"Staff ratios, patient monitoring and record keeping"

After my family’s experience recently, we had hoped never to step foot in FSH again. Unfortunately my parent became extremely unwell this week and presented at the ED in their home town. It was decided they needed to go to FSH for further treatment. They were helicoptered to FSH ED. Apparently it was the only option (my other parent had requested anywhere but FSH).

I rushed from my home in the country to meet my parent at the ED. We spent 4 hours there and it was much like other ED experiences we have had at other WA hospitals with various family members. They get the job done, I can’t fault them. Go ED.

In the evening it was decided my parent was going to ward 5a AMU. We got upstairs about 2 hours later along with at least 4 other people coming up from ED. Why so many people would be sent up right before shift change baffles me and I think added to the chaos. My parent was left alone in their room for 1.5 hours with not a nurse to be seen. In my opinion, there was total chaos on the ward - mind you this is the ward where I believe they put the infectious cases: Covid, c.diff, norovirus - I worried staff were not having time between patients for infection control procedures. We had been told the critical treatment for my parent was fluids and monitoring urine output. Their fluids had been disconnected for the room transfer and nobody came to reconnect. We asked multiple times for help but it was shift change so no help to be found. My parent had to toilet multiple times and what came out was supposed to be monitored but no staff had time.

Eventually a nurse on their way home came and reconnected my parents fluids. 2 hours after arriving on the ward, my parent's nurse came to ask all the admission questions. I felt it was not safe for me to leave my parent there until this had been done and I had raised my concerns. An hour later I left for the night.

I returned the next morning with my sibling. We both are healthcare workers and feel we don’t have unreasonable expectations of patient care. We understand staff are busy but what we witnessed in ward 5a is, in my opinion, unsafe conditions for nurses and patients. For 3 days in that ward we did not see a nurse unless we called the bell and even then sometimes it took 30 minutes. My parent was not offered towels or assistance to have a wash - we had to ask for supplies and assist our parent. This is not easy when the patient is hooked up to fluids and devices, you need to know what you are doing. If we had not been there, I believe my parent would not have had a wash in 3 days.

We were present for Doctor’s rounds and knew what treatment was ordered. My parents fluids ran out in the morning and they did not get a new bag for 3 hours despite my sibling reminding staff over 6 times. This is absolutely critical for acute kidney failure treatment. My parent consented to a basic procedure that nurses do every day that was important for monitoring of urine output at 10am and it did not get done until 4pm, during the time they waited no output was recorded at all. My sibling recorded oral fluids themselves, because nurses were nowhere to be seen, then was chastised by the Dr as “they don’t work here” - well what other option did we have?

I believe that patient care is severely compromised in ward 5a and the acuity of patients is too high for the nursing ratio. All staff interactions we had were positive, they are just stretched way too thin to care for the complex needs of critically ill patients in my opinion. My family decided our parent could not be left alone in that ward as we believed it was unsafe and we were required to assist them and advocate for their care.

We were also concerned about our parent catching Covid in that ward as we do not believe staff have time to undergo infection control procedures between patients and we saw overflowing bins of PPE right outside our parents door, we also all have small children at home and we’re concerned about passing on an infection to them. 

Recently my parent was moved to ward 6c and things seem much better. Basic stuff like the nurse popping their head in every so often to check on their patient, towels being provided, input/output being correctly recorded etc. this is basic stuff! I don’t feel like this is an unreasonable expectation!

Medically the Doctors are being very thorough and we appreciate that.

I made my concerns know to patient advocacy and my parent was visited by the nursing unit manager, but I get the feeling the situation in ward 5a is ongoing.

I’m very disappointed in my parents treatment on ward 5a.