A Nurse’s Oath,

The Florence Nightingale Pledge

I solemnly pledge myself before God and in the presence of this assembly,

to pass my life in purity and to practice my profession faithfully.

I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug.

I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.

With loyalty will I endeavour to aid the physician in his work, and devote myself to the welfare of those committed to my care.

  • To recant what mum was given on the 6th:
  • At 7-9am mum was given:

2G Ceftriaxone IV

40mg Furosemide Oral

1G Paracetamol Disperse

5mls Carbamazepine Oral

5mg Salbutamol Neb

0.5mg Atrovent Neb

  • At 12-2pm mum was given:

500mg Clarithromycin IV

7500units Dalteparin SC

1G Paracetamol Calpol

5mg Salbutamol Neb

0.5mg Atrovent Neb

  • At 4-6pm mum was given:

1G Paracetamol Calpol

5mg Salbutamol Neb

0.5mg Atrovent Neb

  • At 10-12pm mum was given:

1G Paracetamol Calpol

500mg Clarithromycin IV*

5mg Salbutamol Neb

0.5mg Atrovent Neb

5mls Carbamazepine Oral

1 drop Latanoprost ea. eye

~Act Twenty Five~

  • On the 7th at 05.00 the nurses notes were:

Settled and slept well.

4% catheter volumes

Bedrest maintained.

  • At 06.00 the Charts read:

*B.P. 129/71, No pulse recorded, O2 98% 4L, resp. 20.

This *was Not written on any nurses notes!

  • At 7-9am mum was given:

2G Ceftriaxone IV

40mg Furosemide Oral

1G Paracetamol Calpol

5mls Carbamazepine Oral

5mg Salbutamol Neb

0.5mg Atrovent Neb

  • Nurse’s notes on Oral Intake Chart on the 7th.
  • (The chart which Commenced on the 6th!)

cornflakes – choking on breakfast.

N.B.M. -> SLT (Speech and Language Therapy) review 2pm.

Below this was written in huge letters by the ward manager!

  • N.B.M.-General Condition – very poor
  • At 09.00 the Charts read:

*B.P. 159/85, pulse 92? (there is another dot at 148 on Chart)?, O2 98% on 4L, resp. 20.

This * was Not written on any nurses notes!

  • On the 7th the  Biochemistry results from the bloods taken at:
  • Collected @10.00
  • Received a@ 11.46,
  • Report issued on the 8th @09.26:-

Sodium *146

Potassium 4.3

Chloride 98

Urea *11.3

Creatinine 78

eGFR >60  (est. Glomerular Filtration Rate)

CRP *396

Bilirubin 4

AST *46

ALT *185

Gamma-GT *476

Alk. Phos. *384

Protein *50

Albumin *17

Globulins 33

Absolutely Sickeningly Inhuman!

  • At 11.10 the nurses notes were:

Bed bath given

Nil by mouth as patient appears to be aspirating. (Choking on food/drink)

Water swallow tests carried out.  Patient gurgling and choking thereafter.

Referred to SALT for swallowing assessment.

Catheter patient and on 4 hourly volumes

Remains on bed rest

MEWS -> 3

Recordings to be monitored ODS

O2 therapy tolerated continuously on 4L

  • The Department of Haematology results were:-
  • Date of sample ?
  • Date of Report 07.02… @ 12.27.
  • *05.02..     FBC:  No clinical Details Provided.
  • PLEASE SUPPLY RELEVANT CLINICAL DETAILS.

WBC 16.42

Hb 11.2

Plts 268

  • At 12.00 the Charts read:

*B.P. 128/91, pulse 100, O2 91% on 4L, resp.24.

This* was Not written on any nurses notes!

  • In fact NO MORE CHARTS would be completed AT ALL until 1.30am on the 8th!

Why Bother?

There again, What wouldn’t be seen?

  • At 12-2pm mum was given:

500mg Clarithromycin IV

1G Paracetamol Calpol

7500units Dalteparin SC

5mg Salbutamol Neb

0.5mg Atrovent Neb

  • At 14.30 the Salt (Speech and Language Therapist) wrote:

Swallow Ax consistent coughing up fluids/puree but due to high effort an difficulty co-ordinating respiratory/swallowing as chest signs less typical of aspirating pneumonia.

Advise:  Very small sips of normal fluids and very soft moist diet.  Monitor chest and for signs of patient distress.

  • Salt wrote on notes:

Speech and Language Therapy (SALT)

ATSP by N. staff who were concerned that patient is having swallowing difficulty.  Assessed for normal fluids + puree.  Tends to ‘dump’ and consistent rattly cough post swallow and some SOB. chest status in Not Typical of aspiration but difficulties co-ordinating breathing and swallowing may be contributing to cough/SOB/huge effort, all of which are denied by patient.

How absolutely desperate mum must have been to get out of there!

This absolutely breaks my heart!

Advise:  continue to small sips of normal fluids and a very soft, moist diet but monitor for changes in chest status or high patient distress.  SLT11.

  • Nurses notes on Oral Intake Assessment Chart:
  • 3pm forticreme  – 30mls.
  • water – sips.

Was I ever informed of this or of any problem regarding my mother?

You guessed correctly!

No!

It’s All A Big Secret!

For Them To Know and Us To Stay In Ignorance

of What is Going On!

~After All, They have the Stage all to themselves, and we are only bit-players!~

~Act Twenty Six~

  • At 15.20 the nurses notes were:

Patients daughter requested a nurse attend to mother’s swollen Right hand.

(A bandage was wound around a couple of times and it was cutting off the blood supply with her hand turning blue).

I …………responded immediately to the request, and left to fetch scissors to cut this.

Mrs……… hand was indeed swollen due to her Venflon having tissued.

They talk to people like fools.  This was clearly because of the bandage cutting into her wrist!  The venflon was tissued alright but this was not the cause of the hand turning blue!

I informed Mrs……….daughter of this and informed the medical staff.

Who were the medical staff?

Why was this not observed by the nursing/medical staff?

Mrs……..daughter was extremely disgruntled intimating that the nurses are extremely cruel ‘torturing her mother’.

Everyone knows that use of words which are edited cleverly can be used to appear to mean something other than what is stated, and this was indeed the case, when I remarked that this was cruel!  This nurse managed; to add to the damage already written regarding myself; to enhance a picture of a very hostile relative, and nothing could be further from the truth.

I most certainly Did Not receive the information or assistance I so craved, right from my mother entering that ward, and Did in Fact receive hostility from the Ward Manager right from the start!

This person set the scene for unhelpfulness, hostility from day one, and lack of help from a nurse whom I had approached, along with obviously telling nursing staff that I was against them when this was Not True!

I was against indifference, and neglect, and the lack of communication or indeed any information which Never transpired!

As I said before,  ‘This Hogwash Does Not Wash With Me!’

There followed Over one hour and fifteen minutes meeting in a day room with the ward manager and this nurse.

What a naughty girl I was to suggest any mal-treatment of my mum.

Bad Daughter.

Over One hour and fifteen minutes which should have been spent with my mum!

Over One hour and fifteen minutes which should have been spent on care for the patients.

  • The subsequent handwritten report of what had transpired at the meeting consisted of three full pages; to add to the other five written all about ME!
  • This totalled Eight pages.
  • All the nurses notes written about my mum added to Eight in total! 
  • Surely there is something wrong somewhere when a ward which is short staffed has a ward manager and nurses writing up mainly petty and untrue remarks. 
  • What about the time this takes? 
  • No wonder the records are in such a shambolic state. 
  • Every single one!
  • Plus open to a great deal of abuse because of this shambles in organisation, or should I say non-organisation!

Dear ‘O’ Dear.

A shambles if ever there was one.

Report:

‘Myself and nurse… asked what her concerns were.’

(1) Mother’s Venflon had tissued.

(2) The doctors and nurses have no communication.

This was because I was sent from FY2 to the ward manager who in turn would send me back to FY2 without any solutions!

(3) Every task is compartmentalised.

(4) One occasion her mother’s legs were not covered.  One occasion?

She was kept in bed and Catheterised after this.

(5) Staff had been ‘fiesty’ towards her.

(6) She did not believe the food chart completed by staff.

This was in response to my stating that day that my mother’s teeth were falling out of her mouth and she had lost weight:

‘She’s Not Lost Weight!’  ‘What weight is she?’ Looking through her papers on her lap she said ‘We’re weighing her today’. ‘What time?’        ‘Four O’clock!’

Details:

‘Mrs….. venflon had tissued and her hand was swollen actually her skin was stretched and shiny like a balloon and blue)……. claims she came in and saw it before staff had seen it and if she hadn’t then staff would never have found it.’

What a load of bunkum.

I actually said it could have been dangerous to my mother if no found in time before more harm was done.

In any case did she not require this?

‘I explained that tissued venflons were very common.  I explained the reason why and told her that the staff are in and out of the patient’s rooms all day and especially when they are acutely unwell.’

So That was why No other Chart Observations were recorded for the rest of that day after 12.00hours!’

‘and it would have been discovered the next time we attended to Mrs….’

Now, given the fact that no nurses usually attended patients during visiting hours, this would mean that mum would have sat like that for at least an hour and a half!

‘I stated that while I actually didn’t feel the need to discuss my professional relationship I told her that the doctors and nurses communicated all day regarding patient care and that she was wrong in her opinion.’

This verifies what I said regarding ‘not feeling the need to communicate to relatives’. They may communicate to each other, for what it is worth, but they certainly Do Not communicate with a patient, relative or carer especially one who has a Legal and Binding Power of Attorney.’

Got it in One!  Because that Is The Prevailing Attitude.

Patients are here for us to do what We like and they do Not say Boo!

That is Why they are called Patients!

We are Not here to explain to Anyone whatsoever!

Relatives are a nuisance and an obstruction to this process and are tolerated begrudgingly!

So, when they communicate all day, is that when doctors are Not Off Duty?

Which days are ‘all day?’

(3) I do not know what …means by this.     I don’t imagine she would!

(4) …….states that on one occasion when she came in her mother’s legs were cold and uncovered.

This was the day mum was sitting ‘frozen’ in the ‘dayroom’ with the ‘props’ after having had a shower when the MRSA beds were being steamed, an she had No bedsocks on or feet propped up and her limbs once again were frozen!

She was also staring into space.  Being drugged can cause this but so can hypothermia!

‘I apologised for this unreservedly but I did say that the staff did their very best to deliver the highest standard of care at all times but on some occasion – things got missed.

(5) Again, I apologised for any ‘perceived’ nastiness, and said I would address this with the staff.

Unbelievable, another excuse to blame the daughter for badmouthing the staff when it was herself who instigated everything!

‘In defense of the staff……talks over you constantly, and interrupts you when trying to answer her.’

This was a new thing for me and the reasoning was because I was tired of either receiving no proper answers or a pat answer such as ‘it’s common for swelling feet and limbs to occur with steroids’.  ‘It’s common for Venflons to tissue!’.

Maybe it’s time for these to Stop being so Common?

These are real live human beings we are talking about here, not some robotic pieces of metal who are being programmed to die!

First Do No Harm!

Why was mum on so Many Steroids?

plus ‘her venflon had tissued’ with no redress to the effects on my mother!

‘As documented above – (this must have been on some of the other sheets written about ME, because I’m Soooo important?)  she has been ill-mannered on several occasion.’

This is completely untrue but considering the caliber of my accusers I shall let you, The Readers, be the Judge!

(6) ‘…..refused to believe the entries on the food chart, as she said her mother wasn’t swallowing well…

The ward manager herself told me that my mother had a sore throat days ago!

…I went into extensive detail re.  this i.e. thin fluids can be not tolerated, while thicker consistencies are easier to swallow.

I covered stage 1 & 11 fluids Textured A-E diets.  Assured her that the nurses do not routinely lie about patients intake.’

I did not accuse nurses of lying.  I stated that I did not believe mum had been eating well, and was told that a nurse had fed her chicken pie and I immediately wondered how she could chew and swallow this with her teeth falling out of her mouth.

Remember, I knew nothing at all about the SALT or any problems, all I saw were her teeth falling out!

This was my conversation but obviously it has been mis-stated as per usual from this source.

This ward manager adamantly and forcefully attempted to convince me ‘She’s Not Lost Weight!’ when clearly this was untrue.

In fact mum lost half a stone in just over a week’s stay in that establishment.

I explained fully, thoroughly and sympathetically all the answers to her queries.   I was professional and courteous despite….  provocative attitude, and the wild accusations being verbalised.’

This all sounds so professional and even nice, doesn’t it folks?

  • She Did Not write that I had apologised if I offended anyone, and she and the nurse accepted my apology!
  • She Did Not write that when she mentioned about the MRSA problem that she told me they actually had a major problem with C. Difficile.
  • (I am still unsure whether she was sharing a problem she had, and which I at the time felt sympathy for her predicament, or if this was something else for me to worry about and she was allowing me to? But I shall err on the side of the sympathy vote meantime, rather than appear paranoid.)
  • With the sheer unadulterated and obscene amounts of drugs given to elderly and infirm patients (and also to elderly in nursing homes ) with All of the Endless Authorities turning blind eyes to this, along with chopping and changing these at a rate of noughts I am not in the least surprised.

Talk about inviting Trouble!

Trouble must be a constant visitor to the NHS!

  • She Did Not write that she told me they were short staffed, and that I had shown an appreciation for this.
  • She Did Not write that she agreed the meals were cold.
  • She most certainly Did Not write that she asked me ‘If I wanted my mother resuscitated ‘ should this be necessary and that I had at this time most vehemently said ‘Yes!’

‘She must have pretended to write as I saw her motioning this!’

‘Also it is noticeable to me now that she asked this at this meeting, as the events which followed were particularly ugly!’

Co-incidence?

There is No Such Thing in the Universe.

This merely suffices to fill a gap which many cannot explain otherwise.

  • She Did Not write that she told me ‘Don’t worry about her not eating.’  You can go three weeks without food! and that my mother had been fed by one of the nurses and while she did not normally feel the need to explain herself nevertheless she would try to explain that my mother’s condition warranted that she take drinks which are of a custard-like consistency to enable her to swallow without choking, and that she was receiving these.

Would this fact not be of some importance for a daughter to know about?

  • She omitted to mention that I had taken in Fortisip on the First Day of mum’s arrival in that place and she had placed this in her fridge!  Such was her aggressive manner to me that day, that she obviously forgot!
  • What she failed to mention was the fact that my mother had been Choking on breakfast NBM SALT Reveiw 2pm that same morning, had only drank Forticreme 30mls and had sips of water at 3pm, accompanied by the fact that it was only ‘After’ my telephone calls to the Consultant’s Secretary and Dietitian? the day before that ‘One of the nurses had fed her’ and by all accounts this was the only day she had done so, apart from the choking incident that morning, yet her extremely defensive and aggressive manner belied the fact that her words did not match the facts, that for two days my mother’s teeth kept dropping down and I wondered how it was possible to eat Chicken Pie?
  • She Did Not mention the fact that my mother was being taken for a Doppler while I was wasting my time with her!

This discussion lasted over one hour and fifteen minutes.

The fact was that it lasted from 20minutes to Four until 15 minutes to Five.

Watch This Space!

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