An experience of NHS nursing
This is an account by Vanessa, a young woman friend, a qualified Psychoanalytical Psychotherapist and a mother of two children, of her experience of nursing after a major operation on her spine in a big and well-known London teaching hospital. She was writing in reply to the response of the relevant hospital trust to her original complaint, sent from the trust’s website.
I have just had cervical spine fusion surgery at [a leading London NHS teaching hospital]. I was here four years ago on the same ward, undergoing disc replacement surgery.
I arrived on a Sunday evening with another woman whom I shall call Jan. She was a large, friendly woman. She arrived on crutches just after me with her husband and family. My bed wasn’t made when I arrived; the rubber mattress was covered by a ripped sheet but that was all. When I asked for the bed to be made the male nurse looked at me as if I was mad. I’m not asking for a cool gel mattress and some flowers and a 1000 count linens, just a simply made bed would do the trick.
“What do you want?”, he asked me. I asked for a top sheet and a pillow: I got the top sheet.
Nothing of this would have registered as other than to be expected. I am not fussy about trivial things. I had been waiting for surgery and was eager to be there. With hindsight however it was a indication of what was to come.
I remembered from before that recovery on this ward was hard. This is a ward of heavy surgery, drugs and pain. It is a rough and long road to recovery, a road that we need to be supported on with care and encouragement. This is not going to be nurtured here: nothing is nurtured here.
It has deteriorated since my last admission. There was no sense of anyone being in charge or of one being in anyone’s care. On getting up for the first time I asked one young student nurse to help me: she tutted and said she was busy. There seemed to be no communication between nurses, no consistency or continuity. The ward is chaotic, the male nurses were rude and abrasive, snapping at students and each other. It was as if we were not there; no one had any time for us.
The level of distress was palpable, especially at night when it felt as if the few staff were overwhelmed. Jan had had massive surgery. She had been in theatre for about nine hours. After five days we were both off our morphine drips and had been visited by the pain management nurse, who wrote us both up for slow release morphine tablets and oral morphine to take whenever there was any breakthrough pain.
That evening a woman friend asked the nurse if he could look at my dressing, which was bloody and oozing. Once my friend had gone the nurse approached me complaining. I pointed out that my friend was no nurse. He pulled my dressing off and started rubbing at my wound. I was extremely uncomfortable about this but he continued. It was when he came at me with tweezers to remove my steri strips that I knew were supposed to stay put for another week that I screamed at him to stop. It was terrifying. I got the distinct impression that he would have done anything asked of him regardless. It was as if we were in charge.
During the night I woke to hear Jan wailing. This continued for some time; she was getting more and more distressed. No nurse came to see her. I got out of bed to be with her. I sat and held her hand and dabbed water on her forehead and in her mouth. I was there for an hour. She was desperate for relief; there was blood weeping over her sheets. The nursing assistant was obviously distressed herself. She kept going to try to get the nurse but he didn’t come; she stood watching, helpless. When the nurse eventually came he was flustered and cross: he had been dealing with a distressed male patient. He shouted at her: “…this is bed 7, not bed 6, I have already done bed 6.” That was why he hadn’t bothered to come.
All he said when he got to her was: “What do you want?” Anyone in their right mind could see that she wanted relief from her pain. She was near delirious and in no state whatsoever to be asked what she wanted. He was unaware that she could have liquid morphine and told her there was nothing he could do. He was completely uninterested, and irritable. I pointed out that she was more than likely written up for liquid morphine as I had been. As anyone knows who has had anything to do with spine surgery, one has to keep on top of the pain, otherwise it is engulfing. There was absolutely no need for her to have been allowed to get in to this state. Dealing with major surgery makes one terribly vulnerable. One regresses to a completely dependent state which is distressing in itself. We need our carers to be sensitive to this, not angry and dismissive. We already feel like a burden.
I have never been more eager to leave a ward. I left the next day. Betty, the other woman in the bay, had had her hip replaced; she could only get out of bed with a special brace on. She was left in her chair with no knickers on. Eventually she called me over and I put them on for her; the indignity was embarrassing for her. I am haunted by the experience of watching elderly disabled people being treated in this way (we are all registered disabled); watching their husbands come every day to be with them and take loving care of them that they hope is going to be sustained in their absence. I could manage better, I am 15 – 20 years younger than them: their treatment was disgusting. When Jan and I came in to the bay of four, a woman who was about to leave said it was like being in Holloway. She was discharging herself: they wanted to give her a blood transfusion which she refused, saying all she needed was some decent healthy food. I imagine the women in Holloway get better treatment. In many ways we are the lucky ones: we get to leave, the staff have to work in this environment.
I am sorry for the nurses who were so stressed: they are as vulnerable to the system as we, the patients, are. There seemed to be an excess of semi-qualified student nurses and assistants who couldn’t actually do much, and very few qualified nurses. Those that there were seemed to be cracking under the pressure.
In response to my initial complaint you assured me that if I needed to come back into the ward you would make sure that I was comfortable with returning. This is not my point. It needs to improve for everyone, not just those that have the strength to complain. We have enough to get over in terms of the surgery that we have undergone without the traumatic lack of care that I believe we were all subject to.
You also stated that a ‘female member of staff is always available on request’. This is not good enough: it presupposes that we are well enough to voice our wishes. This is not always the case, especially in the first few days post-operatively. Maybe preferences ought to be checked before we go to theatre.
My experience was not one that you would have associated with a great London Teaching Hospital. It was more worthy of a third world country. What is in fact brilliant surgery is tainted by appalling after-care. It was a disgrace, and is not something I would either wish to repeat or have anyone else suffer.
Postscript by Brian: I have commented on this deeply disturbing letter, and more generally on the problem of appalling standards of nursing in many NHS hospitals, in a new blog post: please see