RNOH Patient & Public Involvement Forum visit report
Angus Mackinnon Unit
January 2009
Background
Jayne Brown has been appointed manager of the ward which consists of spinal and
orthopaedic patients. She has just returned from 4.5 months sick leave and cannot yet work
with patients. Rachel Brown is now doing Tissue Viability and still based on the ward.
There are currently 20.9 full time equivalent members of staff but the ratio of 1.2 staff to
patient remains, as there are now 13spinal patients on the ward compared to 9 last year, the
ward is only funded for 7 spines. This is still a cause for concern as there is no spare
capacity. There is much “fire fighting”.
Compulsory training is accommodated but there is no time for any extra.
The staff moral is high and they feel they are well supported.
Jayne would like to restart team meetings.
Patients are encouraged to accept their responsibility for their own wellbeing.
Visiting is flexible and depends on the circumstances. Some patients have young children
who need contact with the parent.
Accommodation and Equipment
The new build will bring improved accommodation but there are no plans to increase the
number of staff.
The ward appeared clean and well organised.
There are only 2 toilets able to accommodate wheelchairs and 1 large shower/bathroom.
The wet room leaks and therefore cannot be used until the workman come up with a solution.
Strong Beds are available to accommodate large patients
The trolleys are big enough
There is 1 large wheelchair.
Theoretically internet access is now available to patients but it is of limited capacity and often
not available. Some patients have installed their own booster sets giving TV and Internet
services but these will go when the patients leave.
2 Patient Interviews
Mr S
Mr S has been in hospital for 15 months after shoulder surgery. The surgery was successful
and he was very happy with it. He is a big man and has found his recovery time difficult. He
felt that the nursing care was excellent and could not be bettered elsewhere. However he
had some suggestions on short comings.
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Mr S felt that the long (12 hour) shifts meant that there were many day to day
changes of staff. Not knowing who was on duty led to a feeling of isolation bearing in
mind the patients are immobile and therefore cannot leave their rooms.
He also stated that the long shifts and insufficient numbers of staff made them
overtired leading to irritability. He told us that as he weighed 130 kilograms it was
difficult for two nurses to carry out his day to day nursing care. He said that he felt
this had led to a bed sore he had developed.
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NB. The ward manager told us he had insisted on going home before his treatment
was complete, and he had had to be readmitted.
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He also said he felt lack of staff led to infection control problems although this was
better than any other hospital. He felt the staffing problem was due to lack of support
and understanding on the part of the senior management
Mr S also had many suggestions for improving the general environment bearing in mind that
the patients on this ward are very long stay.
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Mr S told us that the room could be cold in the winter as the boiler was not reliable
TV and Internet access should be improved
Room environment should be improved – his blinds had been broken for months and
the tap had also been dripping long term
More variety of food type was needed, he said it was tasteless and predictable
although the vegetables were good
Better cleaning – he could not communicate with many of the cleaning staff as their
English was not up to it
Mrs V
Mrs V had had a spinal injury 20 years ago. She had been well and independent until life
problems caused depression which led to multiple bed sores. She has been in hospital for 8
months and is now waiting for the last sore to heal.
She has been very happy with her treatment and stay at Stanmore.
She said the staff are lovely and have become good friends. Any problems have been
sorted out quickly – as when she was moved from a double room to one she found lonely
and depressing. As soon as possible she was moved to a room where she was happy.
She had good access to the internet due to the patient in the next room having their own
booster set which she could share. This was contributing much to her wellbeing.
Her morning routine takes upward of an hour but she found the nurses efficient and quick.
She said the cleaning was fine.
The food became very monotonous after some time.
She said she felt the nursing staff struggled a bit with the work load.
Recommendations
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The Staff should be commended for managing so well in difficult accommodation with
barely adequate numbers.
The staffing ratio should be seriously reviewed and improved both for their own wellbeing
and that of the patients.
The wet room should be sealed so more patients could shower comfortably.
The boiler should be fixed or refurbished
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Patients’ rooms should be made comfortable – Mr S should have his dripping tap and
broken shutter mended urgently.
It is important not just to leave problems to be resolved by the new build.
Internet and Television access should be reviewed to find a way of getting a reliable
source. Having a source which is inadequate is a waste of money.
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