Hello, all. To introduce myself, I am not a nurse; rather, I am the son of an elderly patient - my father - currently in hospital in Mississauga, ON. In fact, I am writing this from his bedside.
My father, 84, is suffering from renal failure and also has severe dementia and has been plagued with both for many years now. My mother, 77, has cared for him at home all this time. It has been a very rough road for a very long time, but with tremendous care from my mother and his doctor, he has - sadly in a very real way - persevered. That said, his doctor explained that should he ever need to go to the hospital again, there would not be much he could do, going so far as to recommend getting a DNR form registered. We agreed as a family and my mother has done so.
He is now in hospital since last Tuesday as he had experienced a severe increase in fatigue to the point where couldn't walk. The ER doctors explained that his creatinine level was 500 - very high. What we thought was just a rash from diapers turns out to shingles. They confirmed everything we had already established about not treating him any further and that we are looking a palliative situation. They were quite compassionate and we all prepared for the end. We were told we would be admitted and they would do everything possible to keep him comfortable. In a way, this was very much a relief as my mother was at the end of her rope and unable to care for him any more. That's when things went south.
Without getting into too many sordid details, the net result is that the care we have received since being admitted feels woefully inadequate. We have been in the hospital a few times before, so we understand the disjointed nature of the doctor-nurse-hospital relationship, but this round has been the worst.
First, we were never advised that the shingles outbreak would warrant isolation. The first night nurse saw the chart and went into a frenzy installing a HEPA filter in the room and getting everyone into gowns and masks.
The next day, this man who has no gas in the tank still has the werewithal to want to relieve himself in the bathroom. We - my mother, brother, and myself - don't know what to do, so we try and get him there using a comode chair. We're successful a couple of times, but one time not. Mess on the floor. Nurse calls are usually answered immediatly, but no one actually shows up for several minutes - usually well over 10 or 15 - while my dad is sitting in, and staring at, his own feces. Nurses walk into the room asking us what supplies we have. Gowns, masks, diapers - nothing's ready.
Later that day, after talking to a palliative care doctor and going through this conversation again, we were transferred to a negative pressure room. Again, supplies are constantly lacking. At one point, again after a bathroom call, I see the nurse running around looking for a fresh night gown and bed pad. No bed pad - using another night gown instead. Wait times have gone through the roof. Usually 30 minutes or more now.
My father has been issued sedatives to sleep at night so he doesn't try to get up on his own. My mother being my mother, is sleeping with him in his room every night. First room had a spot to lay down, new room does not - we brought in our own cot. Nevertheless, last night, my mom did not notice my had had gotten himself up and halfway to the bathroom. Thankfully she got to him just in time to catch his fall. No time to ring the nurse. After she finally situated him so she could call, it took more minutes than I would expect to respond - 5 or more, as I understand. What would have happened had she not been here? He's behind double doors as it is, then stuck in the bathroom to boot with no comprehesion that he's even in a hospital. When my mother raised the notion of a bed alarm, they told her there were none available. I may well spend the night tonight for fear of another fall.
As for nurse compassion, it's up and down, but mostly down. We've had really great and compassionate nurses at times - they are angels that make a world of difference. We haven't really had that this time, and most just don't care at all. We had one nurse who I guess just assumed my dad was deaf because he's old and literally yelled at him while he's half out of it. It startled the hell out of him and he yelled back at her. It's a revolving door of nurses here - usually no more than 2 days in a row with the same nurse and we are always starting from scratch trying to explain the situation and my dad's needs.
All this is to say nothing of the unbelievable lack of cleanliness throughout the public areas of the hospital - gobs of dust everywhere, blood on the walls in the bathroom (something I immediately brought to someone's attention, only to find it cleaned over 24 hours later), and on and on. This whole situation is feeling a little sureal. But I digress.
I apologise - too many sordid details after all!
Back to my primary question. Compassion and supply issues aside, what can/should I expect for nurse response times in a hospital in Ontario? Should it matter if the patient is in isolation? I intend to bring the whole situation up with patient relations - at the suggestion of one of the doctors, and I know I can't change the world overnight, but I would at least like to get an idea of what I should be expecting. If nothing else, to ease my and my family's own minds.
Any insight is appreciated and if you have bothered to read this far, my gratitude for allowing me a chance to vent a little.
