Poor communication

There are two main problems that Peter wanted to bring to our attention. The first is about poor communication related to his surgery. The second is poor communication and planning about his discharge home. Both of which have an impact on Peter and his wife.

Poor communication about surgery

Peter was admitted to hospital in September for a radical nephrectomy (removal of his kidney). As Peter was prepared for surgery, one of the doctors came to see him. The doctor told Peter that he had 

  • grade 4 cancer, that 
  • his operation was very risky and 
  • he would not be able to have an erection following the surgery. 

Imagine Peter’s surprise when the doctor asked him if he would be happy with this. Peter was not expecting this information at all.  

Everything the doctor told Peter (just before his surgery) was wrong. The doctor came into Peter’s cubicle, checked his name with him and then explained the operation in more detail. To help him do this, the doctor started to draw a diagram. Peter works in healthcare and suspects that something isn’t right. He asked the doctor if his drawing was of his kidney and the doctor replied, no, this is your prostate. 

Peter informed the doctor forcefully that he was not having an operation on his prostate and explained what surgery he was expecting to receive. The doctor apologised and explained that he had swapped surgery with another consultant and had the wrong patient (despite asking Peter to tell him his name). The doctor then left the cubicle.  

Thankfully, Peter did receive the correct surgery and his operation went well. 

Poor communication and planning prior to discharge

Peter was unable to have his operation in a hospital closer to home. This meant that his wife had to drive further to visit him and bring him. The furthest his wife ever drove was to the local supermarket and back. She was not used to driving at night and on unfamiliar roads. So, as you can imagine, this was somewhat stressful for her.

Now comes the day of discharge. Peter was advised mid-afternoon that he would likely be discharged home that evening. Before he could go home, the doctor just wanted to check his latest blood results were okay.
However, some confusion about his blood results meant the doctors delayed his discharge. By now, Peter was just desperate to go home.

When Peter was discharged home, he was told to ring his GP if he had a problem. The nurse gave him a selection of dressings to go home with for his wound.

However, Peter and his wife (in their early seventies) would have liked further reassurance that there was some continuity of care in the community. He had received major surgery after all. There didn’t appear to be any, though.

Peter believed that they were generally active pensioners, so they fell between the gap when assessed for additional care support at home. Consequently, significant pressure was put on Peter’s wife to care for him and she became exhausted.

Although we hear of ‘joined-up care’ between hospitals and the community, Peter did not experience this. Rather, the opposite seems to be happening. As Peter says,

‘streamlining resources becomes a series of escalators, designed for speed and efficiency, but not necessarily best practice or in the patient’s best interests.’

What can healthcare professionals learn from my experience?

My operation went well, but the hospital ward was very disorganised. I was kept in the hospital an extra night because I had a long journey home, but we waited too long the following day to go home. The junior doctor was concerned that my blood results were poor that day when in fact, no one had taken my blood. Finally, a very good staff nurse and another doctor sorted the problem out. I had a blood test and was discharged home. However, the delay meant I was not discharged home until 9 pm that night. It was too late. Discharge plans need to be in place and patient circumstances must be considered.

What do you want other patients to learn from your experience?

My wife went to the GP surgery the following day to ask for ongoing care. She asked the receptionist if there was any continuing care for me and was told no. We were on our own. We have no family, live in a small hamlet and the nearest shop is 3 miles away. We are both retired NHS workers. If you think you are going to need help after a major operation, please bear all of this in mind and explore who might be able to support you.

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