A Tale of Two Hospitals, disparity of care in the Irish Health Service

by - Wednesday, August 01, 2018

If you have read any of my previous blog posts, you may have gathered that I have a lot of experience of hospitals. Between Síomha's Ulcerative Colitis and my Carotid Artery Dissection we have clocked up a huge amount of hospital hours between us. Síomha more so, as her condition requires constant treatment and she has attended Naas hospital up to this point (where I also attend).
This is a slightly different post than usual as I now have experience of a brand new hospital and it has just thrown into light how much the care in Naas hospital is negligent and poor, to an extraordinary degree.
When I refer to care, I'm referring to the entire process, from first interaction with reception, right through to actual medical care by doctors and nurses.
The care in Naas hospital this year, in particular, has been atrocious. Two A&E admittances for Síomha, in both cases left on a chair unattended for hours whilst urgently needing care. Not once, but twice, she was incorrectly assumed to have the vomiting bug and assigned to general doctors instead of the gastro specialist whom she has literally been seeing for years. The first mistake led to her being discharged prematurely (which we thought unusual at the time but sometimes you just have to trust to the medical professionals when you don't know any better). She became incredibly ill at home, at one point literally barely having the energy to walk. We had to go to the K-Doc out of hours clinic and were told at that point to go back into A&E. She was AGAIN mistakenly assumed to have vomiting bug and was put into a cubicle with a contagious sign. (Which frankly was a good thing because otherwise she would have been lying on a trolley in a dangerously overcrowded A&E treatment area).  It was only when she was asked a couple of questions by the nurse that I copped on that the mistake had been repeated. They were also working off a tiny chart instead of Síomha's huge tome of medical information based on all her previous treatment.
After Mark complained, a bed was found for her and she commenced the treatment that should have been given in the first place. The gastro team was still not informed that she was there and literally found her by accident because they recognised her! This was after being told twice that they would be informed of her presence.  We then had to literally fight to get her provided with food that she could actually cope with. Despite her writing out what she was able to digest (quite limited admittedly, when she is in a flare up), it was ignored by catering staff and Síomha was reduced to tears by their uncaring attitude. Again we had to complain and try to keep her fed by bringing in food and doing our best to ensure that she could actually eat some of the food provided.
Unfortunately, one of the difficult things about Ulcerative Colitis treatment is that steroids are the go-to drug to bring down inflammation. An adverse effect of steroids is extreme mood change and this has been an issue for Síomha which has gotten worse each time she has been prescribed steroids. Now this is a well known effect of steroids and should be taken very seriously - here is a link with some info: Psychiatric Adverse Effects of Corticosteroids. Yet again there was a battle for this to be acknowledged and helped. At no point did we feel that we could relax our vigilance and just trust to getting adequate medical care in the hospital.
I also had my own recent experience of poor care in Naas hospital. I had to re-attend recently due to having issues related to my previous Carotid Artery Dissection. I had a very brief appointment after the usual lengthy wait and I was baldly informed that I may have had another dissection. To be honest, it was quite a shock and I could have done with a gentler approach! I was also scheduled for an 'urgent' scan but the scan appointment when it finally arrived was September. I had been given a clinic appointment that was to occur before the scan. This obviously made no sense so I had to ring up and change the clinic appointment for after my scan. When I tried to ring and find out if the scans (MRA and MRI) were to be done with contrast (or dye) because I thought this might give a marginally better picture, I spoke to an admin member of staff who couldn't help and told me I would have to go through the doctors. When I asked to speak to one of my doctor's team, I was told he had no team and was away for two weeks so there was basically not one person who could help or give me information.
For all the years we patiently put up with this treatment, I assumed somehow, that this was the norm in Irish hospitals - until this year. Síomha had to attend Kilkenny for a broken hand earlier this year and has just been admitted again with an infection related to her Ulcerative Colitis.  Both times I was with her and experienced the excellent care there. Not only the speed with which Síomha was seen to, but the kindness and gentle approach of the staff in informing us and answering my questions without making me feel like a nuisance. Yesterday we were waiting for some time but on 3 different occasions, someone came out and gave us information.  When I was told that Síomha was to be admitted, I mentioned the steroids and I was listened to, and taken seriously, and the doctor who came to see Síomha, once she was in her cubicle, actually asked if it was ok to administer the steroids. Again everything was explained and every time someone spoke to us, we were asked if we had any questions. It seems like a basic thing, but anyone who has been in hospital or dealt with a serious illness, knows how hard it can be. You feel extra vulnerable when you are sick and from my perspective, both as a patient and a mother, I appreciate so much any kindness, because it helps lift the burden a little. For Síomha, little comforts like having proper curtains around the bed and soft blankets make a huge difference. And even better, she asked for vegetarian food without being made feel like she was just being difficult.
Síomha herself has observed that the whole atmosphere and attitude of the staff in Kilkenny is world's apart from that in Naas.  I can't begin to speculate why that might be but I am profoundly relieved that she can now see a gastro specialist in a hospital where patients are treated like human beings and are actually looked after, not just in terms of direct medical care, but also in terms of psychological welfare.

Síomha can't believe how well she is being looked after! :)

Cheerful Curtains!

An actual screen, no horrible worn out curtain!













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