Three days of severe anxiety following umpteen calls without a prognosis or update on the wellbeing of his 86-year-old hospitalised dad has seen a Cape Town man urge Western Cape health authorities to improve their communication with the worried loved ones of their patients.
When Ashraf* – who asked for his identity to be withheld – was finally informed of the health status of his father, their trauma was exacerbated.
He suffered severe organ damage and was later told there was nothing more that could be done for him.
“We appreciate the care and treatment he received. But for us, it was a nightmare not knowing what was happening while he was in hospital for what we had thought would be a few hours on a sodium drip,” he told News24.
“My sisters and I only have my father. We lost our mom 26 years ago. We just wanted to know what his condition was because he was there alone. We couldn’t speak to him or see him or ask if he was doing okay or needed anything.”
While they believe that the hospital staff did all they could to help his dad, he argues that much more could be done to keep worried loved ones informed of a patient’s condition.
Ashraf’s father was admitted to Groote Schuur Hospital in the early afternoon of last Saturday, after receiving a referral from his GP that his sodium level was dangerously low.
He drove his dad to the entrance, while he waited in the parking lot for over three hours after he was pushed in in a wheelchair to the emergency ward as he was too weak to walk.
Ashraf was later urged to go home as tests and bloodwork were to be conducted.
“My father had recently recovered from Covid-19, but had suffered severe damage to his kidneys. That night, at about after 20:00, I phoned the hospital, hoping for an update or just a check-in that he was still all right. There was no answer; not at the switchboard or the emergency ward.
“I tried again the next morning and located the ward he was in. The nurse said my father was okay, but that there was no doctor available to give me details on his condition. I was told to call back the Monday.”
When he tried the next day, he was told that doctors were still doing their rounds and that he should call back later. He phoned back in the afternoon.
“My calls were being ignored. I could hear someone was picking up, but the phone would be put down before I even spoke to the person who answered. I phoned and phoned and phoned, probably for 15 minutes, from my cellphone and landline. No one answered.”
That night, his sister tried the same number and it was answered by a nurse.
“He had been very rude, asking why she was bothering him when he had just come on his shift. He gave her an earful and hung up on her.”
Ashraf phoned half an hour later and got through to a different nurse who said no doctor was available.
“They said he was resting and was fine. To me, fine is not feedback. It’s not good enough, especially considering I can’t see him and had no idea of his condition.”
Undeterred, he tried again. He said his calls, like the day before, were rejected.
“Finally, on Tuesday afternoon, a doctor phoned me with feedback. They were focused on his kidneys and waiting on blood cultures. They had done all the checks and scans. I appreciated that.”
On Wednesday, the doctor phoned again, informing them that his dad had started coughing blood and would be put on antibiotics. His kidneys had been severely affected by Covid-19, Ashraf said he was told.
On Thursday, his sister got the call from the hospital.
“We were informed that there is nothing more they can do for him.”
‘I just didn’t know this would be the last time’
Ashraf said, while he is grateful for all the doctors and staff did for his father, they could have been saved much anxiety through proper communication.
“All we wanted to know is how he was. That was all.”
Provincial health department spokesperson Mark van der Heever said, while aware of the need for communication with family members about the wellbeing of their relatives, hospitals were still experiencing pressure in relation to the number of patients admitted for both Covid and non-Covid conditions, which placed additional pressure on the entire system.
“Due to each hospital experiencing its own unique circumstances and challenges, they each have their own measures in place which can be managed by themselves and within the available capacity,” he said.
“Hospitals have a central exchange which directs the call to the relevant ward where the ward clerk will answer the phone and link the caller with the relevant senior staff member – professional nurse, nursing manager, operational manager, or doctor – to provide an update on the patient’s condition.
“However, as resources are stretched, and their priority is to ensure the patient is cared for, they might not be always available to attend to the call. Notes are kept for follow up return calls to provide family with an update when these staff can do so. At times, when they do return the call using the recorded number of the next of kin in the patient’s file, the call goes unanswered.”
Van der Heever said, when a person was terminally ill, the doctors’ prognosis was of a poor nature and no further medical intervention could be explored, the treating doctor would contact the registered contact number on the patient’s record to inform the next of kin.
“Ideally, where possible, the family will be notified and the hospital will go out of their way to ensure the family can say goodbye to the patient.
“While this is the ideal process, we should also be mindful that there may be times when the hospital capacity is stretched and there is perhaps no space available for family members to be accommodated (to adhere to Covid safety regulations) or staff are attending to patients and not able to communicate immediately with the relatives.”
Ashraf’s father is expected to be discharged on Monday to spend his final days with his family.
Dilshaad Rajie told News24 that when her father Amier was transferred to Groote Schuur on Sunday 6 September by ambulance, she had not known it would be the last time she would see him alive.
She would only learn two days later that he had not woken from an induced coma and was expected to die.
Amier, 65, suffered from emphysema and had been short of breath, prompting his family to take him to a private hospital, where he was stabilised before being sent by ambulance to the government facility as he didn’t have medical aid.
“He was still able to talk to us, but his chest was tight. We had had similar instances before so we knew what to expect. I just didn’t know this would be the last time.”
Amier had phoned his wife at midnight, 03:00 and 05:00. Dilshaad said he even told her he was craving crème soda, but that the doctor had told him he shouldn’t have it because his sugar levels had been elevated.
He never called again.
“His phone was off. That whole day, we couldn’t reach anyone for an update on his condition, not a nurse or a doctor. We phoned again at 20:00 and finally got through to a nurse who said he was sitting up. We took that as good news.
‘It’s like he knew’
“The next day, we phoned and were told that they had had to sedate him and put him into an induced coma the day before. How could that be, if he was still up that Monday evening? It made no sense.”
Alarmed, her brother who lived in Port Elizabeth drove down to Cape Town.
“We decided to go to the hospital, but they wouldn’t let us in because of the Covid protocols. We wanted to see him, so my brother entered through another entrance, saying he had an appointment with a doctor.
“He found my dad’s ward, but couldn’t see him.”
That Tuesday, a doctor finally phoned with information on his condition, but the prognosis wasn’t good – Amier had not woken up from the induced coma.
“They told us he was on his last. We asked if we could rather fetch him but the doctor was adamant that they keep him there, saying they will make him comfortable.”
Distraught, but determined to see the man who still drove from Rondebosch East to Plumstead every day to pick up his grandchildren from school to spend time with them, Dilshaad and her brother drove back to the hospital to try and see Amier.
Security, however, would not let them through. Even employees the family knew were unable to provide them with updates on his condition.
“We stood and argued for about 40 minutes when a nurse came and said one of us could go up to him. I asked about his condition, but she wouldn’t say.
“My brother had gone in, but my dad had already passed. He had still been warm – he probably died while we were at the hospital.”
A bereft Dilshaad said her father had, the day before being admitted to hospital, still taken a drive through Athlone where he used to live, for old times’ sake.
“It’s like he knew.”
Groote Schuur Hospital was approached for comment. This will be added once received.
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