"Distressing End of Life"

Last week my elderly father was brought to RPH by ambulance in the early hours of the morning, from his nursing home. It seems there were some communication failings along the way - one of which left me forgotten in a secure family/NOK waiting room in A&E for 3 hours - these are not the crux of my complaint but certainly added to our distress.

Involved in decisions

As my father had pneumonia under COVID protocols, he had to be swabbed which meant we were not allowed to see him until the results were known. He was admitted under the care of AMU (Ward 5) and moved to isolation/negative pressure rooms on ward 9C (Respiratory). It was a few hours later that I found out my father was on Ward 9C by ringing around wards/reception and finally Consumer Engagement.

Explanations

Team work

Treatment

Nurses

Pain relief

When I arrived on the ward a little after my parent was moved, the nursing staff seemed worried about Dad. He was delirious and his body language showed clearly that he was in pain. They were waiting for a Dr from AMU to review him urgently.

As the room had been "beige carded", I was not allowed to see Dad. It wasn't until another couple of hours that the COVID clearance came through and we were allowed to see Dad. But, nothing had prepared us for what we saw. A frail old man, semi-naked, delirious/writhing with pain and screaming out for the pain to stop. He was so overcome with pain he could not recognise us.

 

We immediately called the nurse and asked for additional pain relief and requested an urgent review. It took about another hour until Dad’s pain was anywhere near managed, and following discussions with the AMU consultant, we decided to stop all treatment and observations to prevent any further distress and move to palliative care only. 

I feel the nurses and NUM were concerned by my father’s condition when he was brought up from A&E and paged/contacted AMU several times. It took several hours before a Dr attended. I understand it to be a well-known issue that due to patient load/other priorities, getting Drs from AMU to attend a patient on another ward can be challenging at times. In my opinion, this is a known risk/issue and this should be managed by the hospital, and if it cannot be managed, then surely there must or should be escalation protocols that allow others to step in? 

I still have visions of what we saw every night. It’s not the final vision anybody wants to have of their parent. When his siblings and peers ask 'he didn’t suffer did he?', I have to bite my tongue as I believe the truth would be too distressing to tell them. How could someone be left like that for so long? This question still eats into me.

 

Dad passed away after the second night. The palliative care he finally received was excellent.

On a positive note, the nurses & NUM on Ward 9C were fantastic & caring. I witnessed their distress too on the condition in which my father was left.

On the night of my father’s passing, the nurse on Ward 10C (Amy) was wonderful, insightful & caring.

Unfortunately, even post-death, there was a further issue. There was a 4-day delay in the issuing of the 'Cause of Death' certificate so the cremation that had been scheduled for 6 days after his passing had to be cancelled at short notice and rescheduled. I contacted the hospital chasing the certificate on the following week and the mortuary told me they were waiting for the Dr and chasing it. I haven't received any explanation for why there was a delay.

With regards to my complaint, I have already approached the RPBG Consumer Engagement Unit but I don't believe they understand my need to sit with and speak with someone. By being able to talk through and verbalise the issues, it would help me understand better what the issues are, what went wrong or what was done right but I didn't understand. Having to submit complaints via a keyboard and then wait & wait for a response just makes the feelings worse and what was a complaint, becomes a grievance. Please "engage"!