31st July 2014
Dear Sir / Madam
Re. J__ inpatient, Bosworth Ward
I have held off writing until now because I was originally under the impression that my partner’s mental health advocate had written you a letter about her circumstances on Bosworth Ward. Prior to this I had assumed that messages had been passed upwards by staff on her ward, at least passed to the unit co-ordinators who would effect real change to her temporary circumstances.
On Saturday 19th July she was admitted to the Bradgate whilst still recovering from a massive overdose, mentally and physically exhausted (the last time I had seen her was on oxygen with drips and monitors). She had been told that she was lucky that a local bed had been found. It was also mentioned that several wards were not taking on patients due to rain damage, which is mockery of all the money spent on building and repairs in recent years (I know this because of disruption in two of my partner’s previous stays, and complacent comments in letters from the Trust). I am still pretty angry about the patients’ kitchen being locked on Ashby Ward with no drinking fountain for a month due to unfinished repairs, risk and a disgraceful internal squabble over finances.
She was admitted to Bosworth Ward, and eventually adapted to the idea that there would be no continuity with her previous stay on Ashby Ward. She accepted that she wouldn’t be going back to Ashby Ward. After her much disrupted stay for 8 months on Ashby Ward and a rushed return home, apparently it’s quite common to “bounce back” in terms of recovery, and yet this continuity was not acknowledged. The wards back on to each other, perhaps a visit or chat with familiar staff might have helped. As per usual, it took several days for her drugs to match her prescription, not to mention being made to beg for PRN meds. But all this is to be expected because admissions to wards at the Bradgate have always been amateur (fix the computers, sort of the phamacy) and God help the patients who arrive just before the weekend, because any special requests or problem solving may as well be ignored until the consultant is back the follow week.
Tonight will be the 13th night since admission that she has not slept in a bed (the last bed she slept in was at the LRI). Why is this? She was assigned a bed on a dormitory and has repeatedly explained in a panicked near-phobic way that she cannot sleep in dormitory due to her history - which naturally is part and parcel of her condition. She has depression, anxiety, suicidal ideation and OCD amongst other things and yet no concession has been made that staying in a dorm might be counter-productive with regards to her recuperation. I see and hear of this all the time on the wards, unnecessary and avoidable situations which trigger and aggravate already upset people - one example is the lack of staff for escorted leave.
She was told yesterday in ward round that they will let her go home in a week’s time. So far that means for more than half of her ward stay she will not have had adequate sleep, i.e. she did not sleep in a bed. She was told on Tuesday that a room on the ward would be made available on Friday (or might be made available). That was supposed to console her? I find it extremely hard to believe that there are no rooms that can be made available in the rest of the unit - why was this request confined to Bosworth Ward? I have seen on many occasions previously that nurses are very happy to disrupt the continuity of patient care by move them around the ward from room to dorm, room to room etc. She was told by a doctor that having a room is a “privilege” and similar sentiments have been expressed in the past to her, making her feel very guilty - this is not a choice. If dormitories are the norm in mental health care, then why have all of your new wards built with rooms without dormitories? I’ve seen in the press that the Trust is supposed to never turn anyone away, or at least find them accommodation in another facility. Then why is it that every member of the CMHT and the crisis team tell my partner that there won’t be a place free in hospital? Why should the availability of beds ever been the concern of an unwell person?
I sent requests to Customer Services to possibly inquire about a room anywhere in the unit but it appears to have simply been passed back to the ward itself, or perhaps ignored by anyone able to re-allocate beds between wards. The bed provided for Jo was inappropriate and did not recognize her needs or condition (as stated in the recently celebrated Welcome Pack, which incidentally she didn’t receive until the LAMP worker gave her a copy four days in). Two days ago we finally found out who her named nurse was (in absence of the named nurse assigned to her upon admission), only then were her swollen weeping legs bandaged -upon referal to the tissue viability nurse- despite being seen by a junior doctor previously. This is a side effect of her medication as prescribed by your doctors, the odema splits the skin and smelly fluid seeps out. I can provide photos. This is much than normal, and apparently elevation or rest on a bed greatly reduces the swelling. So, let me emphasise what is going on here: for her own very good reasons relating to her condition and history she can’t sleep in the dorm, she is seen night after night sitting up, special arrangements are made to elevate her legs on a chair. She also has back ache, which she is prescribed painkillers for (not available for a day until after admission) She dozes in the day in the middle of the ward. Shift after shift goes by, the staff seem to be aware of the problem and she accepts that it is normal to “camp out”- moving around with a bag, using a locker for her possessions. This isn’t just a problem with settling in, she is terrified of the dorm. She is still suicidal. She has had only a handful of one-to-one chats, and I’m pretty sure that she hasn’t been well enough to take part in any OT activities on the ward (which seem to be few and far between, on the ward). At what point did you start dehumanizing patients that somehow this level of existence seems normal in a place that has a duty of care? How is she supposed to even start to deal with her mental health when she is busy trying to manage and cope with this surreal and uncomfortable way of living?
I had already planned to provide feedback to yourselves and the Trust Board regarding shortcomings and perhaps a few positives about her previous stay on Ashby Ward. I have held off putting in an official complaints partly because in matters of day-to-day ward care your formal complaints are too slow, and partly because I don’t trust your system. The Care Quality Commission told me that it is important to make complaints formal, but I am exhausted by the dysfunctional nature of the Bradgate Mental Health Unit. You don’t learn or improve anything. Some of your nurses don’t even have people skills, and a zero understanding of what being confined to a ward means for the patient. Every request is like something out of the ordinary. Every denial of a normal activity is a potential trigger. No wonder so many patients abscond, and worse kill themselves. There is no continuity between wards with regards to care, rules or risk assessment, patients have to find their way through even after cursory orientation. Staff forget how absurd everything is. Patient facilities vary, the hygiene, safety and quality of the facilities vary. Your visitor facilities (during visitor hours) are non-existent. Your organization uses the phrase “acute wards” as if it absolves them from any therapeutic ongoing care. “Patient-centred care” is also nonsensical in your one-size-treats all containment approach with some rushed tick-box care-plans. Jo was told on her previous stay that the wards could not cope with her suicidal behavior. Can someone please explain what the Bradgate Mental Health Unit is actually good at? Apart from the new locked doors and intercoms (which staff are hopelessly inept at operating) I can see few positives to any admission.
My partner woke up in a chair this evening and she had forgotten that she didn’t have a room and as I was leaving had thought that she could retire to her room, and she remembered that she’d be staying on chairs tonight. How am I supposed to leave her, knowing that only the absolute minimum has been done to make her comfortable? Why are you still open, why are you even allowed to keep running this service? Give me a reason not to send this letter to every newspaper, MP and service-user groups I know.
W____
Partner/Carer for inpatient J, Bosworth Ward.
(Email, address, phone etc.)
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