Hospital wards

[Andrew2018]

I have just been in hospital for non diabetic elective surgery and noticed several diabetic issues and wondered about the experience of others in this regard?.
1) The Ward Dr's insisted on wanting to access GP records for my dose rates despite repeatedly being advised I am under a Consultants Clinic, the one at their hospital, even naming the Consultant.
2) Dr's clearly seemed to think dosage was something fixed, as in 12 units with every meal etc. No idea about carb counting.
3) Hospital food, where menu gives no carb details at all, and prepack foods such as jelly just come marked "contains fruit juice and sugar", so ones meal dose cannot be established except by guesswork once food arrives. ( I run on Novorapid and Levermir).
4) The ward testing for their records is done too far before meals, as in 1 1/2 hours before.
5) A request for a test at 3 am was not welcomed by night staff, who then thought a reading of 4 was OK. They reluctantly accepted that to me this was too low, ( it'd have been a full blown hypo within an hour in my experience ), but had no idea what to provide, or, it seemed interest, nor did they come round later to check again ( breakfast was several hours away )

Things got better once I was able to access my own meter ( I was too rough after surgery to leave bed and find it for 48 hours !), though one perpetual irritation is that no matter how often it's explained, they put me down as Type 2, despite my clinic records giving me as Type 1. Even my GP has done this, even after being told specialist clinics and Consultants all state very clearly I have been Type 1 since the onset of diabetes. ( went from a sugar intolerance controlled by diet, to full on Type 1 very suddenly, ie the insulin production stopped dead very suddenly at 35. The fact I am on Metformin seems also to confuse, it's there to overcome resistance to insulin, not promote production.
Be interested if this is a common experience or if our local NHS has more issues than the surgery I underwent !

 

[NaijaChick]

This is extremely scary. Please can I ask you to write all your issues down and send to the head of nursing ASAP. This shows a clear lack of diabetes education on the part of the nurses.

 

[kitedoc]

Hi @Andrew2018, I have witnessed some similar things years ago. One would think that with so-called better university training of nurses and doctors that things would have improved. (and I am talking about Australia)!!
I put it down to the the education system which encourages rote learning, lack of problem-solving, inflexibility and not being allowed to think or act 'outside the square'. That in turn reflects on the attitudes not only of University lecturers but on the hospital system which is supposed to be part of under-graduate and post-graduate HCP education. And for each profession that also reflects on hospital educators, registrars and consultants etc.
The only glimmer of hope I have seen in all this, in Australia at least, in that there is a growing emphasis on the community being involved with the standards of hospital accreditation, members of the community being invited in increasing numbers onto hospital working parties and thus having the ability to influence hospital policies, provide feedback and even be invited to speak with under-graduates and post-graduate HCPs about their experiences as patients, as diabetics and so on. Health consumers as an impetus for change is gathering some momentum despite State Government attempts to reduce funding to such groups!!
It is a slow path however as HCPs are notoriously resistant to such notions. Overcoming inflexibility is a challenge !!
The other way that patients, health consumer hold some sway is that all Government-funded health research projects now require community involvement from the beginning to right throughout the research design and implementation in order to attract funding. I live in hope !!! Do such incentives for community involvement in hospital policy, HCP education policy and in research exist in the UK ?

 

[DavidGrahamJones]

I have just been in hospital for non diabetic elective surgery and noticed several diabetic issues and wondered about the experience of others in this regard?.

Welcome to the forum. I hope you have a speedy recovery. I have experienced some of the things you have noted in the UK.
1) I had 3 major surgeries between November 2014 and January 2016. I am not on insulin but all my other medication was discussed at my pre-med. It's worrying that they should want to look at any records for doses, I'm no expert but doses would depend on your diet. They must have been totally convinced that you were type II. My father and a cousin are insulin dependent and don't carb count, it has never even been discussed with their doctors.
2) They really were convinced you were type II.
3) If it wasn't so serious it would be funny. For type I patients it's essential. They seem to be keen to cater for everyone's allergies but not so careful about diabetics. Even as a type II I had to make do with whatever was on offer minus the carbs.
4) I'm not making excuses but it looks like one is expected to suit their routines and not individual routines.
5) Inexcusable, not sure why asking for anything at 3am is a big deal, depends on the ward I expect. My NHS experience on a ward with 6 lots of groups of 4 beds was that there seemed to be only 2 nurses on duty and one of those was very junior, inadequate in my view, but that's another story.

It's important that you document your concerns, you might have survived but . . . . . . You should also write to your consultant and ask why weren't your notes available to the doctors on the ward. You have expressed your concerns on this forum and we can all commiserate but you should document your concerns and write to the hospital and your consultant separately. The Patient Advice and Liaison Service is a good place to start. I have found them to be very helpful when I had concerns regarding my mother's treatment some years ago.

All the best.

BTW They won't change their ways unless we tell them.

 

[Dark Horse]

I have just been in hospital for non diabetic elective surgery and noticed several diabetic issues and wondered about the experience of others in this regard?.
1) The Ward Dr's insisted on wanting to access GP records for my dose rates despite repeatedly being advised I am under a Consultants Clinic, the one at their hospital, even naming the Consultant.
2) Dr's clearly seemed to think dosage was something fixed, as in 12 units with every meal etc. No idea about carb counting.
3) Hospital food, where menu gives no carb details at all, and prepack foods such as jelly just come marked "contains fruit juice and sugar", so ones meal dose cannot be established except by guesswork once food arrives. ( I run on Novorapid and Levermir).
4) The ward testing for their records is done too far before meals, as in 1 1/2 hours before.
5) A request for a test at 3 am was not welcomed by night staff, who then thought a reading of 4 was OK. They reluctantly accepted that to me this was too low, ( it'd have been a full blown hypo within an hour in my experience ), but had no idea what to provide, or, it seemed interest, nor did they come round later to check again ( breakfast was several hours away )

Things got better once I was able to access my own meter ( I was too rough after surgery to leave bed and find it for 48 hours !), though one perpetual irritation is that no matter how often it's explained, they put me down as Type 2, despite my clinic records giving me as Type 1. Even my GP has done this, even after being told specialist clinics and Consultants all state very clearly I have been Type 1 since the onset of diabetes. ( went from a sugar intolerance controlled by diet, to full on Type 1 very suddenly, ie the insulin production stopped dead very suddenly at 35. The fact I am on Metformin seems also to confuse, it's there to overcome resistance to insulin, not promote production.
Be interested if this is a common experience or if our local NHS has more issues than the surgery I underwent !

It's worth complaining to the hospital - the NHS encourage this as it gives valuable feedback about how processes can be improved. https://www.nhs.uk/using-the-nhs/about-the-nhs/how-to-complain-to-the-nhs/

 

[KK123]

Hi there, my type 1 Mum was in and out of hospital for years. I can tell you without hesitation that the hospital was not able to look after a patient's diabetes properly, even in the diabetic ward. You mention tests being done an hour before dinner, yep, regularly. Sometimes it was done an hour after dinner, insulin was NEVER done on time and sometimes it was missed out altogether. I could write you pages of their mistakes. Someone mentioned you having to fit in with their schedule, how disgusting is that when you have a condition that REQUIRES insulin to be given within a certain time of a meal to try and stay healthy and er….not die, especially when you are at your weakest in a hospital. My sisters and myself visited my Mum practically every day and the first thing we did was look at her notes, find a Nurse and discuss her medication and what she had been given and when. If that wasn't satisfactory, we sought out the Sister, EVERY time and discussed it with her. That meant a lot of waiting around and we made sure we were there when the Consultants came round and discussed it with them as well. We visited at meal times (even though they discouraged it) and fed our Mum ourselves some of the time, she had the beginning of dementia and was given insulin and left to eat her food on her own which she didn't half the time. My advice is to complain and if necessary, make an official complaint, that did improve matters a little, they used to see us coming and rush to give us an update. Remain interested and polite, ask to see your own notes, make a point of writing down everything they say to you whilst they can see you doing it. I know it sounds ott, but the Nurses (who are lovely) do not have a clue about how to treat a diabetic patient in relation to amounts of insulin required, when it's required and how it actually works. x

 

[kitedoc]

Hi there, my type 1 Mum was in and out of hospital for years. I can tell you without hesitation that the hospital was not able to look after a patient's diabetes properly, even in the diabetic ward. You mention tests being done an hour before dinner, yep, regularly. Sometimes it was done an hour after dinner, insulin was NEVER done on time and sometimes it was missed out altogether. I could write you pages of their mistakes. Someone mentioned you having to fit in with their schedule, how disgusting is that when you have a condition that REQUIRES insulin to be given within a certain time of a meal to try and stay healthy and er….not die, especially when you are at your weakest in a hospital. My sisters and myself visited my Mum practically every day and the first thing we did was look at her notes, find a Nurse and discuss her medication and what she had been given and when. If that wasn't satisfactory, we sought out the Sister, EVERY time and discussed it with her. That meant a lot of waiting around and we made sure we were there when the Consultants came round and discussed it with them as well. We visited at meal times (even though they discouraged it) and fed our Mum ourselves some of the time, she had the beginning of dementia and was given insulin and left to eat her food on her own which she didn't half the time. My advice is to complain and if necessary, make an official complaint, that did improve matters a little, they used to see us coming and rush to give us an update. Remain interested and polite, ask to see your own notes, make a point of writing down everything they say to you whilst they can see you doing it. I know it sounds ott, but the Nurses (who are lovely) do not have a clue about how to treat a diabetic patient in relation to amounts of insulin required, when it's required and how it actually works. x

just imagine if each time they visited they wrote in the notes. That is a great way to get attention to deal with the problems !!

 

[Andrew2018]

Thanks everyone. Glad, but sad and angry it seems to be more than just me !. Without going into great detail, I will be chasing this up with the Trust, because on the surgical front I was subject to a major surgical error, which none of the medics have owned up to, but the qualified nurses and theater team all kept dropping hints as hard as they could without risking their necks, with the theater team confirming I came out of anesthetic screaming, and yes, had to be put under for rapid corrective measures, the urologist had missed the fact he had perforated my bladder and flooded my abdomen with saline when flushing the bladder. Net result a basic procedure I have had before evolved from a two day stay into 6 days, ongoing pain and a pubic catheter for the next 4 weeks minimum. Not one Surgeon has admitted a problem, but none told the same tale either...... The only surgeon not seen, the one responsible. I am likely, much as I hate it, to take litigation.

 

[KK123]

Thanks everyone. Glad, but sad and angry it seems to be more than just me !. Without going into great detail, I will be chasing this up with the Trust, because on the surgical front I was subject to a major surgical error, which none of the medics have owned up to, but the qualified nurses and theater team all kept dropping hints as hard as they could without risking their necks, with the theater team confirming I came out of anesthetic screaming, and yes, had to be put under for rapid corrective measures, the urologist had missed the fact he had perforated my bladder and flooded my abdomen with saline when flushing the bladder. Net result a basic procedure I have had before evolved from a two day stay into 6 days, ongoing pain and a pubic catheter for the next 4 weeks minimum. Not one Surgeon has admitted a problem, but none told the same tale either...... The only surgeon not seen, the one responsible. I am likely, much as I hate it, to take litigation.

Hi Andrew, sounds awful. We all know Surgeons do a brilliant job most of the time and they are good people etc, but when a mistake is made they should own up well before litigation stages. I do wish they were open about it (I know as individuals they probably can't) but administratively they should. I would make an official complaint first as then they are obliged to look into it and provide you with an initial response as to what happened. x

 

[kitedoc]

Hi Andrew, sounds awful. We all know Surgeons do a brilliant job most of the time and they are good people etc, but when a mistake is made they should own up well before litigation stages. I do wish they were open about it (I know as individuals they probably can't) but administratively they should. I would make an official complaint first as then they are obliged to look into it and provide you with an initial response as to what happened. x

A number of hospital such as in Australia have an 'open disclosure policy' where mistakes such as you describe are admitted in full frankness to the patient. Strictures to practice and disciplinary action can occur if this policy is not followed.
It may be worth chasing up whether such a policy exists in the NHS and/or the Health Trust the hospital resides in.

 

[Bluetit1802]

My sisters and myself visited my Mum practically every day and the first thing we did was look at her notes

You were lucky you could see her notes. When I was in hospital on 2 occasions I was not allowed to see mine. They were kept in a file at the nurses station. On one occasion I was being wheeled for an X-Ray. The porter put my file on my knee. Of course I opened it and started to read it until he stopped to speak to a nurse who immediately took the file away from me and told me off, very firmly. I did ask about this later and was told that in order to see my notes I had to apply through official channels via admin.

 

[donnellysdogs]

Not the only one, begged for glucose to be turned on before 2 breast cancer ops and both had nurses that didn’t have a clue. One hospital totally ignored me and walked me to theatre totally hypo and under 2 when I asked to test on the operating table. Ended up with me swearing at the surgeon telling him he was going to kill me and having a full nasty hypo before passing out.
2nd hospital fortunately I had my diabetes nurse/educator with me who went berserk at the ward nurse when she didn’t know what to do 30 mins before my op. Ended up with me eating 2 sugar cubes and the Ward nurse screaming at me that the operation would have to be cancelled and she would have to tell the anaesthetist... op still went ahead!!!

They had absolutely no idea on the wards.

1st hospital had a huge complaint put in (horrendous all round for treatment) to the CEO via PALS who were also hopeless due to change of staff.

 

[Seacrow]

The nurses on the wards I've been on generally have no clue. Horrifyingly, in 2009, I was admitted for a kidney stone and found out that the nurses on nights thought injecting insulin was the right treatment for a hypo. I kicked up a real fuss over that.

More recently, the nurses said that rules on patient medication have changed. All medicines MUST be surrendered to the ward staff. I showed them my insulin pump and said, good luck with that.

 

[Rockie123]

I have just been in hospital for non diabetic elective surgery and noticed several diabetic issues and wondered about the experience of others in this regard?.
1) The Ward Dr's insisted on wanting to access GP records for my dose rates despite repeatedly being advised I am under a Consultants Clinic, the one at their hospital, even naming the Consultant.
2) Dr's clearly seemed to think dosage was something fixed, as in 12 units with every meal etc. No idea about carb counting.
3) Hospital food, where menu gives no carb details at all, and prepack foods such as jelly just come marked "contains fruit juice and sugar", so ones meal dose cannot be established except by guesswork once food arrives. ( I run on Novorapid and Levermir).
4) The ward testing for their records is done too far before meals, as in 1 1/2 hours before.
5) A request for a test at 3 am was not welcomed by night staff, who then thought a reading of 4 was OK. They reluctantly accepted that to me this was too low, ( it'd have been a full blown hypo within an hour in my experience ), but had no idea what to provide, or, it seemed interest, nor did they come round later to check again ( breakfast was several hours away )

Things got better once I was able to access my own meter ( I was too rough after surgery to leave bed and find it for 48 hours !), though one perpetual irritation is that no matter how often it's explained, they put me down as Type 2, despite my clinic records giving me as Type 1. Even my GP has done this, even after being told specialist clinics and Consultants all state very clearly I have been Type 1 since the onset of diabetes. ( went from a sugar intolerance controlled by diet, to full on Type 1 very suddenly, ie the insulin production stopped dead very suddenly at 35. The fact I am on Metformin seems also to confuse, it's there to overcome resistance to insulin, not promote production.
Be interested if this is a common experience or if our local NHS has more issues than the surgery I underwent !

Hi Andrew this is an interesting read and I have often found when I have been in hospital that its scary when staff seem to know so little about type 1 diabetes eg I am on novo rapid and Levemir but on several occasions in hospital I was brought Novo rapid at night time instead of Levemir. I was scared stiff at the thought that a nurse didn’t know the difference but even more scared that if I hadn’t had my wits about me they would have given it to me and I would have been dead in a short space of time. I’m sorry about your experience. I think training about diabetes needs to be implemented with nurses and Drs. Keep well. Carolyn.

 

[JohnEGreen]

When I was first diagnosed with MG non of the nurses and some of the doctors knew almost anything about it I got so fed up with having to explain it to them all the time I arranged for a load of leaflets explaining the condition giving info on does and dont's when dealing with the condition and left them on the nurses station on the ward and spread them around some of the other wards may be an idea when hospitalised to take some explanatory leaflets and such and leave them where staff can pick one up and read and learn.

 

[PenguinMum]

I am shocked by these experiences above and I seriously think they should all be joined up and sent to the Secretary of State for Health especially as its not all happening (I assume) in one failing trust. On a less serious note in two separate hospitals I been given wrong doses of tablets I brought in though luckily I was with it enough to point it out in time, the other one locked up my meds and I went without for 3 days until I came out of High Dependency and was compos mentis to ask for them. This caused me a lot of pain quite separste to the surgery. I must admit I often wonder how many of these mistakes happen with vulnerable elderly who have noone to check up on them.

 

[bulkbiker]

I know I'll be in a minority here but why do we give the NHS such leeway?
We hear quite a few tales of appalling treatment, mistreatment and misdiagnosis here but we seem to let them all off the hook.
Have we been brainwashed into the its "Our" NHS mindset that we can't see that it is simply not fit for purpose.
In cases of acute conditions it seems ok but give it something in the chronic field and there seem to be a comedy of errors except that for most of us they really aren't all that funny.
I'll go back under the bridge now....

 

[PenguinMum]

I know I'll be in a minority here but why do we give the NHS such leeway?
We hear quite a few tales of appalling treatment, mistreatment and misdiagnosis here but we seem to let them all off the hook.
Have we been brainwashed into the its "Our" NHS mindset that we can't see that it is simply not fit for purpose.
In cases of acute conditions it seems ok but give it something in the chronic field and there seem to be a comedy of errors except that for most of us they really aren't all that funny.
I'll go back under the bridge now....

I agree with you and I did point out my mistakes which werent life threatening to the sister in charge. In both cases they dismissed it and said how super busy the nurses were. The real problem I think is when you are in a hospital environment after major surgery you feel very vulnerable and not physically able to fight the fight. When you recover you just want to close the door on that episode of your life. I am as guilty of that as anyone.

 

[Bluetit1802]

We hear quite a few tales of appalling treatment, mistreatment and misdiagnosis here but we seem to let them all off the hook.

When I was about to start chemo I had to see the oncologist to be told which chemo regimen I would be on, and to sign the consent forms. It was the registrar that I saw. As soon as I was home I looked up the protocol for people in my situation (the oncology department of my hospital put PDF's on line with all this information). I saw immediately it was the wrong regimen for me. I contacted the chief oncologist, he went through my files, and changed it to the correct one. He destroyed the consent forms and issued me with new ones to sign.

So I didn't let the registrar off the hook, and I believe he was in trouble for his mistake. I could have been in worse trouble had I not been proactive enough to check matters and take it further. From that day onwards, I have checked every single thing. Knowledge is power and all that.

 

[becca59]

I know I'll be in a minority here but why do we give the NHS such leeway?
We hear quite a few tales of appalling treatment, mistreatment and misdiagnosis here but we seem to let them all off the hook.
Have we been brainwashed into the its "Our" NHS mindset that we can't see that it is simply not fit for purpose.
In cases of acute conditions it seems ok but give it something in the chronic field and there seem to be a comedy of errors except that for most of us they really aren't all that funny.
I'll go back under the bridge now....

Not in a minority, I agree. We should always question and stick up for ourselves. Pre diabetes (luckily) in my younger years I stood up and told a registrar to get out of the consulting room and fetch a consultant immediately. He had inferred there was nothing wrong, that I was an hysterical woman due to the fact that I had had a recent miscarriage. That I needed to go home and grieve quietly. Within a few hours I was on the operating table with an about to burst, as big as an apple, ovarian cyst. NEVER not question if you feel unhappy!