A wee story.
George ‘Geordie’ ‘Specs’ Hastings was 72 when he died on 29 January 2017 after a short illness.
George was one of the town’s characters, seen and greeted by many as he sat on the doorstep of his flat in Assembly Street, Dumfries. George had a very full and active life, working in many of the key establishments in and around Dumfries. He was a family man, a much loved Dad, Granpa, Great Granpa, a big football fan and just a popular guy who always had a smile, ‘hello’, quick quip and happy chat. He amused many with his stories and his legendary sun tan was achieved he claimed in (on) ‘Door Steppie’, many puzzling where that exotic place was. The volume of family and friends attendance at his funeral service reflected the status he had in our community.
George ‘took ill’ and was in painful, deteriorating health for a number of weeks in late 2016, culminating in his attendance at the Emergency Department, DGRI on 15 December 2016. George had been under the care of his GP(s) and District/Practice Nurses, with little apparent improvement in his ‘sciatica’ as George intimated to folks.
His attendance at ED saw him immediately admitted to hospital, the duty ED Doctor recognising a significant deterioration in George having seen him some 3 weeks earlier and the review of George’s ‘on line’ recent blood test results indicating a significant health problem –news to his family. From then George was submitted to a range of checks, tests and treatments for what was quickly identified as tumours on his spine, bladder and lung. The immediate response and care provided by the ED medical and nursing staff was exceptional.
He was admitted to ward 7 and the medical team contacted the Oncology team in Edinburgh. This resulted in George being transferred to the Western General Hospital for a spell of treatment before returning to DGRI ward 12. It was here that he and his family experienced ‘Open Visiting’ which made life easier for all of them. Unfortunately though, due to bed pressures, George was transferred to a Cottage Hospital that did not have the same visiting freedoms. This led to extreme frustration for Georges family and friends as they had to travel some considerable distance to visit him only to find they had to wait for some time in an area they didn’t know to get ‘access’.
Why was George moved to a Cottage Hospital some distance from friends and family? Well this is sometimes necessary when beds are tight but is not seen as good practice however we must remember the need of the patients at the ‘Front door’ who need admission and maybe extremely ill. However in this case something was missed….George was dying, this was beyond doubt. There were no beds in the Alex unit but was he the best person to move to a CH? This is answered when it became apparent that George ‘needed’ a blood transfusion and required transferred back to DGRI to receive this.
Following this George was moved to a Nursing home where he died one week later on 29th January 2017, 45 days after initially presenting to ED. This last week was not the best for him as caring staff did their best with a dying man who was in pain and discomfort. This raises some questions; did George require a trip to Edinburgh in what was to be the last month of his life? Was it fair to move him so many times, 6 overall, when he was dying and needed a little comfort, love and continuity? Did he require the final move in his last days? DGRI was busy, it was the Christmas and New Year spell that often leads to real pressures but what happened to George? He just disappeared in the busyness and ended up being passed from pillar to post, not the best way for such a kind, respected man to end his life.
There may be no easy answers but there are some things we can do – our New Hospital will have open visiting on all wards and we can replicate this in all our hospitals. We can have more realistic discussions with patients and their families to prevent unnecessary trips either to Edinburgh or other major centres and for other treatments that may only prolong death rather than life. But the main thing we can do is remember George, and all the other patients like him. They are not simply ‘bed blockers’ or ‘the stroke in bed 3’, they are people, with lives, families, friends and stories. They matter and as such should be treated with kindness and respect.
Thought for today
George was a ‘Ten out of Ten’ chap. His end of life care and treatment did not reach that standard.
We often hear that lessons learned and procedures put in place will make sure no repeat of the identified problem events. As you go about your professional business today – will you really make sure that you listen to patients views and wishes, that you ask Whose Needs are Being met? and What Matters to Them? to do our best to ensure that there will be no other terminally ill patients who have to suffer a similar journey to that of George Hastings?
John McGoldrick was a friend of George Hastings