Last update 21st. June 2004

PPIFO

From: Robin Redmile-Gordon

To: ken.cunningham@sash.nhs.uk

Sent: Monday, June 21, 2004 7:38 PM

Subject: Crawley Hospital A&E procedures

Dear Mr. Cunningham,

I write concerning the experiences I had on Sunday 20th June when attending my mother, Eleanora Redmile-Gordon, who had been admitted by ambulance at around mid-day. My mother had been discovered by the homecare visitor on her late morning call. She had fallen and banged the side of her head on something sharp, this caused a deep wound to her head with a significant loss of blood and rendered her unconscious. The homecare visitor called the ambulance and her office then called and notified me some thirty minutes later.

I immediately called the hospital and spoke to a nurse in A&E who was familiar with my mother's admission. She ran through the list of current medication which I confirmed but she had no knowledge or seemingly any access to records relating to my mother. I therefore went to some lengths to explain her history, in particular that of stroke for which she has been treated at Crawley hospital in A&E, as an inpatient for two weeks and at the Dove Day Ward of the hospital. The symptoms of her stroke are that she feels dizzy, collapses unconscious and has no recollection of the event. As a result she has greatly impaired memory function and so asking her any questions about her health, history or symptoms is all but useless. The nurse apparently noted all this down and confirmed she would appraise the attending doctor.

When I attended the hospital my mother was in X-ray. When she returned the wound to her head had been stitched and I waited for the attending doctor to come around about an hour later. He confirmed that the X-ray results were clear as was her blood sample and that she was ready to be discharged. He was a very pleasant man and I have no complaint about his demeanour but it was clear he had no knowledge whatsoever of mother's history. I asked him if he had checked for signs of stroke and the look of concern on his face told me he had not. Once I explained the history he was very attentive and reasonably thorough in checking her physical and neuro responses, asked about pain in the stomach and head, asked me for a comparative assessment of her current state and, once he had finished, I was satisfied that he had carried out reasonable precautions based on this "new" information. He did not, however, consider a scan was necessary. I would contend that in such circumstances - both a severe blow to the head and her stroke history that a scan, preferably an MRI, is essential but he of course would have been counting the cost. I was concerned that his examination was carried out without the benefit of protective gloves but more on that later.

As a final precaution he requested a urine sample which he wanted for a final test before he was happy to discharge. Knowing that this would take a little while, I took the opportunity to go out and finish some other urgent tasks, change the car to one more suitable to carrying my mother and received a call on my mobile an hour or so later to advise that mother was ready for discharge. When I arrived to collect her I found her sitting in her blood-stained dressing-gown on a hard chair in a corridor between triage and reception. My mother is 86 years old and, as described, frail and distressed following a frightening fall and a seven hour hospital process.

Here are the issues:

  1. Why, when my mother has attended this hospital on numerous occasions in the last three-four years, both in A&E *and* both as an in-patient and out-patient in other wards, is it necessary for me to provide this basic yet essential medical history?
  2. How is it possible that having been provided with this information - specific to this incident - the doctor treating my mother is blissfully unaware of the facts and consequently about to discharge her without the appropriate examination?
  3. What illustration of respect is it to place an 86 year old woman in that condition on a hard chair in a corridor? I am sure that beds are precious but there are always other more appropriate options.
  4. The only person I was able to observe wearing a pair of gloves during my entire time on the ward was the young male nurse who assisted my mother with a commode to take the urine sample. Once I realised that this was the same pair of gloves he used for all his tasks it was clear that they were their to keep his hands clean during his "unpleasant" duties rather than to protect against cross-infection of the patients. Still this sorry state of affairs persists.
  5. I know this ward is due to close soon and services transferred to Redhill but honestly the state of this building is an absolute disgrace. I recall hospitals in the fifties that were far better presented, maintained and cleaned and the only reason we had to suffer those dowdy places was because we were in austere times recovering from the second world war. I have been in third world hospitals in war zones that were in only a marginally worse condition and in that regard one has to respect the fact that the staff continue to work in these appalling conditions. Having said that, every member of the team on that day originated from a third world country but somehow I think they expected to find conditions a little different when they came here - either way, thank heaven that they came!

I look forward to your comments and assurances in due course.

Yours sincerely

Robin Redmile-Gordon


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