Final Report > Chapter 9: The Paediatric Cardiac Surgical Service in Bristol > Parents at the BRHSC and the BRI > Information made available to parents and the process of obtaining consent
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Information made available to parents and the process of obtaining consent
36 The parents would be seen by various members of the medical staff following admission. Mr Dhasmana and Mr Wisheart would see the child and parents before surgery, [34] as would the anaesthetists. Dr Pryn, as anaesthetist and intensivist, said that he always visited the patient on the afternoon or evening prior to surgery. He attempted to make sure that his visit coincided with the presence of the child's parents or guardians, although that was not always possible.
37 However, Dr Jordan told the Inquiry that a further assessment, following admission, was not always easy as far as the cardiologists were concerned, as the children were sometimes admitted directly to Ward 5 at the BRI. [35] He stated that he tried to see all patients on the day before their operation. However, because there was no formal arrangement for this to take place, he stated that he often arrived at Ward 5 to find that the child had been sent off with the parents into the town, once the routine tests had been carried out. The physiotherapists would also have their own conversations with parents and families.
38 The Counsellor in Paediatric Cardiology, Mrs Helen Vegoda, a qualified social worker, who took up her post in January 1988, told the Inquiry that on occasions she would sit in on the meetings when details of the surgery were explained to parents. She said that she would usually try to ascertain whether parents had understood the explanations given to them by the surgeons or cardiologists and, if not, would arrange for a further explanation to be given by a consultant, registrar or nurse. [36] The Cardiac Liaison Nurse, Miss Helen Stratton, who was in post from November 1990 until February 1994, said that she had wished to attend the BRHSC to provide support to parents at the time of diagnosis. As a nurse she felt that she would be in a better position than Mrs Vegoda to explain clinical matters to parents. However, she was essentially prevented from doing so by issues of `territory' arising between her and Mrs Vegoda. [37] Following her qualification as RSCN in 1992, Ms Warren attended outpatients' clinics so that parents could talk to her after they had seen the consultant.
39 At the BRI, the admitting nurse was responsible for welcoming the child and family to the Unit prior to carrying out a pre-operative screening for infection. [38] On admission, the nurses talked to the parents and families about the child's operation, about intensive care and other aspects of the treatment. [39]
40 The experience of parents differed according to the urgency of the operation. For urgent operations, parents were told when they could expect surgery to take place, and asked to telephone closer to the time to find out if the operation was on schedule. [40] For elective operations, arrangements were made to see the family in the outpatients department, and if the family accepted the advice offered, the patient's name was placed on the surgeon's waiting list. The parents were informed when the operation was expected to take place, enabling them to plan ahead. In practice, these estimates sometimes proved inaccurate.
41 While their child was in the ICU, parents might be given different information by nurses about their child's treatment within a relatively short space of time, due to the fact that different consultants conducted their ward rounds at different times. [41] Advice given at 8 a.m. could sometimes be changed at 9 a.m., or countermanded by someone from a different specialty.
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Footnotes
[34] WIT 0084 0066 Mr Dhasmana; WIT 0120 0359 Mr Wisheart
[35] WIT 0099 0040 - 0041 Dr Jordan
[36] WIT 0192 0003. Mrs Vegoda said that she would never try to explain the medical aspect of any procedure as she was not qualified to do so
[37] In January 1992 it was agreed that Miss Stratton would work at the BRI, and Mrs Vegoda at the BRHSC
[38] WIT 0213 0032 Julia Thomas
[39] WIT 0120 0150 Mr Wisheart
[40] WIT 0084 0067 Mr Dhasmana