"Lack of Communication and care"

A year ago my parent entered Fiona Stanley Hospital for gastric surgery to remove a portion of their stomach for adenocarcinoma.  They recovered very well considering the information we were given and was transferred in the middle of the night to Fremantle hospital for 'rehab' after 10 days.  Despite my other parent being present every day and the family coming most days with them, communication and plan was not relayed to us until my parent's move during the night.  

My parents were from the country, staying with us and not easily able to travel to multiple places for care or visiting.  On our arrival, we found Freo were not prepared for a patient so acutely unwell, especially on the weekend, they didn't know how to access my parent's port and did not get them out of bed due to a catheter still being in situ.

We realised my parent was slightly confused which was new and put it down to the late move and lack of sleep. The next morning they were on a mattress on the floor as they told us they were a high risk for falls.  They were extremely confused and unable to eat or drink without help.  They were supposed to be on a grading diet from liquids to puree food etc to slowly get back to normal following surgery. 

My parent continued to go down hill over the following days and the Fremantle medical staff were nothing but kind and concerned and doing everything possible to get them back to FSH due to their acuity and for MRI as they thought my parent had a stroke.  It was during this time we were informed that the medical team at FSH had changed my parent's clexane to warfarin which was never meant to happen. My parent had been on warfarin for over 25 years and was diligent with their levels and care. Throughout their cancer treatment they had been on clexane and was to remain so until treatment completed, 5 months post surgery. I feel this was the contributing factor to 'the stroke'.

My parent was eventually transferred back to FSH again in the middle of the night to await an MRI.

We received the most appalling treatment at FSH from both nursing and medical.  Being a nurse, I asked daily for information and for an MDT to find out what was going on. Some nursing staff were seemingly blatantly rude at this request, others were too junior to assist.  We were told that my parent 'probably' had a stroke but there was no assessment done in regards to their oral intake and if they had a swallow reflex, there was no assessment if they had weakness down any side, they did not get physio, OT, dietician or speech input. 

We were also told it could be delirium from the lack of sleep and moves and major surgery. We were given virtually no information and my parent continued to decline mentally and physically as they were unable to continue rehab.

When my parent arrived back at FSH they were loud, laughing and hallucinating and we were so distressed as this was out of character, to be told they were 'fine' by the nurses and spoken down to like we did not know our own parent. The following day they were virtually unconscious and did not respond at all for the 6 hours we were with them! Despite denials we found out days later my parent had been sedated. They were not being fed or given drinks while we were not present.  Writing this now is so distressing. As a nurse who works full time clinically, this is the worst treatment I have ever had the misfortune to witness and I wish I was more forceful in my concerns at the time.

We waited 10 days for the MRI only to be told they 'put them in the machine and their pacemaker played up". We had been waiting for cardiology to adjust the pacemaker to allow the MRI.  I recall we then continued to be fed information - such as 'there is nothing we can do' 'their pacemaker needs to be removed and replaced as there is a wire loose'.  'they can't have an MRI due to their pacemaker' - despite putting them in the machine and waiting 10 days.  "They are staying at FSH because they are so unwell'.

Again we were called 10pm at night and they were transferred back to Freo 'for rehab'.

My parent continued to be confused and not progressing with rehab due to this.  We experienced compassionate staff and a beautiful team at Freo, however we had no answers as to what had happened, there was now just an assumption of a stroke.  We continued spending 5-6hours a day with my parent as they seemed to make slow progress.  Unfortunately my other parent arrived one morning and they had vomited and aspirated during the night. They called a MET call and by the time my sibling and I arrived, my my parent was agitated and making it clear they did not want interventions.  They were transferred to another services' hospice within 48hrs and died within 36hrs of being there.

So many small events occurred throughout the 6-7 weeks my parent was in hospital that I believe all contributed to their poor outcome, I have only listed a few of the complications and poor treatment. But as a medical professional for nearly 30 years, the experiences we had at FSH on the medical wards were unacceptable and frightening. There was no communication, no consistency, no care at all on these wards. Our previous experience with extended stays in both Oncology and Infectious diseases had been exemplary, I expected nothing less this admission, I was bitterly disappointed. 

My parent was in their 70s, but they were fit and in good health. They recovered from surgery and the outlook was to return to normal life caravanning and doing their gardening.  My parent and our family were completely let down medically, and I believe their death came from incompetence and a lack of care from an overburdened medical system.