My Dad’s A Goldfish – It’s not just me!

20140830_201126

The Goldfish in his chair enjoying a visit from a neighbour’s cat.

I’m interrupting the chronology of the Goldfish’s lengthy stay in hospital to share some words from the chief nursing officer in Scotland, Professor Fiona McQueen.

Often I feel I am a grumpy old woman, always complaining about nursing staff (and often some doctors and care agency staff) who don’t listen, are not professional and seem to have little or no understanding of patient care. I was delighted, therefore, to read first in the newspaper and then on her blog that it’s not just me. Someone a lot higher up the food chain has also noticed, publicly commented and expressed a desire to see things change.

In her New Year blog post Professor McQueen gives examples of the kind of bad practices she has witnessed during 2015 and writes: “I expect registered nurses to speak to all patients and their families with unconditional positive regard and never again will a registered nurse say to a patient, ‘if you wet the bed we’ll call you pishy-pants

“At all times I want nurses and midwives to put their patients first. No skipping off for a break when relatives need to speak to you or, worse, when patients should be having their meals served.”

As you might expect there has been a fair amount of outrage at her words from nursing staff and from their union. Gordon McKay, a registered nurse and chairman of Unison in NHS Ayrshire says: “My experience is that nurses work unpaid, way beyond their contracted hours to provide world-class care rather than ‘nipping off for breaks’ as is claimed, and that nurses speak to patients and relatives with the greatest of respect and kindness…”

Well, Mr McKay, threatening to call a patient pishy-pants is neither respectful nor kind.

The outraged ones don’t seem to have noticed Fiona McQueen also says: “I have met some outstanding nurses and midwives and hear of examples of care being delivered that is so good it’s breath taking.”

This is something many of us on this and other blogs have discussed and we’ve all said that there are nurses (and carers) who are wonderful and do a fantastic job – but they should not be the exception to the rule. I am sure many good nurses must be cheering (even if they have to cheer in private) with relief at Fiona McQueen’s words. How disheartening it must be to see colleagues bring your profession into disrepute.

Professor June Andrews, a registered nurse and director of the Dementia Services Development Centre at Stirling University has given her support to the chief nursing officer’s words. She says: “As a hard-working nurse, knowing that other nurses and midwives who, not for want of resources but because of attitude, bring down the profession, I would be glad to have them outed.”

The day after the story appeared in a national newspaper Fiona McQueen issued an apology saying she had not intended to offend hardworking nurses. I don’t think it IS the hardworking nurses who will be offended and I salute Professor McQueen for telling it as it is and for wanting all nursing staff to work together to eradicate bad practice.

You can read Fiona McQueen’s blog post here.

Advertisements

My Dad’s A Goldfish – Jelly

In the great trifle debate, I’m not an advocate of jelly being included. In fact, I’m not really a jelly person. I’m sure I ate it at parties when I was a small child, possibly may even have liked it but other than a vague memory of mashing ice cream into red jelly, turning it into a pink swirl, I don’t really remember.

My mother made a kind of milk jelly with evaporated milk and I do recall eating cubes of undiluted jelly as a teenager. We’d heard or read somewhere the gelatine it contained was good for making our nails grow strong.

As an adult I have never felt the need to eat the wibbly-wobbly stuff and would never choose it on a menu – even if it did have champagne in it or liqueur soaked raspberries. I am beginning to worry though, if the time will come – when I’m in my dotage – if I will be forced to eat the stuff again?

The reason I am worrying about this is because I’ve noticed a marked tendency for nurses to order it for the Goldfish. Like me, the Goldfish would never choose jelly for pudding. His choice would be apple pie and custard, sticky toffee pudding, syrup sponge or, if it’s a cold sweet then he’d go for banoffee pie (his favourite) or a rich chocolate mousse. Okay, I know those are not all options on a hospital menu but the sponge puddings and apple pie are. Jelly ALWAYS is.

For some reason during this hospital stay it’s been impossible to fill in the menu for the Goldfish, which means the poor man has been presented with jelly on several occasions. He doesn’t eat it.

Me: “Would you like me to fill in dad’s menu card?”

Nurse: “Already done.”

Me: “How is his appetite? Is he eating better?”

Nurse: “Well, he didn’t eat his pudding.”

Me: “What was it?”

Nurse: “Jelly and ice cream. Nice and easy for him.”

Me: “But he doesn’t like jelly.”

Nurse: “He said that was what he wanted.”

Me: “It’s in the notes we brought in for you and in the notes they made on admission for likes and dislikes.”

Nurse: “I asked him what he wanted and he said he wanted jelly.”

Me: “No, you asked him if he wanted jelly and he nodded. He has dementia. If you asked him what he wanted he wouldn’t remember the list of choices and be able to decide. He can’t make choices but he is still the polite, eager-to-please gentleman he always was and so he will nod in agreement to whatever you ask or suggest.”

She scrawls NO JELLY!! on the board above the Goldfish’s bed and vanishes down the ward, no doubt swearing about stroppy family members who seem to think they know best.

My Dad’s a Goldfish – Hospital continued

Day 2: I visited the Goldfish in the afternoon but he was asleep, looking very peaceful and did not wake up. The nurse I spoke to said he’d eaten lunch and had been “very happy and cheerful earlier”. I wanted to believe her.

DH went in the evening. The Goldfish was asleep. He woke, grunted something unintelligible and went back to sleep. DH returned to report that staff is disappointed with the lack of progress the Goldfish has made and a doctor had ordered the drip, which had been stopped when he seemed to be doing well in the morning, to be put back in again. The doctor also wants an MRI scan to be done.

Day 4: The Goldfish was so much better – astonishingly so. He was sitting up, bright and alert, delighted with the chocolate and biscuits I brought. Anyone seeing him would wonder why he was in hospital! They were even talking about him coming home soon – which is worrying as he hasn’t yet been out of bed. And he still has the catheter in.

Day 5: The Goldfish wasn’t quite so bright today. He is still in the admissions ward as no bed has become available in either of the two wards to which he could be admitted. They are no longer talking about sending him home. I learned today about the power an occupational therapist (OT) can wield.

The OT is concerned about his mobility. He hasn’t been out of bed since his arrival in hospital and she wants to see him walking before allowing him to be discharged. He won’t be discharged within the next two or three days – which will bring us to a weekend, unless he comes home on the Friday. I noticed the pain chart records the Goldfish is not in pain. I ask how they know this because I know his arthritic hip is very painful. The nurse said they ask him if he is in any pain. I point out he has dementia and she huffs at me.

Day 6: The Goldfish was finally transferred to a ward but is not doing well. DH, in an attempt to stop me pissing everyone off with my sarcastic questioning of their care of the Goldfish volunteered to talk to the staff. He is the most diplomatic, Wee-sis comes next in the diplomacy ranking – I come nowhere.

DH came home fuming. “The nurses,” he said, “know everything. They won’t listen or accept what anyone else can tell them about the patient in their care. They know.” Usually he can find something positive to say, but not tonight. No scan done. Catheter still in place. I just feel so depressed. The Goldfish very poorly.

Day 7: I went in this afternoon and found the Goldfish really not well – despite being assured he was “comfortable” and had had “a settled night” before I went in to see him. He was struggling for breath. Time for diplomacy was over. I pressed the buzzer for a nurse and insisted there was something seriously wrong and I wanted a doctor to see him. She pulled the curtains, insisting I step outside while she and another nurse examined him. They called for a doctor.

A junior doctor arrived and invited me to join him INSIDE the curtains while he examined the Goldfish. He has pneumonia. Antibiotics and a drip sent for. The doctor was lovely – talked us through what he was doing and why. I smiled to myself when he got in a bit of a fankle with the syringe of blood he’d taken and asked me to hang on to it while he attended to the drip. I suspect a nurse should have been there but we got on fine without one.

Day 8: The Goldfish much better again and eating well. He is one tough cookie. I have no idea what gives him the strength to fight back so hard – but fight back he does. We had a chance to speak to a doctor. He said the seizures are part of the dementia and they will put the Goldfish on an epilepsy drug. We discovered during the course of the conversation the Goldfish had had more than one seizure since admission – but no one had told us. The MRI is now not considered necessary. The doctor made a note that the catheter should be removed.

Fingers crossed we’ve turned a corner.

My Dad’s a Goldfish – seizure

There’s just no knowing what’s coming round the corner at you. The Goldfish was on great form on the morning of Friday, May 20th 2014 and in hospital by the evening. In the morning he was alert and talkative. He didn’t even have his usual post-breakfast and shower nap. I couldn’t leave him to go and work in the other room so brought paperwork and laptop into the living room. He is fascinated by the laptop and likes to ask questions about it.

DH came up in the evening bringing fish and chips, which the Goldfish tucked into with his customary relish. Afterwards, DH took the Goldfish to the station to collect our son who was coming down for the weekend and I took the chance to go for a walk. I was back, doing some weeding and wondering when I’d have the chance to do the same in my own garden when the DH phoned from the hospital.

All had gone well on the drive to the station but on the way back the Goldfish started to shake uncontrollably and lost consciousness. Son, sitting behind his grandfather held on to him. DH turned the car and headed straight to A&E knowing it would be quicker than waiting for an ambulance. He called ahead so they were expecting him.

By the time I arrived the Goldfish had regained consciousness, though was very confused, and still in A&E waiting for a bed. His speech was not good. Last year when he lost consciousness, his speech came back after about ten minutes. We don’t really know what happened then as it was before the Step-monster had moved out and Wee-sis arrived one morning to find the Goldfish out cold on the hall floor.

Doctors can’t find any signs of infection so don’t know until test results come back and further investigations are done if it was a stroke or a bleed or ‘just’ the dementia. Wee-sis arrived, having had to find someone to cover her shift.

A bed was found in the admissions ward. The nurse, who admitted him, was she told us, brought in specially to look after him. I was torn between apologising for messing up her night off and congratulating her on being able to earn some overtime. For once, I held my tongue, determined not to alienate the person who would be looking after the Goldfish.

When he was ‘settled’ (I’m learning hospital jargon) Wee-sis and I sat with him for a while. He  became increasingly agitated, wanting to get out of bed and we realised he needed to pee. They had put a sheath on, which he’d pulled off so I called the nurse to tell her the Goldfish needed to pee. She said it was okay a sheath was in place. I said it wasn’t because he’d pulled it off. She sighed and tutted and came to look, sending me and Wee-sis out of the room. She then called another nurse and told me the Goldfish “has to be catheterised because he’s unable to pass urine.” I didn’t argue and we waited outside until the job was done.

We went back in to say goodnight. Torn between wishing he could just slip peacefully away and willing him to fight. I’m sure he’ll fight. He is physically strong enough to fight back and will come home – thought will, no doubt have taken another step or two down the dementia slope. I’m not ready to lose him.