An experience of NHS nursing

This is an account by Vanessa, a young woman friend, a qualified Psychoanalytical Psychotherapist and a mother of two children, of her experience of nursing after a major operation on her spine in a big and well-known London teaching hospital.  She was writing in reply to the response of the relevant hospital trust to her original complaint, sent from the trust’s website.

I have just had cervical spine fusion surgery at [a leading London NHS teaching hospital].  I was here four years ago on the same ward, undergoing disc replacement surgery.

I arrived on a Sunday evening with another woman whom I shall call Jan. She was a large, friendly woman. She arrived on crutches just after me with her husband and family. My bed wasn’t made when I arrived; the rubber mattress was covered by a ripped sheet but that was all.  When I asked for the bed to be made the male nurse looked at me as if I was mad. I’m not asking for a cool gel mattress and some flowers and a 1000 count linens, just a simply made bed would do the trick.

“What do you want?”, he asked me. I asked for a top sheet and a pillow:  I got the top sheet.

Nothing of this would have registered as other than to be expected.  I am not fussy about trivial things.  I had been waiting for surgery and was eager to be there. With hindsight however it was a indication of what was to come.

I remembered from before that recovery on this ward was hard. This is a ward of heavy surgery, drugs and pain. It is a rough and long road to recovery, a road that we need to be supported on with care and encouragement. This is not going to be nurtured here: nothing is nurtured here.

It has deteriorated since my last admission. There was no sense of anyone being in charge or of one being in anyone’s care. On getting up for the first time  I asked one young student nurse to help me:  she tutted and said she was busy.  There seemed to be no communication between nurses, no consistency or continuity. The ward is chaotic, the male nurses were rude and abrasive, snapping at students and each other.  It was as if we were not there; no one had any time for us.

The level of distress was palpable, especially at night when it felt as if the few staff were overwhelmed. Jan had had massive surgery. She had been in theatre for about nine hours. After five days we were both off our morphine drips and had been visited by the pain management nurse, who wrote us both up for slow release morphine tablets and oral morphine to take whenever there was any breakthrough pain.

That evening a woman friend asked the nurse if he could look at my dressing, which was bloody and oozing. Once my friend had gone the nurse approached me complaining.  I pointed out that my friend was no nurse. He pulled my dressing off and started rubbing at my wound. I was extremely uncomfortable about this but he continued.  It was when he came at me with tweezers to remove my steri strips that I knew were supposed to stay put for another week that I screamed at him to stop. It was terrifying. I got the distinct impression that he would have done anything asked of him regardless. It was as if we were in charge.

During the night I woke to hear Jan wailing. This continued for some time;  she was getting more and more distressed. No nurse came to see her. I got out of bed to be with her.  I sat and held her hand and dabbed water on her forehead and in her mouth. I was there for an hour. She was  desperate for relief; there was blood weeping over her sheets. The nursing assistant was obviously distressed herself. She kept going to try to get the nurse but he didn’t come; she stood watching, helpless.  When the nurse eventually came he was flustered and cross: he had been dealing with a distressed male patient. He shouted at her: “…this is bed 7, not bed 6, I have already done bed 6.” That was why he hadn’t bothered to come.

All he said when he got to her was: “What do you want?” Anyone in their right mind could see that she wanted relief from her pain. She was near delirious and in no state whatsoever to be asked what she wanted. He was unaware that she could have liquid morphine and told her there was nothing he could do. He was completely uninterested, and irritable. I pointed out that she was more than likely written up for liquid morphine as I had been. As anyone knows who has had anything to do with spine surgery, one has to keep on top of the pain, otherwise it is engulfing. There was absolutely no need for her to have been allowed to get in to this state. Dealing with major surgery makes one terribly vulnerable. One regresses to a completely dependent state which is distressing in itself. We need our carers to be sensitive to this, not angry and dismissive. We already feel like a burden.

I have never been more eager to leave a ward.   I left the next day.  Betty, the other woman in the bay, had had her hip replaced; she could only get out of bed with a special brace on. She was left in her chair with no knickers on.  Eventually she called me over and I put them on for her; the indignity was embarrassing for her.  I  am haunted by the experience of watching elderly disabled people being treated in this way (we are all registered disabled); watching their husbands come every day to be with them and take loving care of them that they hope is going to be sustained in their absence.  I could manage better, I am 15 – 20 years younger than them: their treatment was disgusting. When Jan and  I came in to the bay of four, a woman who was about to leave said it was like being in Holloway. She was discharging herself: they wanted to give her a blood transfusion which she refused, saying all she needed was some decent healthy food.  I imagine the women in Holloway get better treatment. In many ways we are the lucky ones: we get to leave, the staff have to work in this environment.

I am sorry for the nurses who were so stressed: they are as vulnerable to the system as we, the patients, are. There seemed to be an excess of semi-qualified student nurses and assistants who couldn’t actually do much, and very few qualified nurses. Those that there were seemed to be cracking under the pressure.

In  response to my initial complaint you assured me that if I needed to come back into the ward you would make sure that I was comfortable with returning.  This is not my point.  It needs to improve for everyone, not just those that have the strength to complain. We have enough to get over in terms of the surgery that we have undergone without the traumatic lack of care that I believe we were all subject to.

You also stated that a ‘female member of staff is always available on request’. This is not good enough: it presupposes that we are well enough to voice our wishes. This is not always the case, especially in the first few days post-operatively. Maybe preferences ought to be checked before we go to theatre.

My experience was not one that you would have associated with a great London Teaching Hospital. It was more worthy of a third world country. What is in fact brilliant surgery is tainted by appalling after-care. It was a disgrace, and is not something I would either wish to repeat or have anyone else suffer.

Postscript by Brian: I have commented on this deeply disturbing letter, and more generally on the problem of appalling standards of nursing in many NHS hospitals, in a new blog post:  please see

4 Responses

  1. Tim Weakley says:

    I note with dismay that Vanessa does not appear to have been visited by her surgeon during recovery, or by any other member of the hospital staff senior enough to raise hell with the people on duty in the recovery ward and to get incompetents fired or at least sent for further training. This was a teaching hospital, too; it makes you wonder what the students are taught about post-operative care, and what if anything they learn about what goes on in their hospital’s wards.
    I was fortunate enough when living in the USA a few years ago to have had Blue Cross coverage via my employer, and to have been in the vicinity of a particularly good hospital. During this time I had a colon resection – OK, not the most drastic operation, but still a major one. The surgical and nursing staff were both very professionally competent and very kind. I was particularly impressed by how they got the analgesic drip right, so that I was pain-free when I came round (provided I avoided coughing and sneezing) and stayed that way, but was not groggy after the first couple of hours; also, how I was visited each morning by the ‘pain team’ to find out how I felt. That place remains my exemplar for the kind of treatment all NHS patients in Britain should be getting.

    Brian writes: Thank you, Tim, for this informative comment. In a new post on my blog (here) I have taken up, among other things, your important point about the failure of senior hospital managers, surgeons, other consultants and doctors to spend enough time in the wards, to realise what harm is being done too often by atrocious nursing, and to do something about it. Would the leaders of any other profession tolerate such seriously harmful practices for even a day?

  2. Clive Willis says:

    Brian, This is appalling. I sat for 20 years on a health authority. Apart from our own efforts on the HA to stamp out this sort of thing, there was an inexpensive watchdog called the Community Health Council which snapped constantly at our ankles. Why were these important bodies scrapped (by Labour, I might add)?

  3. Lorna says:

    This is a dreadful tale.  I also complained – at the treatment meted out by a nurse during the night when I was in agony after an operation – but it pales in comparison.  In due course I received a fulsome apology from the hospital manager.

    Brian writes: Thank you for this, Lorna. It’s a sorry state of affairs when someone who has had as dreadful an experience as the one you describe has to qualify it by pointing out that others have experienced even worse. It’s striking too that an experienced and widely read journalist testifies that whenever she writes about examples of the terrible deficiencies of NHS nursing, she receives scores of letters and messages describing similarly terrible experiences. Yet any suggestion that remedial action is urgently necessary is seemingly taboo.

  4. jenny says:

    I am truly sorry for you [Vanessa], but sadly not surprised. After 4 years of looking after parents over 85 I feel utterly betrayed by a system which saw 90 year old Burma hero father undiagnosed with a femur fracture and untreated for over 6 weeks, dying with hospital-acquired MRSA, Parkinsons victim Mum allowed to sustain serious injury on a Ward and, in 6 admissions, treated on 4 of them in mixed sex accomodation: 4 times, aged over 85. Dad last summer was left 18 hours without fluid despite the instructions of the Consultant.

    The Trust concerned does nothing about standards, its staff continue to tell outright lies and life is miserable for the vulnerable. This is a rotten and unaccountable system, guaranteeing that the lowest standards can pertain.

    Brian writes: Thank you very much for this, Jenny. I am passing it on to Vanessa, the writer of this article. It’s so depressing to find that any account of bad experience in NHS hospitals at the hands of incompetent, indifferent and indolent nurses prompts so many stories of even more horrendous experiences, such as yours and your parents’. All one can say is that it’s worth keeping on protesting, and publicising NHS failures, if only fractionally to deter those responsible from continuing to abuse their patients with impunity. A letter (or even an email) to your MP is more likely to get results of some sort, however unsatisfactory, than any number of complaints to the relevant Trust or even to Department of Health ministers direct. You might also tell your MP in your letter that you are preparing a letter to a national newspaper about your parents’ experiences but that before you send it you want in fairness to incorporate in it any explanation that the Trust concerned wishes to offer. Sincere condolences: good luck!

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