I was treated in the HDU dept of Watford General for 5 days after major surgery and the care was first class and amazing - I couldn't fault it at all as everyone was brilliant. I was transferred to the General Ward after 5 days and the care here was appalling. On the first evening in this ward I was left in a side room without access to the emergency button, without adequate pain relief and then with a nurse that had not been trained to do the job they had asked her to do. My iPhone and iPad had been put across the room so I couldn't reach them to call a member of my family to tell them what was happening. I was in such a state by the following morning that I had to yell at a passing nurse I recognised to come and help me - this was not until late morning. Before this a Health Care Assistant had popped in to put a bowl of water and towels in the room and then left but had not stayed long enough to find out that I could not perform this task. When she came back, she said that the water had gone cold (this shows how long this was) and asked why I had not done anything about washing myself - I then tearfully explained that I could not move as I had drains & drips etc all around me and that I could not reach the call button. She came back some time later with new warm water and helped me to to wash myself. Later the same evening, I was transferred to a 6-bed side ward and I could reach the call button this time. The communication between the doctors looking after me was not good and there was a difference of opinion about when to take drains out etc. Consequently, 1 drain was left in longer than my surgeon deemed necessary which meant I could not go home as planned. When I was unexpectedly seen by my surgeon on a Saturday morning, and he found the last drain still attached, there was no-one on the ward (being a Saturday) qualified to removed this - so he did this himself and signed the paperwork for my release - I was very grateful indeed as I was feeling quite well. First thing the following morning, I had to battle with the staff nurse in charge to get released, and even then she did not pass this information on to the duty doctor, so when he came onto the ward, I had to call him across myself to carry out a full examination for discharge as the paperwork had been signed by my surgeon the previous afternoon. This examination took place at approx 10.30am on Sunday morning and he removed all of my wound dressings, which numbered about 10 in total, including the largest one which was approx 250mm long across my back. He signed the dishcharge paperwork and told the staff nurse to re-dress my wounds and order the drugs I needed from the pharmacy. After an hour I pushed the call button to ask when my open wounds would be re-dressed and was told they were very busy, so I asked if I could have a clean gown as I was naked from the waist upwards and the curtains were closed - I didn't fancy spending any more time on my own behind the closed screens. A clean gown was provided but the open wounds did not get dressed until approx 4.30pm that afternoon - I think this is appalling! The pharmacy finally delivered the drugs at approx 5.15pm and I was allowed to go home. After such brilliant care in the High Dependency Unit, the above was quite a shock, and even if I was not comparing the two wards, the care I received on the General Ward was far below what I would call Good. I hope this review will help the system to be improved for other future patients.
I went into premature labour at 34 weeks and 4 days. Due to my waters breaking and the baby being in breach position, my son was delivered by Caesarian Section. Unfortunately, I went into labour during the operation resulting in my sons head becoming stuck. The surgical team therefore had to make a vertical incision, in addition to the horizontal incision. My son needed to be resusciated by the paediatric team. There were also additional complications in that the front of my uterus had a high density of blood vessels resulting in issues with visibility and loss of blood. Positive Aspects of my Care:- * We received a full debrief from a member of the surgical team informing us what happened following the operation. * A member of each team involved in my C-Section spoke to us and answered our queries prior to the operation. * The team were patient and reassuring during issues with anaesthetic - 2 spinal blocks were required. * Our son received excellent care on the Neonatal Ward. * I felt well looked after in Triage, Delivery and Recovery Wards and have no issue with any of the care I received there. * Many of the midwives provided excellent care and ensured I received monitoring and my medication promptly. * My husband and I received advice and instruction on the Neonatal and Transitional Care Wards and felt well supported. * I was provided with a private room in order to recover following my C-Section. Areas for improvement * I would have benefited from more advice and support in forming a clear plan to help establish breastfeeding given that I was separated from my son. On reflection, I feel that although unintentional, I was set up to fail and I feel that women whose babies are on Neonatal should receive additional support to ensure that these vulnerable children can benefit in the short and long term from breast feeding. Although some advice on hand expression was given initially when I was in Recovery, I was unable to master the technique whilst there and despite requesting support whilst on Katherine Ward, was just given a leaflet (which we had already received). This resulted in my son not receiving any of my initial colostrum (as we were separated for over 24 hours). I was initially denied a breast pump despite this being recommended by one of the midwives due to my issues hand expressing. When I did finally receive a breast pump, no one warned me that by following the 4 hour routine set by Neonatal, this would create problems with my milk supply. Issues with my latch were not spotted by staff until my day of discharge. By the time we received advice from a lactation consultant following discharge, it was already too late to deal with low supply issues. * Opportunities should be provided for mothers to have skin to skin contact with their babies on Neonatal. * On arrival on Katherine Ward on 10 November 2016, I was not entered in the book and therefore the doctors were not aware I was on the ward. I received an apology from one of the doctors the following morning. This resulted in me not receiving adequate pain medication or my oral antibiotics. My cannula also had to be left in for 24 hours as no one could access my blood results to confirm whether I needed another blood transfusion. I was also misadvised by midwives who clearly did not understand the issues arising from my surgery and advised me to walk to Neonatal. This resulted in me collapsing in the bathroom later that afternoon and having to be advised and supported to use 'labour breathing' as pain control. This negatively impacted on my ability to visit and successfully breastfeed my son. * The delay in receiving oral antibiotics may have contributed to my infection which resulted in me shaking, high pulse and temperature during the visit to my son in Neonatal which again impacted on my ability to bond with a breastfeed my son as I was too poorly to hold him. * In the early hours on 13 November, I asked a healthcare assistant to deliver some expressed milk to my son who dismissed it as 'mainly water' until I insisted that she take it. I did not feel supported in my efforts to express in very difficult circumstances and the only advice I received was how to use the breast pump machine, not how to effectively boost or maintain my supply with it (eg. how frequently and how long to use it). No one checked on my progress or advised me further. I was therefore on the machine for over an hour at a time which impacted on my recovery. It was only later that I was advised that this should have been 10 minutes. * On evening of 14 November, my pain medication was significantly delayed by over 1.5 hours despite 3 separate requests for it. This resulted in me having to take morphine so I could remain mobile which meant my baby could not consume my breastmilk. On several occasions, my pain medication was significantly delayed which negatively impacted on my recovery. * At 6am on 15 November, with no prior warning, a midwife and health care assistant came into my room, put all my belongings on the bed and wheeled it down to Transititional Care. I was half asleep and disorientated, having intended to use that time to express for my sons feed. I was then left trying to sort my belongings (which had accumulated after a stay of over a week) and I was informed that my son would be joining me in 10 minutes and I would then be responsible for his care. My husband was not there to support me and due to my surgery and the subsequent infection, I had spent very little time with my son. This resulted in significant distress which I feel could have been reduced by an explanation of why I was being moved with some urgency and if possible, a short delay so that I could process what was happening. * On morning of 16 November I was provided with my 6am medication at 7am. At the time I was caring for my son and took the tablets without question. By 7.25am I began wretching and was very close to vomiting. I pressed my call button and asked the health care assistant if the midwife could advise what I should do as I suspected there was an issue with my medication. No midwife came to my assistance until the change of shift. There was then discussion as to whether I would need to be removed from the ward and my son returned to neonatal. I had been able to recall a pink tablet being in the medication I had been given, which turned out to be ibruprofen which should have been given in my 8am medications so it could be taken with food. In order to cut a corner, it appears that my 6am and 8am medications had been combined and I had effectively been given a toxic mix on an empty stomach as breakfast was not served until 8am. I view this as completely unacceptable and very easily avoided. If due to time constraints the midwife was unable to visit me at both 6 and 8am then this could have been easily resolved by placing the medications in 2 separate cups and informing me that one cup should not be taken until later. I did speak with the senior midwife prior to my discharge and raised my concerns about my very mixed experience on Katherine Ward. Some of the midwives were excellent but the team is being let down by a few individuals. I was particularly concerned regarding being 'lost in the system' on my first day on Katherine Ward and the issues with my medication - be it delays or the mixing of medication cycles. I was advised by both the senior midwife and the Community Midwife team to put these issues in writing so risk assessments could be reviewed.
My midwife was Nikki and she was fantastic throughout my pregnancy. She kept me informed and answered any questions I had and was very reassuring. I went to the MDAU a few times during my pregnancy and each time I noticed how hard the midwives in there work. It had always been extremely busy when I have been there and they try their best to see you as quickly as possible. I feel like the amount of staff should be reviewed. A lot of the time the delay is waiting for the doctor to sign you off once the midwife has seen you.
The midwives were excellent on this ward. I was lucky enough to have Audrey as my midwife who really helped me with feeding my baby. As I had a C-section, it was really helpful that my husband could stay the night. I would have had to press the buzzer to call the midwife every time my baby needed anything, as I couldn't even lift him out of his cot. Allowing partners to stay is a great idea and I imagine that it allows the midwives to get on with their work. My only issue was the fact that you are forced to have your curtain around your bed open at night. I did not feel comfortable with being in my bed clothes in a room with 4 other couples who I did not know. I felt especially sorry for one girl who was in the ward for one night, as she was not with anyone and was clearly very uncomfortable with the amount of people in the room with a total lack of privacy. This is the only thing that needs changing, it's not appropriate.
I received excellent care from Shannon, Anne and Sylvia. I had been in labour for 18 hours and they were extremely supportive. I had to have a C-section eventually and it was handled very well - I was well informed and felt confident in the care I was receiving.