I thought it would be interesting to write some reflections on a recent stay in hospital as a learning exercise and to share the experience.
This was the first time I have stayed in hospital:
I went to hospital with right iliac fossa pain. The onset was 10 days previously with a gradual worsening. For the last 3 days it had been painful to walk and change posture. Examination tests proved negative for appendicitis because there was no rebound pain and pain was not severe enough on palpation. Blood tests showed signs of infection which were worsening.
I was admitted to hospital and put on IV antibiotics for infection. The following day I had an ultrasound scan which showed something around the right ovary. The next day a CT scan showed a large abscess in the right iliac fossa due to a ruptured appendix. Surgery was scheduled for the following morning. After several hours in surgery the appendix was removed and abscess cleared up from the encompassed viscera with a wash out to try to clear the infection. There was a further four days in hospital with an abdominal drain in situ. Total time in hospital: 8 days.
What went well?
The objective was achieved – the problem was identified and resolved. There was a delay in diagnosis due to atypical symptoms.
Each day in hospital the team of doctors do their rounds in the morning and evening (a bit different at the weekends – less doctors and less rounds). There are usually three doctors – the consultant, a registrar (?) and a junior doctor. In the morning the doctors plan what will be done that day – bloods, scans etc. In the evening they come back and report results. The junior doctors busily wrote down all that was planned and arranged for that plan to be put into action.
The system of getting around the hospital for scans was good. A porter would turn up and wheel you down for your appointment (not that you knew when your appointment was) and you would go in straight away and be immediately returned to your ward afterwards.
Once the problem was identified I was put into surgery as soon as possible. A thorough explanation was given of the procedure and the risks involved.
Some of the staff were excellent. Some took great care and pride in their wound care and trying to make bandages as effective as possible. I had to have wound coverings replaced regularly as the drain leaked more than it caught! Some were very responsive to patient requests and needs and clearly enjoyed their work. Hospitals are extremely busy places and the pressures on staff can be quite intense some responded very well others didn’t. There was a challenging patient on my ward which really exposed staff strategies for dealing with conflict – some were excellent.
What didn’t go well?
In the beginning it took hours to get a bed. I arrived at 4pm and had a bed after midnight – this was a second visit from the previous day due to symptoms worsening. Many other people in the waiting room had been there since 10am waiting for a bed. We were all admitted after midnight. Nothing can happen really until you get a bed but once you get a bed it seems to be yours until discharge as you are moved around the hospital on it.
The process in the hospital can seem slow with one scan per day. More positively though, everything planned for the day by the doctors always got done and reported back on the same day.
Some of the staff seemed to have very poor moral and you felt like you were troubling them to ask for something. The ward I was on was staffed by agency mostly so at times there was a sense they didn’t really know what they were doing. Some of the staff were excellent as I have already stated – the cleaner was particularly enthusiastic and friendly.
The food. The food was fine to eat, no complaints about the actual food. The choice of food was somewhat strange for unwell people. I had curry one day and then another day when I had been particularly poorly it was smoked haddock pie. There were often omelettes available too. I have a gluten free diet – one day there was no gluten free food left, thankfully it was a day when I was too unwell to eat anyway! The menu was marked up for dietary needs, some days you couldn’t actually make a gluten free meal – there was potatoes and vegetables but nothing in the meat/protein section was gluten free. There was an elderly lady near me struggling to eat and she did not receive appropriate food or help most of the time.
Night-times – People who are unwell need their sleep, this is something that is well known. The hospital has this strange policy of checking blood pressure, pulse and temperature every 4 hours – that’s 10pm, 2am and 6am through the night! Understandable if you have a raised temperature or unwell but when you are in recovery phase it seems somewhat unhelpful. Some night staff have a great knack of creating a quiet, restful environment; others seem to make a lot of noise through the night – talking loudly etc.
Discharge – Getting out of hospital seems almost as much of as a challenge as getting in. There were four out of six on my ward being discharged on the same day. We all waited at least 4 hours from being told we could leave, I was first to go so I don’t know how much longer the others waited. One of the biggest hold ups was getting the medicine from the pharmacy – a complaint I have heard many times before.
Overall I am obviously extremely pleased with the care of the doctors and staff in using their skills to restore my health. I really feel for those working within the NHS. Staff are under a lot of pressure from workload and patient demands, they have an enormous number of forms to keep filling in. Staffing levels are a constant pressure – my ward had agency staff 80% of the time it seemed. Finding beds for people is very difficult, especially in the right area of the hospital – 2 people on my ward should have been elsewhere. Getting a bed and getting out of a bed are real issues. There seem to be some major inefficiencies in processes and yet some great work being done too.
I hope this gives you a bit of an insight into what it is like in hospital, this is one experience anyway, I am sure each is unique.