A NOTICE detailing what nurses should do in an emergency appeared in a staff room only hours after a woman bled to death following breast cancer surgery, a fatal accident inquiry heard yesterday.
Gillian Edgar, 42, a staff nurse, told the inquiry at Edinburgh Sheriff Court she had never seen the protocol before the incident, but only heard about it "by chance".
Shown another protocol specifically for emergencies following breast surgery
, Ms Edgar said it was the first time she had seen it. She was in charge of the night shift in ward six at the Western General Hospital, Edinburgh, on 22 March, 2006.
Marlene Wightman, 49, of Dalkeith, had a mastectomy that afternoon. Ms Edgar said at the handover from the day shift, no concern was expressed about Mrs Wightman. She was told a junior doctor would check on her.
Ms Edgar checked Mrs Wightman's blood pressure at 8pm and found it was dropping and her heart rate had risen. Ms Edgar said she and the doctor had "a plan" that Mrs Wightman's condition would be reviewed at 11pm, but if there was any deterioration before then the doctor was to be called.
The nurse admitted that instead of checking Mrs Wightman every hour, she did so every two hours.
Miss Edgar said she checked Mrs Wightman again at 10pm, and although her patient complained of "feeling tender and uncomfortable" she did not regard that as an emergency.
At 10:45pm, Ms Edgar said she went to check on Mrs Wightman and found she was "not responding". She told another nurse to contact the hospital's night emergency team of doctors and nurses. Mrs Wightman died early on 23 March.
The surgeon who had operated on her, Michael Dixon, was not told of the deterioration in her condition or asked to return to the hospital. He noted "a failure to realise this unfortunate woman had lost a great deal of blood. This was a preventable death".
Ms Edgar said in September 2006 "something like this happened again and I left. I couldn't work there any longer".
The inquiry continues.
The full article contains 357 words and appears in The Scotsman newspaper.
