t need a response thank you. 

I would like to see a focus on patient-centred care relating to basic activities of daily living and dignity. Also, with discharge planning and communication, although a family member or friend may be present, it is important to ensure the primary care giver/next of kin is aware of the care plan, I do wonder whether the plan was only communicated to the family friend who was keeping my family member company that day. I am happy for this to be used as a consumer story for education purposes.