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Self control in hospital

S

sninge

Well-Known Member
Messages
120
Location
Charlwood, Surrey
Type of diabetes
Type 1
Treatment type
Pump
To cut a very long story short my father who is type 2 on insulin is in hospital with late stage 'Copd' having had a chest infection, on steroids and because 10 days ago after being addmitted he had a couple of hypos he was unaware off his humalog 40 units at mealtimes was stopped and he was left on just humalin I twice a day, after realising his sugars were now far to high they have put him on 10units mealtimes, I live 350 miles away, arrived yesterday to take him out for couple of hrs but he wasnt allowed to leave the ward as sugars were 33!! I have been type 1 for 35 yrs and the problem is black and white but they wont listen, never felt so frustrated/angry in my life but what I want to know is if there is any protocol/ document form I can produce to allow my father to have his pens back and take control of his own insulin, I have photographed his notes that show it took 55mins before they gave him insulin after a reading of 'hi'. They allowed him to eat treacle pudding at lunch yesterday despite his sugars being 23 before and the type 2 nurse working there told me she wouldnt have been able to say no either, I could scream and yes I have cried!!!
 
What country are you and your father living in?
And what else are they feeding him?
Has his long acting insulin been adjusted also?
 
kitedoc said:
What country are you and your father living in?
And what else are they feeding him?
Has his long acting insulin been adjusted also?
Click to expand...
We are in uk, im in Surrey and my father Cumbria. They have halved his eve humalin I at night and kept his am the same!
 
You can put in a complaint to pals .
 
Can you get in touch with his usual diabetes team? They may be able to assist and advise the ward.
I know my team does ward visits.
 
Xsorry to hear about what is happening to your father.
Being in Australia i am not au fait with legal and health procedues over there. I am hoping that someone like @Cumberland might be able to help.
As a general suggestion, not advice or opinion:
1) Could you ask staff if there is a disbetes specialist involved with your father's care and if so, request and require a meeting with him/ her?
2) If there is no diabetes specialist involved then ask, request, require to see the doctor in charge of his care.
1) or 2) are designed to get to the bottom of what is happening to your father's diabetes care and see it overhauled
3) also work out who your father has as his representative, power of attorney/ legal proxy to nanage his health needs if hecwas rendered unable to do so himself. He may have named you or someone else, ideally that arrangement is in place or may need to be done in case you need to move to step 4)
4) if no joy with 1) and 2) above, consider whether you are willing to write your factual concerns about and factual account of your attempts to addreess your father's diabetes management. You would be writing as a concerned relative and ? Proxy/ next of kin etc. In his medical record (EDIT)
I hope things can be sorted about your father's insulin and dietary management without having to resort to 4), but there is a saying about health record notation, 'If it is not written down, then it did not happen'.
Hopefully others on yiur side of thevworld have other suggestions as well.
I wish you all success for your father's health and ask you to take care with your own health at this trying time.
 
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helensaramay said:
Can you get in touch with his usual diabetes team? They may be able to assist and advise the ward.
I know my team does ward visits.
Click to expand...
This was the advice from his dsn!!!!!!!
They were advised to give him just 4 units to correct the 30 reading despite him.being so resistant, needless to say within 2 hrs in rose to 33!!!!
He just wants/needs to choose his own doses but dont know how to get them to let hin, he usually adjusts his own insulin but had dementia type symtoms on admission but is now back to himself!?
 

Sninge, are you with him at the moment, or at home? Is it fair to assume that your father is as concerned as you are? Did he choose the treacle sponge, or whatever it was?

If you are there, and can be there tomorrow, there's something to be said being present.

In your shoes, I would intend to be at the hospital tomorrow morning, and ask to speak with your father's doctors, and offer to wait until that happens. You can certainly follow up with your concerns in writing, but knowing how slowly the NHS sometimes works, it could take a week to have a written submission acknowledged, never mind any reparative actions to be put in place.
 
I would say email the PALS team immediately and tell them that you want to make a formal complaint. Explain the issue and ask how they suggest you get your father treated correctly. Tell them you intend to go the local paper with the issue if you don't get a reply from them tomorrow morning. (If you get a rapid and sensible response, the threat may be enough.)
Meanwhile get the info as to who his consultant is from the ward. You should be able to get this without a problem as it's not confidential. Demand an urgent appointment to see the doctor on the ward asap and tell the ward staff you've contacted the PALs team. In addition, ask to get your father checked for mental competence.

(Added: This is necessary because they need to acknowledge that the dementia symptoms have passed before they will let him take any decision himself.)

If you just turn up with no appointment, in my experience it is unlikely you will get to see any doctor the same day, but if you tell staff where you have travelled from they may allow you in outside normal visiting times. This might allow you to monitor what is going on.

Why did your father choose Treacle Sponge ? Does he understand that that was extremely unwise as they won't give him more insulin to bring his levels down ? What understanding of his current condition does he have ? What are his blood sugar levels like normally ?
 
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sninge said:
Thank you, will have a look and def be a letter of complaint, not sure where best to send it and probably just be sent a pack of lies in response!! I have taken photos of his notes as evidence!
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Good move, keep it. The case in my link, even though the family had pointed out several times that insulin was not being given correctly, they were ignored, so any evidence you have is valuable.
 
sninge said:
Thank you, will have a look and def be a letter of complaint, not sure where best to send it and probably just be sent a pack of lies in response!! I have taken photos of his notes as evidence!
Click to expand...
Did you look at the link I posted for you? It's definitely worth a read through before you take your next step, it's all the protocols for insulin administration in the Cumbria Health Care Trust and there is a bit about patients being able to administer their own insulin.
 
Wow!! Just read it, oh so similar! Heart breaking story, will show nurses later!!
Was allowed to take him out this pm, today they didnt insist on blood test before he left, he tested an hr after we left and it was 22, couldn't correct as they have all his pens so told them on return, the 3 nurses acknowledged my comment but stayed at their desks, told them when I left it was now 23, had to leave then but as he was about to have tea hope they injected him but im sure it wouldn't have been any more than mealtime insulin so instructed dad strictly no carbs! Going back shortly so will ask consultant and dsn names ready for complaint!!
 
He chose to eat the pudding himself!!! I know, not a wise move!! Trouble is on his usual 40 units he may have got away with it but not on 10units and sugar levels of 23 before lunch, I doubt v much the nurses even told him it was 23 and with a type 2 nurse on duty makes it even more shocking they didn't advice him not too!!
 

Not all of Cumbria are covered by Cumbria Healthcare Trust. Kendal and Barrow are lumped in with Lancaster and I think it’s called Morecambe Bay. I’ll check and come back.

Carlisle covers a lot of the rest, but I think the west coast are separate

Googling the actual hospital is the best bet as this takes you to the umbrella trust first.
 

Sninge, I have recently been involved in commenting on some new guidelines for inpatient care for people with diabetes (pwd), here. Policy seems to be that PWD are offered the full menu, and whilst not encouraged to eat sugary foods, they make their own choices.

I breathed an inward sigh when I read that patients requiring GF diet could go to an a la carte option. Yes, I'm GF. I rarely look on that as being a big win, but I'll take it in this instance.

On a serious note, your challenge may be a round the confusion your suggest your father had on admission. Of course, confusion can be a sign of infection, dehydration or imbalanced electrolytes, as well a other worrying things.
 
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The west are covered by Carlisle
 
I'm very sorry to hear about your situation. I was wondering if there was a chance your father has any backups at home? Would it be going against hospital rules if you were to bring his backup pens and insulin to him? I think that would be better than the hospital administrating his insulin. I find it strange when I was in hospital a long time ago, the hospital told my mum to bring my pens into the ward. They couldn't afford to give me pens from their stash. what about the possibilities of you bringing food to him that would be better than him eating off the hospital menu? Like some low carb food items and some hypo treatments. I agree with everyone to write a formal complaint to PALS, it is unacceptable that your father doesn't have control over his diabetes and access to his pens.
 
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