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FB complaint against CGH standard of care by Isabella Alexandria Lim
Warning: Long post ahead.
Writing this to rant about my family’s disappointing experience with Changi General Hospital (CGH) where my grandma was warded before her transfer to National University Hospital (NUH).
On 19th Feb, my grandma was admitted to CGH due to a fall at home. She suffered a compression fracture and was required to stay in the hospital until she was fit to go home. During her stay in CGH, her dementia declined, leading to her crying all day. We wanted to bring her home so she could feel better but unfortunately she contracted Urinary Tract Infection (UTI) during her stay and could only be discharged after the UTI cleared.
On 4th April, doctors said her UTI had cleared and so my family brought her home. At home, her crying continued and she still had trouble urinating/had blood in her urine so she was admitted back to CGH on 7th April. (Are the doctors sure her UTI cleared on 4th April then??)
My grandma continued to be warded and on 18th April, the doctors finally transferred her to ward 68, a dementia ward, so she could receive better care for her dementia condition. Ward 68 was where things went downhill. My grandma’s appetite declined and she complained of stomach aches and vomited blood. The doctors suspected she had ischemic bowel but because of a few reasons (e.g. old age and poor kidney function), a contrast dye scan to confirm the diagnosis and surgery was not an option for her. The doctors told us that she would most likely die because were no other treatment options except palliative care.
On 25th April, we were told that based on her condition, she would only have a few days or a week to live. Until now I can’t comprehend how her condition declined so quickly from a fall to UTI to this. I was heartbroken. Nonetheless, we wanted her to be as comfortable as she could be. The doctors started her on a feeding tube because she didn’t want to eat but she vomited the food out the first time she was fed so they stopped the feeding completely. Due to water retention in her hands and feet, they also stopped the IV fluids completely.
On 26th April, the nurse on duty told my entire family to stay overnight as my grandma’s vitals were going down and that she would most likely die that night. My grandma however pulled through for 9 more days without food and water. I stopped going to work so that I could be there to take care of her.
26th April to 3rd May:
During the days that I was at CGH ward 68 every day from morning 9am till 2am at night, I saw how some of the nurses and doctors were unprofessional, unsympathetic and insensitive towards my grandma and family. Here are some incidents that happened at ward 68:
1. Family members not updated with complete information
The first few days after the doctor’s prognosis, my grandma was still fully conscious and could speak. However, she became super unresponsive one day. We asked the doctors why and they told us that they administered morphine to her at 8pm the previous night. Now, why weren’t we made aware? Please bear in mind that my grandma has dementia, cannot speak/understand much English and would not have been able to understand what morphine was or how it could have helped her, therefore would not have been able to consent to morphine. Moreover, once my grandma was on morphine, she never fully regained consciousness until she passed away. I really wish we were at least informed about the morphine administration instead of keeping quiet UNTIL we asked why she was unresponsive.
2. Unsympathetic, insensitive and unprofessional staff
Because my grandma’s body temperature was really low, the doctor recommended a heater blanket to keep her warm. This heater blanket was on for about a week until one morning, we realised it was missing so we asked the nurse where it went. She said that the doctor ordered it to be removed and that my dad was already informed. Guess what? Nobody informed him. My aunt then asked them to put it back on and the nurse told her “Put everyday got cost you know??”, and mind you, this was the first time we were informed about the charges. Regardless of cost, we requested for it again.
On one night, I wanted to ask the doctor whether it was possible to pursue other treatment options for my grandma since she was fighting and hanging on. Unfortunately, my grandma’s primary care doctor wasn’t on duty so an on-call doctor showed up. The first thing she said when she saw me was “I just want to say that I don’t know ANYTHING about your grandmother” while raising both her hands in the air as if I asked her to surrender?? Errr. I understand that as an on-call doctor she may not know much about the patients BUT she could have at least read my grandma’s case file first OR ask me how her condition was instead of making me feel like I was forcing her to answer something against her will. Unprofessional and rude!
On the same night, my grandma’s heart rate went from 40bpm to 110bpm. I went to the nurse and asked her if she could come over. Guess what? She looked at me in the eye, SIGHED and asked me to wait, turned to her colleague, mumbled something into her colleague’s ears and continued sitting down. Look, I understand if you’re busy, you could have let me know that you’d come by when you’re free, but come on, a LOUD SIGH was really uncalled for. In fact, it made me really angry. Anyways, the colleague that she was whispering to showed up after 15 mins and we asked her about my grandma's heart rate. Her reply? It “depends on God”. Depends on God??? Are you kidding me. It was then we asked her to call the doctor and the on-call doctor mentioned above showed up. Again when she came into her room, and when we asked her about the heart rate, she raised both her hands up in the air (again) and said “errrr there’s so many of you here” as if we were intimidating her. Most of us weren’t even talking to her, we were just listening and trying to understand. And the way she spoke to us was rude as well.
4. Refusal of blood test
Despite doctors and nurses saying that my grandma was going to pass in a few hours/1 or 2 days since 26th April, my grandma’s condition seemed to be stabilising so we requested for another round of blood tests to see if there was maybe an improvement or anything that we could have done for her. We spoke to the doctors about this and were denied the blood tests because according to them, “the results will be the same, so no point doing another blood test”. Hmm ok. On 3rd May, the day we transferred my grandma to NUH, they finally agreed to the blood test and we actually found an improvement in her lactate count and WBC count, however, by then her kidneys had already started to shut down. If the blood test had been done earlier when we requested for it, would it have been different? Maybe. Maybe not. But we wouldn’t know because they refused to do it.
5. Poorly run wards
The nurses were not present at the nurse station or the ward most of the time. We always had to wait, had to request for change of diapers, change of position to avoid bedsores etc. there was almost no initiative taken by nurses and most of the time, our family members did everything. We even helped open the doors to the ward (ward 68 is locked and requires a button to open the door) because there was no one available at the reception desk to do so and the doorbell would RING for ages until someone opened the door.
Because of the lack of care, the insensitive remarks and just overall disappointing service, my family considered a transfer to NUH many times. Whenever we brought it up to the doctors, they would deny our request stating that “doctors in the other hospital would say the same thing” or “she would probably die on the way in the ambulance” so there was no point. Finally, on 3rd May, we had enough. We had a talk with the primary care doctors and they reiterated that my grandma was on palliative care and they were giving her the best they could. Were they? Were they trying to maximise the quality of life of my grandma during her last days or were they just waiting for her to die??? We decided to transfer her against the doctors’ advice. We figured that if she was going to pass away regardless of the transfer or not, we would rather place her somewhere where she could receive dedicated care. We were asked to sign a release form stating that CGH will not be liable should anything happen and they kept emphasizing on the fact that my grandma would most likely pass in the ambulance. When we called NUH and told them we wanted to transfer my grandma over, they said it was possible but they needed to speak with the CGH doctors or else we would have to be admitted directly into A&E. Guess what? Our primary care doctor refused to speak to NUH at all. The nurses also refused to book an ambulance for us to get to NUH and told us to get an ambulance on our own. We eventually managed to get a private ambulance and are so thankful we went ahead with the transfer. My grandma made it to NUH.
Upon arrival, my grandma was wheeled into the emergency room. The doctor explained that by then, her condition had already declined severely and so there was really nothing much they could do. Anyway, just to clarify the reason for our transfer was not to miraculously “save her” but instead give her the best care that she wasn’t getting at CGH. When she was admitted, the nurses alerted us to my grandma’s severe bedsores. The bedsores were really bad. We knew the bed she was using at CGH helped prevent bedsores but we had NO IDEA that her bed sores were this severe. NUH immediately started treating the bedsores by applying creams and protecting the wound with medicated gauze - something CGH did not do. They also moved my grandma every 1-2 hours. At CGH, the nurses never moved her until they were changing her diapers, so we always had to do so ourselves.
The service at NUH from the moment we reached the hospital was a complete change from CGH. My grandma was immediately placed under end-of-life care and we were given booklets and guides on how to cope with end of life. My grandma was given heel sponges to prevent further bedsores and compression stockings for her severe water retention - none of which were done by CGH. They conducted frequent checks (diaper change, position change) on my grandma every 1-3 hours. Also, before they did anything to my grandma, they would say “Ah ma, sorry ah, I’m going to change your diapers” compared to some of the CGH nurses who could still joke and laugh with each other while they were changing her diapers.
The doctors and nurses at NUH are better equipped to deal with families going through a difficult time. They were kind, sensitive and respectful to my grandma (and us) and it felt like they were giving her 100% care even though she was going to pass. They also moved us to a private room. The last 3 days of my grandma’s life at NUH was made so much better. She was comfortable and she was treated with respect and dignity, like any other normal patient in the hospital would be. To be honest, it really felt like the staff at CGH had given up completely on my grandma when they decided to put her under palliative care. Just because she was on palliative care, does it mean that a hospital doesn’t treat her bedsores? Does it mean that they can give her as little care as possible? No. You treat a dying person with the same dignity and respect as you would treat a regular patient.
CGH, I urge you to re-evaluate your training towards your staff for end-of-life protocols! Learn how to deal with families who are going through a difficult time. Don’t make insensitive remarks like “it depends on God”. Most importantly, treat your dying patients with the same respect and care you would give to a regular patient in the hospital. It was heartbreaking to see my grandma in the state that she was during the last days of her life. In fact, I wish we had admitted her to NUH from the start. Now, we have to pay a 5 figure medical bill to CGH for what? Disappointing service.
My grandma passed away peacefully on 5th May 2019 in NUH surrounded by all her children and grandchildren. My family would like to thank the doctors and nurses at NUH Ward 6A for making the last 3 days of her life a much more comfortable one. Thank you all.
*No bed sore photos because they are too graphic and I myself can't bear to look at them*
https://mustsharenews.com/changi-general-hospital-complaint/
Warning: Long post ahead.
Writing this to rant about my family’s disappointing experience with Changi General Hospital (CGH) where my grandma was warded before her transfer to National University Hospital (NUH).
On 19th Feb, my grandma was admitted to CGH due to a fall at home. She suffered a compression fracture and was required to stay in the hospital until she was fit to go home. During her stay in CGH, her dementia declined, leading to her crying all day. We wanted to bring her home so she could feel better but unfortunately she contracted Urinary Tract Infection (UTI) during her stay and could only be discharged after the UTI cleared.
On 4th April, doctors said her UTI had cleared and so my family brought her home. At home, her crying continued and she still had trouble urinating/had blood in her urine so she was admitted back to CGH on 7th April. (Are the doctors sure her UTI cleared on 4th April then??)
My grandma continued to be warded and on 18th April, the doctors finally transferred her to ward 68, a dementia ward, so she could receive better care for her dementia condition. Ward 68 was where things went downhill. My grandma’s appetite declined and she complained of stomach aches and vomited blood. The doctors suspected she had ischemic bowel but because of a few reasons (e.g. old age and poor kidney function), a contrast dye scan to confirm the diagnosis and surgery was not an option for her. The doctors told us that she would most likely die because were no other treatment options except palliative care.
On 25th April, we were told that based on her condition, she would only have a few days or a week to live. Until now I can’t comprehend how her condition declined so quickly from a fall to UTI to this. I was heartbroken. Nonetheless, we wanted her to be as comfortable as she could be. The doctors started her on a feeding tube because she didn’t want to eat but she vomited the food out the first time she was fed so they stopped the feeding completely. Due to water retention in her hands and feet, they also stopped the IV fluids completely.
On 26th April, the nurse on duty told my entire family to stay overnight as my grandma’s vitals were going down and that she would most likely die that night. My grandma however pulled through for 9 more days without food and water. I stopped going to work so that I could be there to take care of her.
26th April to 3rd May:
During the days that I was at CGH ward 68 every day from morning 9am till 2am at night, I saw how some of the nurses and doctors were unprofessional, unsympathetic and insensitive towards my grandma and family. Here are some incidents that happened at ward 68:
1. Family members not updated with complete information
The first few days after the doctor’s prognosis, my grandma was still fully conscious and could speak. However, she became super unresponsive one day. We asked the doctors why and they told us that they administered morphine to her at 8pm the previous night. Now, why weren’t we made aware? Please bear in mind that my grandma has dementia, cannot speak/understand much English and would not have been able to understand what morphine was or how it could have helped her, therefore would not have been able to consent to morphine. Moreover, once my grandma was on morphine, she never fully regained consciousness until she passed away. I really wish we were at least informed about the morphine administration instead of keeping quiet UNTIL we asked why she was unresponsive.
2. Unsympathetic, insensitive and unprofessional staff
Because my grandma’s body temperature was really low, the doctor recommended a heater blanket to keep her warm. This heater blanket was on for about a week until one morning, we realised it was missing so we asked the nurse where it went. She said that the doctor ordered it to be removed and that my dad was already informed. Guess what? Nobody informed him. My aunt then asked them to put it back on and the nurse told her “Put everyday got cost you know??”, and mind you, this was the first time we were informed about the charges. Regardless of cost, we requested for it again.
On one night, I wanted to ask the doctor whether it was possible to pursue other treatment options for my grandma since she was fighting and hanging on. Unfortunately, my grandma’s primary care doctor wasn’t on duty so an on-call doctor showed up. The first thing she said when she saw me was “I just want to say that I don’t know ANYTHING about your grandmother” while raising both her hands in the air as if I asked her to surrender?? Errr. I understand that as an on-call doctor she may not know much about the patients BUT she could have at least read my grandma’s case file first OR ask me how her condition was instead of making me feel like I was forcing her to answer something against her will. Unprofessional and rude!
On the same night, my grandma’s heart rate went from 40bpm to 110bpm. I went to the nurse and asked her if she could come over. Guess what? She looked at me in the eye, SIGHED and asked me to wait, turned to her colleague, mumbled something into her colleague’s ears and continued sitting down. Look, I understand if you’re busy, you could have let me know that you’d come by when you’re free, but come on, a LOUD SIGH was really uncalled for. In fact, it made me really angry. Anyways, the colleague that she was whispering to showed up after 15 mins and we asked her about my grandma's heart rate. Her reply? It “depends on God”. Depends on God??? Are you kidding me. It was then we asked her to call the doctor and the on-call doctor mentioned above showed up. Again when she came into her room, and when we asked her about the heart rate, she raised both her hands up in the air (again) and said “errrr there’s so many of you here” as if we were intimidating her. Most of us weren’t even talking to her, we were just listening and trying to understand. And the way she spoke to us was rude as well.
4. Refusal of blood test
Despite doctors and nurses saying that my grandma was going to pass in a few hours/1 or 2 days since 26th April, my grandma’s condition seemed to be stabilising so we requested for another round of blood tests to see if there was maybe an improvement or anything that we could have done for her. We spoke to the doctors about this and were denied the blood tests because according to them, “the results will be the same, so no point doing another blood test”. Hmm ok. On 3rd May, the day we transferred my grandma to NUH, they finally agreed to the blood test and we actually found an improvement in her lactate count and WBC count, however, by then her kidneys had already started to shut down. If the blood test had been done earlier when we requested for it, would it have been different? Maybe. Maybe not. But we wouldn’t know because they refused to do it.
5. Poorly run wards
The nurses were not present at the nurse station or the ward most of the time. We always had to wait, had to request for change of diapers, change of position to avoid bedsores etc. there was almost no initiative taken by nurses and most of the time, our family members did everything. We even helped open the doors to the ward (ward 68 is locked and requires a button to open the door) because there was no one available at the reception desk to do so and the doorbell would RING for ages until someone opened the door.
Because of the lack of care, the insensitive remarks and just overall disappointing service, my family considered a transfer to NUH many times. Whenever we brought it up to the doctors, they would deny our request stating that “doctors in the other hospital would say the same thing” or “she would probably die on the way in the ambulance” so there was no point. Finally, on 3rd May, we had enough. We had a talk with the primary care doctors and they reiterated that my grandma was on palliative care and they were giving her the best they could. Were they? Were they trying to maximise the quality of life of my grandma during her last days or were they just waiting for her to die??? We decided to transfer her against the doctors’ advice. We figured that if she was going to pass away regardless of the transfer or not, we would rather place her somewhere where she could receive dedicated care. We were asked to sign a release form stating that CGH will not be liable should anything happen and they kept emphasizing on the fact that my grandma would most likely pass in the ambulance. When we called NUH and told them we wanted to transfer my grandma over, they said it was possible but they needed to speak with the CGH doctors or else we would have to be admitted directly into A&E. Guess what? Our primary care doctor refused to speak to NUH at all. The nurses also refused to book an ambulance for us to get to NUH and told us to get an ambulance on our own. We eventually managed to get a private ambulance and are so thankful we went ahead with the transfer. My grandma made it to NUH.
Upon arrival, my grandma was wheeled into the emergency room. The doctor explained that by then, her condition had already declined severely and so there was really nothing much they could do. Anyway, just to clarify the reason for our transfer was not to miraculously “save her” but instead give her the best care that she wasn’t getting at CGH. When she was admitted, the nurses alerted us to my grandma’s severe bedsores. The bedsores were really bad. We knew the bed she was using at CGH helped prevent bedsores but we had NO IDEA that her bed sores were this severe. NUH immediately started treating the bedsores by applying creams and protecting the wound with medicated gauze - something CGH did not do. They also moved my grandma every 1-2 hours. At CGH, the nurses never moved her until they were changing her diapers, so we always had to do so ourselves.
The service at NUH from the moment we reached the hospital was a complete change from CGH. My grandma was immediately placed under end-of-life care and we were given booklets and guides on how to cope with end of life. My grandma was given heel sponges to prevent further bedsores and compression stockings for her severe water retention - none of which were done by CGH. They conducted frequent checks (diaper change, position change) on my grandma every 1-3 hours. Also, before they did anything to my grandma, they would say “Ah ma, sorry ah, I’m going to change your diapers” compared to some of the CGH nurses who could still joke and laugh with each other while they were changing her diapers.
The doctors and nurses at NUH are better equipped to deal with families going through a difficult time. They were kind, sensitive and respectful to my grandma (and us) and it felt like they were giving her 100% care even though she was going to pass. They also moved us to a private room. The last 3 days of my grandma’s life at NUH was made so much better. She was comfortable and she was treated with respect and dignity, like any other normal patient in the hospital would be. To be honest, it really felt like the staff at CGH had given up completely on my grandma when they decided to put her under palliative care. Just because she was on palliative care, does it mean that a hospital doesn’t treat her bedsores? Does it mean that they can give her as little care as possible? No. You treat a dying person with the same dignity and respect as you would treat a regular patient.
CGH, I urge you to re-evaluate your training towards your staff for end-of-life protocols! Learn how to deal with families who are going through a difficult time. Don’t make insensitive remarks like “it depends on God”. Most importantly, treat your dying patients with the same respect and care you would give to a regular patient in the hospital. It was heartbreaking to see my grandma in the state that she was during the last days of her life. In fact, I wish we had admitted her to NUH from the start. Now, we have to pay a 5 figure medical bill to CGH for what? Disappointing service.
My grandma passed away peacefully on 5th May 2019 in NUH surrounded by all her children and grandchildren. My family would like to thank the doctors and nurses at NUH Ward 6A for making the last 3 days of her life a much more comfortable one. Thank you all.
*No bed sore photos because they are too graphic and I myself can't bear to look at them*
https://mustsharenews.com/changi-general-hospital-complaint/
