Kent and Canterbury Hospital 2016-08-19 Person 2 5 0

Sadly we,experienced multiple errors on this ward,including Chemotherapy either missed or nearly given twice. In each case patient awareness and insistence (despite staff insistence!) prevented this. Very poor approach regarding resuscitation discussion and patient inclusion. My husband who replied that he would like to be resuscitated was told "given your co-morbidity we wouldn't resuscitate. It's a medical decision" one was left wondering why the question was asked and also left feeling very unsafe. My husband felt pressured to take sleeping medication. When he asked the doctor if this was necessary he replied "most patients on this ward are on it" The healthcare assistant in the doorway added " too true, else our buzzers are going all night" I believe patients should be prescribed medication according to their individual condition and needs, not because other patients are receiving it. I also worry that patients are being sedated to accommodate staff convenience. Later after 8 weeks in Guys and a return to Brabourne vital medication was missed resulting in a 3 day stay. This was acknowledged. We also found an inflexible approach to the way blood transfusions were given and Frusimide. Only after a recommendation from Prof. Harrison at Guys were staff prepared to give blood more slowly and Frusimide via diluted drip rather than push syringe. The Doctor insisted it made no difference whereas Guys recognised the need to adjust according to the patients ability to tolerate.Also Guys recommended no more than one unit at a time whereas my husband was being given two. It worries me that this doctor may still believe It makes no difference. After a return to Guys, sadly my husband died in August under their excellent care. It has been impossible not to compare the two styles of care. At all times in Guys my husband was included in discussions about his care. Handovers were done at each bed with the patient included. Consultants visited their patients on the ward and worked collaboratively with ward doctors and staff for the benefit of the patient. The whole experience was one of care, respect, sensitivity and inclusion whereas sadly at Canterbury one felt one was being 'treated' by 'those who knew best' The whole issue of resuscitation was handled so sensitively at Guys with resuscitation procedures being explained right through to life support so that considering all, the patient could make an informed choice which was respected. My husband opted for resuscitation if it was purposeful and at a reasonable level, but declined life support on the basis that it would leave his family to make decisions with doctors to discontinue. The day before my husband died it was recognised that the 3 X chemotherapy drugs were unable to prevent the escalation of his Leukaemia. The Doctor sat with us and explained very carefully the principle of doing good and preventing harm. Clearly no good was coming from the treatment and side effects amounted to a degree of harm. Even then my husband was allowed to say he was happy for 1 chemo to be dropped but wished to remain on the other 2. He died with his Cytarabine attached. I am greatly endebted to Guys for respecting my husband's psychological pace in this. When my husband explained that his reason was because over his 8 week stay these were the 2 drugs that had managed to stabilise him enough for a few days at home (albeit in and out KCH for transfusions and the 3 day stay) The doctor gently replied " that's fine, lets give it one more chance! " I hope some of what I have shared may be of help to future patients. I would also like to add that our experience with the Haemotology team over the preceding 3 years at KCH was excellent. The care was superb and I appreciate greatly their ability to recognise the complexity of my husband's two rare Leukaema conditions and refer him on to Prof. Claire Harrison at Guys.