Sir/Madam

I wish to complain about the treatment we received at Biston Hospital during my daughter's stay from Friday 3 September 2010 for about a week.

Introduction
It is difficult to explain the problem briefly because it was an accumulation of negative attitude and behaviour that resulted in a traumatic experience for both of us with long term detrimental consequences.  Individual issues warrant attention and the whole experience needs addressing too.

Reason for delay in making complaint
I apologise for the lateness of submitting this complaint.  The reason for the delay is due largely to the scale of the trauma and the consequential events.  Our first reaction was relief at having escaped and survived.  Who does one complain to when one regards them as the enemy?  We were then caught up in a fiasco of abuse from the Children Services as a direct consequence of the trouble caused by hospital staff.  That engaged a lot of time and energy and caused significant damage to both of us.  On attempting to complain to them they have acted irresponsibly and the complaint is being delayed deliberately by them.  Eventually I can now make a formal complaint to the hospital trust.

How it started
My daughter, Helen, complained of stomach pains and diarrhoea around 20 August 2010 and I phoned the out of hours doctor and we ended up visiting Biston Hospital in the early hours of the morning.  She was diagnosed with gastroenteritis and sent home.  She continued to have some stomach pain in the appendix region and about a week later on Friday 3 September it got severe and so I called the doctor at about 2 p.m.  We were advised to go to the outpatients department were someone would be waiting for us at 2:20 a.m.

Arrival at the hospital
We arrived at 2:20 and could not get in.  After waiting a short time a kind cleaner let us in.  We were advised where to go by the cleaner and we waited.  We waited for maybe 15 minutes and Helen needed a drink of water.  There was none to be found and no staff available.  Eventually some more cleaners passed by and we asked them where we could find some water.  They kindly went and got some for us.  After some time someone who appeared to be medical turned up and asked us to wait.  Eventually we got to see a kind doctor who diagnosed suspected appendicitis and we were summarily whisked off to another department where we were left to wait with no information about what was happening.  This was not a good start.

Initial treatment
After a long time of waiting and some more water a team of personnel with heaps of equipment pounced on my daughter.  There was very little explanation of what was going on and it felt as though we were just another project for them to exercise their talents.  They succeed in upsetting my daughter.  The main problem seemed to be the impersonal nature of it all.  They seemed so focused on "doing their job" that the experience for Helen was one of alienation and growing fear.

Admission to the gynaecological ward
Helen was then admitted to the gynaecological ward.  Now Helen was 16 at the time and a nurse on the ward was quite concerned for her.  She suggested that she should really be on the children's ward.  But there was no one to make an informed decision and yet more bureaucratic functional decisions were made.  The simple fact was that she could not be admitted to the children's ward because she was 16.  It turned out later that even the surgeon understood the children's ward would have been better for her.  But we were then left on this ward to recover from the ordeal so far.

Relevant family history
We have a history and the relevant part is that we are a father daughter family.  She has no one else to support her.  She had been through an awful lot in the last six years of her life and is sensitive and vulnerable.  Mostly this is initiated by the treacherous behaviour of her mother during the divorce.  We are also dislocated in Biston arriving here recently by force of circumstances with no social network as backup.

Pressure to leave Helen
It was not long before I was being encouraged to leave Helen.  It seems, as I discovered later, there was a drive to make all wards single sex and a male staying on a female ward out of visiting hours was evidently something to be discouraged.  The pressure on me to leave was extremely impersonal and not responsive to the particular needs of the patient but rather focused on the "achievement" of some bureaucratic goal which they never mentioned to me.  I did, however, explain her vulnerability and some nurses got it and some didn't.  The subject of her being on the children's ward where I could stay with her was raised again and dismissed.

Staff shift changes
During the following 48 hours the nursing staff changed many times and each time I tried to explain to pushy nurses why I had to be with Helen.  Somehow the information (that human stuff as opposed to data) couldn't pass through the impervious shift barrier.  To delineate everything that happened in the next 48 hours would take too long and so I will explain some of the issues.

Denial of Helen's feelings
Helen is slight and has narrow veins.  Her cannula was hurting her but when medication was applied she was not allowed to cry or say "Ow".  I do understand people and how they get distressed by someone else's expression of pain.  I do know that we have a long culture of silencing crying children with anything from sweets to smacks.  The friendly resistance was tolerable but when nurses got offensive it was cruel, unacceptable and, in fact, is anti-therapeutic.  Helen is very sweet and very bright.  She astutely explained to one rather kind nurse that it was like traffic lights "'Ow' is a green light and 'Stop' is a red light."  The nurse got it.  But many didn't.  On many occasions a nurse would tell her off for making a noise and in other cases even claim "It doesn't hurt" denying her feelings and alienating her more.  There were claims of "I'm not doing anything." as if the nurse could be in trouble because the patient was in pain.

Deception used to inject drugs
Then there was the trouble with the intravenous paracetamol.  Antibiotics were prescribed for the infection and paracetamol for the pain if she wanted it.  But it seemed as if, since it was on the "list", the nurses had to administer it.  Helen was very clear from the outset that she would have it if she was hurting but as she wasn't she would rather not take it.  Some nurses were so keen to inject this drug into her blood stream that they even lied to her about its therapeutic value.  One stated that it killed germs.  This is serious deception.  But every time, whether the nurse understood or not, it was marked down on the form as "Patient refused treatment."  An unfair and inaccurate allegation.

Sloppy application of drip
On the subject of the application of the intravenous fluid there were numerous occasions when I saw bubbles of air, between one and three centimeters , entering Helen's blood stream.  Worrying though this was I largely assumed the nurses knew what they were doing.  On one occasion I saw a column of air at least fourteen centimeters enter her arm and moments later Helen clasped her chest and said she couldn't breathe.  Not wanting to distress her and assuming that she could be resuscitated at worst, I calmly said I would go and fetch the nurse and did.  On our return the nurse, having checked Helen was still breathing, tapped the bag of liquid and said there was nothing to worry about.  What she had done, of course, was to let the tube hang down as she attached one end allowing a large amount of air into the tube.

Treating Helen as an object and frightening her
At some point a female volunteer (as opposed to a trained nurse) walked briskly up to Helen's bed with a wheelchair and a clipboard and announced that she was taking her for a CT scan.  Helen asked why and the volunteer said because she had to.  A further enquiry as to what this was about resulted in the volunteer handing Helen a piece of paper to sign and telling her that "It might stop you from being able to get pregnant in the future.  Is that alright?"  Helen was stunned.  She asked again what this was for and the volunteer simply said "Are you coming or not?  I have other patients to deal with."  Helen wanted to know more about this and so the volunteer turned her back and walked off muttering something about not having time for this.  No one had ever mentioned a CT scan to Helen.  No one had discussed any treatment with her or talked to her about what they were doing or why.  This had simply arrived out of the blue.

Manipulative and cruel behaviour by a nurse
Then there was the case of Sandy Shore.  This nurse obviously felt that she could control these aberrant people.  She requested that I leave the ward.  I pointed out that Helen was frightened and wanted me there when she was medicated.  I was quite happy to spend time in the day room off the ward.  In an attempt to accommodate the nurse I asked if I could be there when Helen was medicated and she agreed and I said I would go home and asked when the next medication was due.  She said she couldn't specify when it would happen but they do it at about 11 p.m.  I asked if it would help if I phoned prior to that to check if they were on schedule.  She said yes.  Silly me!  I duly phoned and spoke to Sandy Shore who now insisted that I could not come into the hospital.  I tried to explain that this was not helpful to Helen and she said she had to speak to someone and would call me back.  (At one point she had actually told me that if Helen wanted to see me she would have to go outside and meet me there!) What was I to do?  Half an hour later she had not called.  Since I had assured Helen I would be back I thought I had better phone her to let her know what the situation was.  It turned out Sandy Shore was attempting to medicate her and she was distressed.  I asked if I could speak to Sandy and asked her if it was alright if I stayed on the phone to Helen whilst she did her intravenous stuff.  That was fine.  I heard the ensuing exchange between Helen and the nurse.  Sandy Shore was controlling and oppressive.  She became demanding and eventually shirty.  She said abruptly "If you are not going to take the paracetamol are you going to take the antibiotic?"  She left no time for Helen to answer but as Helen said "Yes." Sandy curtly said "Are you refusing your medication?"  Not waiting for an answer she seemed to take the answer to the previous question as confirmation of her expectation and stating "Well there is nothing I can do about it." she packed up her things and left Helen in tears.

Failed attempts to get help
The next day could be described as farcical were it not so serious.  The nurses offered no attempt at a solution.  It was all very Freudian.  The nurses were largely projecting their failures onto the patient.  It was as if holding a "blame card" against a patient was the most important thing to maintain in their defence.  I tried to point out that blame was not the significant issue and could we please focus on

the well being of the 16 year old girl with appendicitis who was currently without medication.  They did not seem to understand.  Apparently it was not their fault.  I suggested a number of things including offering her oral medication.  That eventually happened.  But I also asked if there were such a thing as mediation available in cases where patients and staff were not seeing eye to eye.  They had no idea what I was talking about.  I suggested they might have a counsellor available who could help.  Their response was to ask if I was asking for Helen to see a counsellor. "No.  I want someone who is sympathetic to try to mediate."  The only thing that happened as a direct result of that was a referral to CAMHS.  So I asked if there were anybody that helps when there are serious difficulties with patients.  I don't remember what the emergency action service was called but they did suggest something and I agreed that they might contact them.  They were not available, a message was left, and twenty four hours later a reply came back stating that they didn't deal with children under 18!

Nurse attempts to cover her tracks with false allegations
Sandy Shore then, maybe covering her behind, reported us to the Children Services.  They turned up and interrogated us for 3 hours making the situation worse not better.  There is currently a serious complaint in progress against them.  Sandy Shore (and possibly other nurses but that seems to be a suggestion not a fact by the Children Services) made dark and insidious implications and allusions like "He laid on her bed with her." (not true), "There was inappropriate touching." (not true), "She undressed in front of him." (not true), "She refused treatment." (not true), "She said she wished she were pregnant." (She was asked), "She said she was into witchcraft." (What has that got to do with anything?).  It is clear what Sandy Shore's anxieties are!

Help finally arrives
Eventually I requested that we see the surgeon in charge.  Mr Vinod K Raghunathan arrived and Helen asked him some pertinent questions about intravenous versus oral medication and the benefits (or not) of paracetamol.  He was perceptive, respectful, sympathetic and to the point.  He made it clear that he could not tell the staff nurses where Helen should be but he recommended the children's ward and, failing that, a single room if possible.  He prescribed that Helen's father should be with her if she wanted because it was part of her therapeutic care.  He explained the benefits of intravenous antibiotics even though oral would still do the job.  Helen decided to go back on intravenous antibiotics (in spite of her dread) because it was a more reliable way of recovering faster.  Incidentally the next cannula fitted was far less painful.

Medical conclusion
The conclusion to the appendicitis was that Helen was discharged with the infection cleared and an appointment in six weeks to check it.

The scale of the terror
Helen was at one point on the verge of walking out of the hospital because her experience was so bad she said she would rather die at home than stay in that hospital.  I know my daughter and I know she meant it.  That is how dreadful the atmosphere was.

Continued negative effects
When she went six weeks later the surgeon advised that they should take her appendix out.  Helen went pale.  He pointed out that it was not necessary and it was up to her.  Of course she could not put her life in the hands of those people after the experience she had endured.  She has not had her appendix removed.  Now she suffers regularly from what might be psychosomatic pains in her abdomen.  Incidentally Helen did attend the Park Hospital in Nottingham about her scoliosis and after one visit there she wanted to know if they could take her appendix out.  They were respectful and kind.  It really is as simple as that.

General bad attitude
My experience of the Biston Hospital was dreadful.  It seems to have an air of officiousness and bad attitude.  There are lots of perfectly nice people there but there is a culture of judgemental authoritarian superiority and prejudice.  To add insult to injury I had to pay a lot of money to be able to support my daughter in parking fees alone.

Long term consequences
Our life is difficult enough and I am grateful that someone invented penicillin and that a potentially life threatening condition of appendicitis was healed but our life was tangibly worse after the ordeal.  It has scarred Helen for life and had an overall detrimental effect on her health and wellbeing.  I have significantly higher levels of stress and am suffering psychologically and physically as a result.

Mere objects for their benefit
It is as if we were objects for the hospital to process for their benefit and it was a serious nuisance that we were autonomous and had pathetic things like feelings or rational thoughts.

Summary
• I find it hard to believe that the staff cannot cope with distress.
• I find it shocking that a nurse can lie to achieve an objective of getting a voluntary painkiller into a patient's blood stream.
• It is oppositional and offensive to keep claiming that a patient is "refusing treatment" as some pre-emptive defence.
• It is impersonal and shocking that Helen's CT Scan was not discussed with her and that someone should simply demand she attend out of the blue with a casual remark "It might stop you being able to get pregnant.  Is that alright?"  As if the responsibility for the decision lies with her whilst she is not in possession of the relevant information.  It is disgusting actually.
• The application of intravenous medication was too often too casual to the point of verging on dangerous.
• It is ridiculous that the hospital cannot cope with a father daughter pair because they don't fit their preconceived idea of a patient and family.
• As for Sandy Shore's reporting us to Children Services I hardly know what to say.  If these authorities were benign it could seem to make sense.  I do understand that if there are serious questions about someone's behaviour that a benevolent culture might pay attention and even look into the matter.  If there were anything wrong with our behaviour I would accept that Children Services were notified.  But Sandy Shore was the perpetrator of bad attitude and bad deeds and her purpose in 'reporting' us was not benign.  Her attempt to imply there was something sinister going on by making dark implications and allusions of a serious nature was intended to 'get us into trouble' in a tragically childish kind of way.  Her remarks were lies and her intentions were unkind and clearly promoted by her need to defend herself by blaming someone else.  Ironically the Children Services picked up her 'blame' baton and are now regretting it.

Conclusion
Our visit to Biston Hospital was a total disaster with devastating consequences for both of us.

Yours sincerely

Dave Hook
B.A. M.Sc. MBCS CITP