"Lack of compassion and understanding"

I had a family member recently admitted to your hospital for treatment.  Unfortunately, I could not attend as I am posted outside of Perth during the COVID crisis so I had to support my family member via the phone.

My family member has been prescribed regular medication for the last 5 years after being diagnosed with ADHD and when they were admitted I believe they willingly disclosed the medications and dosages that they regularly have taken. I believe they did not receive their medications for 36 hours post-admission (a total of 5 doses missed), and they became extremely anxious, and thought process became disordered. When a pharmacist eventually attended and sourced the medications after midday, the patient believed they would get the medication for the afternoon dose and they asked for it only to be told by nursing staff that it is too late now. So in total, it was now a further 12 hours before their medications were commenced.

In sourcing the information the pharmacist was advised of all medications that the patient had taken in the last 4 months and so they charted all of these medications without seeking clarification from the patient or myself who was listed as the next of kin. I feel that maybe next time contact a family member who can confirm current medications.

Unfortunately, when medications are ceased I believe the pharmacist is not advised by the patient or the Doctor.

I have phoned the hospital every day to see how things were going and: 

Day 1 - I was informed I could not talk to medical staff that day by a receptionist.

Day 2 - I spoke to a lovely and compassionate nurse and I was able to provide a lot of information especially about the regular medications of which is only 3, and if the patient does not get the regular medications how this affects the patient. At no stage did I confirm that patient takes regular Tapentadol MR because it had been ceased 6 weeks ago.

Recently one night, I found out that the patient has been given Tapentadol 250mg MR BD and even though they have been declining this medication their right to refuse medication was ignored. I know this because I overheard their nurse admonish them for not taking the medications because it was written up and they had to take it.

The next day - Again they tried to decline the medication stating "I am not on that anymore" and again their rights to refuse medication was ignored and they were told they had to take it as I overheard on the phone that morning.

When I phoned and asked to speak to the nurse to explain about the medications having been ceased by the patient's Consultant, I felt this nurse proceeded to be rude on the phone and told me that they have never refused the medication. This is a lie because I heard them berating my family member for not taking the medication and that it was prescribed so they had to take it.

Next, I get a phone call from my family member who tells me that their Nurse has sent in a colleague to tell them to Discharge Against Medical Advise! This colleague was polite, but the nurse who I believe was speaking outside in the corridor to their colleague was overheard by not only the patient but I felt the other patients in the room. Patient is now frustrated, hurt and angry about the way their statements are being ignored.

The patient rang me to ask my advice - I advised that they ask to speak to the Doctor in charge of their care and explain the situation, which was done. I believe the Doctor entered the room but the nurse remained in the corridor. While the discussion about the Tapentadol and needs required for discharge, and could an alternative work was going on, the nurse - talking from the corridor - attempted to tell the doctor they were never told that the patient no longer takes that regularly. Patient talks loudly so they could hear - "Yes I have. Every day I have stated that I am no longer on that medication and I was belittled and told I had to take it."

The Doctor apologised for the misunderstanding about the medication and agreed that the patient could go home.

As a Clinical Nurse myself I am appalled at the treatment that I heard given to my family member over the phone.