Hospitals vary greatly, from large teaching hospitals to cottage hospitals, which may offer minor surgery or respite care.
People with terminal illness need good palliative care, which places special emphasis on pain and symptom control. Palliative care teams include many different specialists in pain control, nursing, social work, psychology and counselling and can be based in hospitals or in the community. Many people we talked to recalled their experiences in hospital. Some talked about their treatment, such as chemotherapy or surgery, others spoke about palliative care or respite care.
We heard about many good experiences in hospital. For example, a woman who had breast cancer went into hospital for a week, partly to have a blood transfusion because she was anaemic, and partly to have her pain controlled. She thought she was lucky to have a single room, and said she quite enjoyed her time in hospital. A man who thought he might not survive his operation was struck by the kindness and humanity of the hospital porters who took him to the operating theatre.
She enjoyed her week in hospital where her pain was controlled and where she was given blood for…
Others were keen to praise the National Health Service, especially if they had been critical of it in the past. For example, a woman who had been treated for cancer with interferon said that she was grateful for all the expensive treatment she had received. A man who had had private care was so impressed at his happy and efficient NHS ward that he decided to stay there rather than return to the private hospital. Another man commented that he did not believe private care could have matched the specialist care he received.
She felt fortunate that she could benefit from expensive treatment.
Good nursing care is just as important as high-tech medical treatment, particularly towards the end of life. Many patients were reluctant to criticise staff, who were obviously overworked, but others had not formally complained in hospital because they did not want to be branded an ‘awkward patient’. Staff shortages, or staff inexperience, were usual problems: a man with colon cancer said that staff ‘were run off their feet’, and that patients often had to wait too long for a simple thing like a bed pan.
A shortage of nurses led to insufficient care at times.
Some patients had stayed in different hospitals or on several different wards and noticed how the culture varied. While some wards were described as happy, efficient, warm and friendly, others had inexperienced and uncommunicative doctors and nurses and poor standards of hygiene and care. This woman contracted MRSA in hospital and said that she rarely saw staff on her ward wash their hands.
Describes the different cultures on the wards she was in and suggests that the ‘tender loving…
In some hospitals the staff delivering food and drinks seemed to pay no attention to whether the patient could eat or drink unaided, simply collecting the trays of cold, untouched food. The daughter of a man with motor neurone disease said that staff were too busy to feed her father or the other patients in the ward who couldn’t feed themselves. However, she remarked that for every ‘dire’ member of staff there was another who was ‘wonderful’.
Patients who needed help to eat were not always given necessary help due to lack of staff.
A man with prostate cancer, who originally came from India, experienced three different hospitals. Two had been ‘very good’, but in one hospital the nurses were too busy to attend to his needs, and he particularly missed his usual diet.
Discussed how hospitals vary. He particularly misses being able to eat properly when staying in…
A woman with chronic obstructive lung disease sometimes spent short periods in her local cottage hospital for respite care. However, she found that staff didn’t seem to understand her health problems and she didn’t get much rest. She would have liked to have had a bed in a hospice, in her area, but there weren’t any for people with lung disease (see ‘Insufficient hospice care’).