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On account of this visit to the hospital and the consequential investigation by the Children Services Dave did make a complaint to the hospital.
Around 20 August 2010 Helen became ill. She complained of stomach pains and diarrhoea. She was then sick and so Dave called the out of hours medical service and was advised to take her to the outpatients department at the local hospital. It was in the early hours of the morning and someone saw her. The diagnosis was gastroenteritis and she was sent home. As time went by Helen improved but she had a persistent pain low in her stomach on the right side. It was intermittent and seemed to be improving. But late on Thursday 2 September it got worse. In the early hours of Friday 3 September Dave called the medical service and once again was advised to take her to the outpatients department of the hospital. The medical practitioner on the phone had spoken to the staff at the hospital and they were expecting them at 02:20 hrs. Dave and Helen arrived and the doors were locked. A bell was pushed but no one turned up. About 5 minutes later a passing cleaner let them into the hospital. The cleaner took them through to a reception area and there was no staff. Dave and Helen waited for 15 minutes and eventually asked another passing cleaner for some water. The cleaner was very helpful and fetched some.
About half an hour after their arrival a medical person arrived and asked Helen to wait. Soon after that a doctor saw Helen and diagnosed suspected appendicitis. Helen and Dave were taken to another department where they were told to sit. No one explained anything and nothing happened for maybe another hour.
Quite suddenly a team of doctors and nurses appeared as if from nowhere and pounced on Helen. She was quite overwhelmed by the rapid fire questions, examinations, more questions, injections, insertion of a cannula, extraction of blood, forms to sign and so forth. In fact the experience began to deteriorate for both her and Dave. I would like to explain in detail some of the psychology of what can go on in situations like this but I will just say that the staff were particularly impersonal and at times judgmental and unkind. There is a lot of discussion and research done in academia and some of it filters through to the relevant professions. It is well understood in the modern world of medicine that patients feel vulnerable and treating them with care and respect is not only desirable but renders better results too. The experience for Helen was traumatic. Nothing was explained to her, she was mostly treated as an object and she was eventually carted off to an adult gynaecological ward and put in a bed. There she was left. Dave sat with her and between them they tried to recover from this sudden and disorientating sequence of impersonal and frightening events over the past two hours.
Over the course of the next 48 hours the situation got progressively more difficult. To keep things in perspective the difficulties were caused by only some of the staff. There are two main problems: individuals who act offensively, and institutionalised bad behaviour. It is one thing to deal with individuals but when prejudice, for example, raises its ugly head it is sometimes the case that because the behaviour is 'normal' other staff reinforce it and start to feel the patient, in this case, is 'causing' the difficulties. The nurses behaviour was unacceptable. Many nurses were kind and supportive. In fact some were very concerned that this 16 year old girl who is slight and was evidently frightened should be on the children's ward where she would be treated more appropriately, more kindly and her father would be able to stay with her. But due to the impersonal nature of hospitals nowadays a request had been put in to the children's ward and, with no sympathy or understanding, the result was a refusal because she was 16. No one could do anything about it.
Dave was a little mystified at the constant attempts to encourage him to leave. Given Helen's general insecurities and the particular situation it was not reasonable to leave her with no familiar support. It became clear some days later that there was a current campaign at the hospital to make all wards single sex. This seemed to be the target for the staff as if they were getting brownie points if they succeeded. None of this was made known to Dave or Helen. But one or two staff nurses were manipulative and offensive in their attempts to belittle Helen's fears and Dave's support. At one stage Dave did ask the three other patients on the ward if his being there was in any way a problem and the patients were very supportive and encouraged Dave to stay because it was clear it was the best thing. Also Dave was not there all of the time. Just a lot of the time. You see Dave was quite willing to spend a lot of time in the day room and only to be in the ward during visiting hours or if Helen needed him for a while. But some of the nurses were fixated on getting him out.
This was all creating an uncomfortable and unsatisfactory environment. There were many incidents that occurred which were troublesome and here is one example. A female volunteer porter (as opposed to a trained nurse) walked briskly up to Helen's bed with a wheelchair and a clipboard and announced that she was taking Helen for a CT scan. Helen asked why and the worker said because she had to. A further enquiry as to what this was about resulted in the porter handing Helen a piece of paper to sign and telling her that "It might stop you from being able to get pregnant in the future. Is that alright?" Helen was stunned. She asked again what this was for and the porter simply said "Are you coming or not? I have other patients to deal with." Helen wanted to know more about this and so the worker turned her back and walked off muttering something about not having time for this. No one had ever mentioned a CT scan to Helen. No one had discussed any treatment with her or talked to her about what they were doing or why. This had simply arrived out of the blue.
In NHS hospitals it seems that the current team of doctors visit the patients. It seems a sad state of affairs that you can be seen by totally different doctors every time and the only thing they have to go on is some brief notes from previous doctors. It is impersonal and although I am sure it works well for standard run of the mill cases it does seem to encourage a lot of potential misunderstanding in slightly complicated cases. It certainly did in this case. Helen was prescribed intravenous antibiotics and intravenous paracetamol if she wanted it. Helen is slight and the first cannula turned out to be fitted badly and it was causing her very serious pain every time they applied the medicine. Unfortunately this resulted in nurses telling her off, denying her pain by saying it didn't hurt, and telling her that they were not doing anything when they were clearly injecting the flush. These statements, and particularly the last one are lies. We all understand how it comes about. Most people have experienced it to some degree. The issue here is that they are lies, they are not supportive, they are primitive robust behaviour that should be recognised and eliminated. People who study medicine seriously know this very well but it seems in this particular hospital that they were still reading the 19th century nursing manuals.
Another relevant fact is that whenever Helen was 'medicated' she declined the optional paracetamol. Her view was that unless she was in pain she did not want unnecessary drugs adding to her system. She may have also had the incentive that it was more pain not less but that is conjecture on my part. But the nurses had a strange attitude. It seems that they are given a task and to be a 'good' nurse they must carry out that task. So they were seriously put out by a patient declining a medication. On a number of occasions they tried cajoling Helen into taking the drug and when that failed they even lied about its therapeutic value. One nurse stated that she had to have it because it killed bacteria (this was the paracetamol she was talking about). When the nurses consistently failed to either trick or bludgeon Helen into having the paracetamol they ticked a box on their paperwork which states "Patient refused treatment". Another lie. Admittedly there was not a more appropriate box to tick but that is one problem with only having boxes to tick. What Helen declined was an offer of pain killers. She never once 'refused treatment'.
As Helen became more confident Dave could spend more time away. On one occasion he discussed the situation with staff nurse Sandy Shore and offered to phone her later in the evening to let her know when he was coming in for Helen's medication. This was happily agreed. But when Dave phoned that evening Sandy Shore told him he could not come into the hospital that night. Dave appealed to her that this would stress Helen unnecessarily but there was no changing her mind. Dave phoned Helen knowing that if he now tried to turn up the rather nasty staff nurse might well call the police and suggest he was somehow unreasonable and should be stopped from entering the hospital. He phoned Helen and explained the situation. Helen was distressed but whilst they were on the phone the staff nurse came to medicate Helen.
The scene that followed was pointlessly unkind. Dave heard the conversation between the two of them and the nurse was clearly intent on making Helen take her medicine. But Helen wanted to know if it was the paracetamol and the nurse said she had to take it. The nurse then exposed a strange piece of psychology which went something like "If you are not going to take the paracetamol are you going to take the antibiotic?" there was a brief pause of less than a second and she continued with "Are you refusing your medication? " as Helen answered "Yes" to the first question the nurse took the answer to be to her second question. With no more ado Dave heard her state loudly "Well there is nothing I can do about that." as she got up and left. Dave was on the phone for a short while longer with a rather upset Helen.
In the morning Dave went to the hospital. He tried to resolve this problem with Helen's medication having been terminated but the nurses were intransigent. There was nothing they could do if the patient refused treatment. After one attempt to convey his interpretation of events Dave soon realised that the best thing to do might be to get some third party to help mediate. But on asking if there were any such thing available for cases where the patient and nurses were not understanding each other the nurses acted mystified and said they didn't know what he was talking about. He suggested they might have a counselling service perhaps. "Are you saying you want her to see a counsellor?" "No. I was wondering if there was a counselling service available to help resolve this misunderstanding." They still didn't understand. Dave tried to suggest that regardless of who might be at fault here the important thing was to focus on helping the 16 year old girl on their ward with her medication. They still claimed it was not their fault and there was nothing they could do about it. Dave asked if there was anyone available who could help when things got difficult and someone suggested that there was the emergency response team. This was apparently a team of people who help when things get difficult so Dave suggested this might be a good idea. Some hours later a nurse told Dave that they couldn't contact the team but had left a message on their answering machine. 24 hours later a nurse reported that the emergency response team could not help because Helen was under 18. The nurse explained that they only helped with younger people if there was something serious like self harm occurring. Helen, with an inimitable sense of humour even in the worst situations, asked for a knife. Well... talk about headless chickens. The poor nurse took her seriously and tried to talk her out of it until Helen got it across that she was joking.
On account of the difficulties that were arising Dave made a request to see the doctor who was in charge of Helen's case. A rather large and imposing olive skinned man with an almost fixed frown on his forehead walked briskly towards Helen's bed. He introduced himself and Helen said she had a few questions she wanted to ask. He said that was fine and it would have to be quick because he was very busy. It was clear this was a kind hearted and efficient man who evidently commanded respect. Helen asked about the paracetamol, the CT scan and the advantages of intravenous antibiotic as opposed to tablets. The Surgeon quickly realised he was talking to an intelligent and articulate person with a good capacity for perception and understanding. They exchanged succinct information and in no time at all he had understood the difficulties that were arising and said that although he couldn't tell the ward sister how to run her ward he would prescribe that Helen's father should be with her as much as possible and certainly when she was medicated if requested. This he said was clearly required for the successful treatment of his patient. He recommended she be moved to the children's ward and failing that should be put in a single room if possible so that Dave could stay with her. Sandy Shore, the officious staff nurse, was clearly put out by this.
There were more complications but to keep things brief Helen had gone onto oral medication but the discussion and respectful explanation from the head surgeon had given Helen the information she needed to make an informed decision to start on the intravenous antibiotics in spite of the pain she experienced in her extremely narrow veins. She also had a CT scan when it was explained to her. Dave was not too pleased about this, feeling it might be overkill given the higher risk of this type of scan over an ultra sound but that is another matter.
From this point onwards things ran far more smoothly and the outcome was mostly successful. Helen was discharged a week later.
It was the day after the staff nurse Sandy Shore had vindictively lied and prevented Dave from being with Helen for her medication that she reported Dave and Helen to the Children Services. On account of the ensuing investigation by the children Services which was a travesty and their incompetent handling of his subsequent complaint he also initiated a complaint to the hospital.
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