Health Service Commissioner : first report for session 1982/83 : selected investigations completed April- September 1982.

  • Great Britain. Health Service Commissioner.
Date:
1983
Catalogue details

Licence: Open Government Licence

Credit: Health Service Commissioner : first report for session 1982/83 : selected investigations completed April- September 1982. Source: Wellcome Collection.

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    practice to use a geriatric chair because they were fittted with a high sup- portive back. The AHA said that the relatives had visited during Christmas afternoon and that they were very angry that the complainant’s mother had been transferred in the middle of the night. They had asked why she was sitting out of bed and the first sister had assured them that this was in accordance with consultant’s instructions and was the first stage in her gradual mobilisation. 7. There is no reference to mobilisation in the medical notes for 23 or 24 December. The relevant part of the entry in the nursing record for 24 December says, ‘Seen by [the consultant] discontinue traction sit out of bed & mobilise.’ 8. The consultant told my officer that the complainant’s mother had started her mobilisation on 24 December, which was a little later than most patients. Her Parkinson’s disease made the decision a very finely balanced one. He said that he knew that she had her first walk that day when she had been accompanied by a physiotherapist. He said that he did not normally include information about a patient’s mobilisation in the patient’s medical notes. He said that he left the pace of a patient’s mobilisation to the discretion of the physiotherapist or the nursing staff and he expected them to refer to him only if they were in doubt. He said that he would not have expected or approved of the complainant’s mother sitting out of bed on Christmas Day for eight hours or more. He also said that a variety and combination of activities were the best means of mobilising a patient with Parkinson’s disease, and he con- sidered that spending a long time in one position could be conducive to dis- location and to bedsores. The consultant said that it was important that the seat of the patient’s chair should be at the same level as the vertical height of the shin, and that the chair should have good high arms. He said that such chairs were not available on ward B. 9. An orthopaedic registrar (the registrar), who had been involved in the patient’s care during this time, told my officer that a reasonable period for the complainant’s mother to sit out on Christmas Day would have been 14 to 2 hours. He did not think that support for her legs would have been essential. 10. A night nurse (the night SEN) told my officer that she had been on duty in ward B early on Christmas Day when the complainant’s mother had been admitted from ward A, and the patient had been put straight to bed. She had also been on duty during the next night and said that when she came on duty at 8 pm the complainant’s mother had been sitting out and that later on she had put her to bed. 11. The first sister told my officers that she had not been trained in orthopaedic nursing but that she had gained considerable experience in it by nursing orthopaedic patients transferred to her ward. She said that she had been on duty from 7.45 am until 2.30 pm on Christmas Day and that the complainant’s mother had sat out of bed from about 9.30 am. She had seen the entry in the nursing report which said that the patient should be gently mobilised and, at about 11.30 am, she had asked her whether she wanted to go back to bed. The patient had declined and had said that she 103