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Why should ear irrigation be an issue? - Carers UK Forum

Why should ear irrigation be an issue?

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As some of you will know I have cared for my mother for many, many years and even though she moved into a care home in January 2016 (after numerous falls), I still care for her, visit two or three times week and amongst other things, do my best to ensure she has a regular supply of chocolates.

There have been many issues with her care home (and still are) but the move of just four miles from her bungalow to a new area also meant the need to change to a new doctor, which unfortunately has raised a whole new batch of bad care issues. Once again I find myself up against mind boggling stupidity and 'can’t be arsed' attitude from those who have the affront to call themselves health care professionals. This time its apathy from her new doctor, who has chosen to ignore my letter in which I ask why there is no hot water in the nurse’s room.

To cut a long story short, the care home ‘lost’ my mother’s hearing aids and won’t pay £69 for new ones. Her doctor has arranged for new free NHS ones to be fitted in a hospital eight miles away instead of the local Specsavers which is just half a mile down the road from the care home. Both doctor and care home forgot to take into consideration my mother’s ears would need to be irrigated first before they booked the appointment. This meant when we arrived at the hospital they could not fit new hearing aids as her ears were full of wax. Were it not for the fact that my mother enjoyed the drive, it would have been a totally wasted journey.

Since this latest gaffe, over the past four months I have been taking her to the new doctors to have her ears irrigated, usually by the nurse and on one occasion by the health care assistant. This is in preparation for the big day when she can once again make the journey to the hospital audiology dept. Today was the fifth irrigation attempt and again it was unsuccessful. I should point out that my mother has had her ears irrigated at her old doctors surgery at least two dozen times over the years and has never had a problem. So obviously they are doing something wrong.

I have asked them on every visit why the water they use in the irrigation pulse machine is always cold. I told them whenever I and my mother had ear irrigation, the nurse always used warm water from the tap. To my surprise the nurse told me, ‘there has never been hot water in the room’. I am not a health care professional, but that statement sounded very odd to say the least. Then on the next appointment and this time with a different nurse, she also said exactly the same, they have never had hot or even warm water in their room. My doubts and suspicions about this surgery were confirmed and that is, no one is bothered about patient care.

A visit to this nurse’s room will mean you can expect a shot of cold water in the ear canal and it's especially chilly this time of year. (I hate to think what a colonic would feel like). This surgery is one of three that share the same building, so I rang another surgery and was told their nurse’s room does have hot water. I felt sure my mother’s doctor was unaware of his plumbing problem, so I wrote a letter to him to say what I had discovered and how the Pro-Pulse irrigation machine should be used, (as clearly the nurses did not) and I personally handed the letter to reception. Two weeks have passed and still no reply, it looks like the letter has been completely ignored. (I meant to say deaf ears) After checking reviews on the NHS Choices website, it appears this surgery has the most negative feedback in the area. So I have asked my mother’s care home to transfer her to a better doctors surgery, with warm water in their taps.

Occasionally I record some of my mother’s medical appointments and other care-related meetings on my phone, this is because I have become a little hard of hearing and have a terrible memory. Below is a small transcript of some of the conversation between the nurse, my mother and me during the second and last visit to the nurse’s room. The conclusion is that the nurse is a liar.

Friday 30th September 2016 2.52pm

Mother: Ahhhhhh...
Nurse: Is that because it’s cold or is it painful?
Mother: Its cold, cold.
Nurse: Well I can't put hot water in there.
Mother: Ahhh...
Me: That's strange... Everyone else that's done it, have used warm water. The surgery in ***** *****, they always use warm water.
Nurse: OK well.
Me: You don't have it here?
Nurse: I've never had warm water out of that tap; warm water out of that tap. And its a public building so I hazard a guess they wouldn't have it if I ask anybody... so. Right, sit up for me.
Nurse: If is too cold, it’s too...
Mother: Uh.. Uhhh...
Me: That water feels quite cold to me. You would know better than me, but with it being wax, you would think you need warm water to soften it...
Nurse: No, no, no the olive oil softens it.
Me: So it doesn't need warm water.
Nurse: No, no, no that why we recommend olive oil because it softens it. I will try again, it will take a bit of time but I can assure you it will come out. But if it’s uncomfortable for the patient then I wouldn't do it. I’ll try one more time Flow, but if it’s uncomfortable, because it’s you that's feeling it and if you don't like it then I will stop, OK. And I will tell them to continue with the olive oil until it comes out. OK? Alright sweetheart.
Mother: Ehh... Uhhhh.


Monday 17th October 2016 11.50am

Me: You've got warm water! (to the nurse)

Nurse: We do have warm water, but the policy says I can’t just put hot water... So I will make sure it’s warm.

Me: It was very cold last time and it was cold on the other occasions as well.

Me: I've just run that water so it will be quite warm. Do you have a thermometer to test the temperature?

Nurse: It comes out at... It can’t come out above a certain temperature. So that’s the first thing. And obviously before I put anything in her ear I will check it.

Me: Because when I spoke to you last time, you said you had never had hot water out of that tap.

Nurse: I do get hot water out of the tap, if you run it for a long time, you've got to get hot water out of the tap. Even then it would never be at a high, high temperature, ever, because it’s a public building so you can’t have a real hot, hot water. If you got taps running hot water then you have a thing over them saying hot water coming out of your tap.

Me: Yeh, but you told me last time and the other nurse, that you never have hot water in this room. So you are contradicting what told me last time. (I then quoted to her the entire section from the Pro-Pulse Irrigator instruction manual on how to use it with warm water. I especially mention the paragraph which states, before use, run the water through the machine to eliminate air and cold water.)

Nurse: No response...

Me: Because every time it’s been cold water.

Nurse: No response...

Me: If you remember two weeks ago, she flinched because it was cold.

Nurse: No response...

Me: And every time I've had my ears irrigated, it’s always been hot water and the nurse always run the tap to make sure its hot water.

Nurse: No response...

Me: Perhaps where you are here, you are on the end of the hot water feed, I'm not a plumber so I don't know.

Nurse: No response...

Nurse: (Finishes putting water in the Pro-Pulse Irrigator.)

Me: Can I just test that water... Yeh that's alright that, better than freezing cold. Good. You know this time of year, it just gets colder and colder.

Nurse: No response...

Nurse: (Puts irrigation cup beneath my mother ear. I offer to hold it, as I have done on every previous occasion, but the nurse says ‘no thank you’. She then inserts the Pro-Pulse water nozzle into my mother’s right ear and presses the foot pedal to start the machine.)

Mother: Ahhhhhhhh.... That’s cold.

Nurse: No response...

Me: That's still cold is it.
Me: I ask the nurse to run start the machine and run the water over my finger and the water was cold.
Me: I thought you had put some hot in... It felt hot in the tank, maybe it needs to run through the system.

Nurse: No response...
Nurse: (The nurse runs the water through the Pro-Pulse system for 5 seconds more.)

Nurse: OK...

Me: Let me try it again... Yeh that's warmer... That why I said you’re supposed to pump it through before you put it in the ear. According to the instruction book.

Nurse: No response...

Nurse: (Continues to irrigate my mother’s ear. I am now holding the cup as my mother has let the water run down her clothes. That's why I always held the cup in the past)

Nurse: Is that uncomfortable?

: It's alright.

Are you sure?
Copy this to both the Care Quality Commission and the nurses governing body.
Hi bowlingbun. Thank you for advice. I was hoping you or someone would tell me how to proceed and I will do as you say. I doubt very much it will make one bit of difference though as in my experience, anyone working in the NHS is a law unto themselves. Nay body cares and they are more concerned about saving money... at any cost.
Hi Tony
Have you considered finding a place that uses suction for ear wax. My husband can't have irrigation as the water makes him dizzy . He says the suction method is so much more comfortable. He went to a local audiologist and said he would never have it done at the GP again.
Do hope your mother gets her hearing aid soon

Hi Susan
When the nurse failed to remove the wax for the 5th time yesterday, she spoke to the doctor and said he is going to arrange an appointment to have the wax removed by suction. Does your husband prefer the suction method as opposed to irrigation? No innuendo intended.

The problem seems to be either cotton wool or tissue that has become lodged. This was discovered on the very first visit, over four months ago when the Health Care Assistant spotted what she thought was cotton wool. The RGN Practice Nurse also noted the obstruction on her first attempt, but on the 4th attempt decided it was only wax. Now (yesterday) she is saying it is tissue. Incompetence, apathy, liar and lack of intuition makes me think she should not be allowed anywhere near a doctor's surgery, at least without supervision.

This cold water irrigation must have been going on for ages. Am I the only one to have spotted the error. Am I blessed with the gift of uncovering dodgy practice, or just unfortunate to always be in the thick of it.
Tony, I think I live on an island surround by it!!

Just been declaring war with social services. Told their Publicity Office that either they sort things out by 1st November or I'm going to the Press.
Whoaaaaaa !!!!!!! Seriously unbelievable to read this absolute farce you having. ...
I have been to my local hospital ( audiology department ) and had the suction done.... I have also been to the nurse at my gp surgery on NUMEROUS occasions ... in fact roughly every 3 month ( I make loads wax !!!!) The syringing at the gp's is always done with warm water. ... never had it done with cold !!
I would complaint for sure. . Ask to see the practice manager .....and I would most certainly take it further with your mum's care home as to the loss of her hearing aids... not good enough... :mad:

Its taken the doctor over two weeks to reply to my first letter, so long in fact that I had written a second and even longer letter headed 'Official Complaint' and also handed that one to reception before receiving their reply. As I expected, he has glossed over the important points like why did two of his nursing staff, quite independently, tell me that they have never had hot water in their room. The doctor's reply says,
' I can assure you', I always know when they say that I am about to be told a load of BS. ' I can assure you that hot running water is readily available in all our consulting rooms and we are therefore able to gain access to warm water for the ear syringing if that is what is required'.
So why the hell did the nurses not use warm water then! His letter goes on to make more BS excuses about, 'considering the issues of scalding and even Legionella, and in certain circumstances would follow the local protocols rather than the manufactures recommendations'. BS! So on that basis they would never use warm water for anything.

In my new letter I say how I deliberately held back telling him about my recording of what the nurse said, as I did not want to appear disrespectful or get any one into trouble. But I realise that was a mistake as his staff have shown no concern for my mothers welfare. So on reflection I have included the transcript from my first post in the letter new of complaint. It will be interesting to see if they come clean or continue with the BS.
I'd see if you can persuade your GP to refer you're mother to ENT for wax removal I think and might now you've pointed out a few things!
Hi Elaine
The nurse told me that the doctor is arranging an ENT appointment and the care home manager said it should be sent to them in a letter. I just hope they don't make her wait for the standard NHS 18 weeks .