About middle of night hospital discharge?

[hawaiibaby]

Giving myself over to MN jury as I'm unsure in the cold light of day but cannot be objective!

DS, 20m has a recurrent viral wheeze which lands him in hospital a lot in winter with breathing difficulties. He sometimes needs oxygen, sometimes just assessment and monitoring with his inhaler. Yesterday we had to go at 5 p.m. as he couldn't stretch between inhalers without struggling / working too hard with breathing. I knew we'd be there at least 4 hours but more likely 6 or 7 for the monitoring side, and we have previously been discharged at 12 and 1 am once they've been happier with him. Other times we've stayed overnight for monitoring or when there has been something else too (chest infection).

Yesterday, he was unable to wait anywhere near the required amount of time in between inhalers in A&E and they told us he'd stay overnight to be monitored once he moved up to the ward, we got up there at 10 pm. Upon admitting him they said he might be able to leave at 2 am IF he managed without the inhaler for next four hours, and if that was the case, did we want to take him home then or wait until the morning? DH had a big meeting at work first thing so waiting up there until 2 so we could go home wasn't ideal and mainly the cold aggravates DS' wheeze so didn't really want him out in it unnecessarily, so we said I'd stay with him overnight and DH would go and get some sleep, he left at 11ish, and overtired DS finally went to sleep.

At 1 am the doctor came and said his wheeze had almost gone, she was happy he could manage without inhaler until 2, and said we could go home after that. I explained the above convo with the nurse and that I didn't feel comfortable taking him out at that time across hospital grounds / car park, he was exhausted and finally sleeping and it didn't seem like the best thing for him. At which point she told me she was discharging him, there was no reason to stay, other parents had to manage and why were we different? If getting to the car by myself was such a big issue someone could take me and he could go back to sleep at home. Basically, I felt like I was being some sort of freeloader on the nhs for not wanting to leave until morning and her manner was bloody rude. I repeated the nurse had asked us and she said she had already told him he shouldn't have and that I could stay then as they weren't full, but if they needed the bed in the next few hours we would definitely have to leave.

So, at 2 am, when they woke DS up for his inhaler and throat exam, I - completely pissed off, knackered and confused - thought we probably should leave as if I settled him back down then we were kicked out for the bed it would be even worse. Then of course we had to wait half an hour while they fannied around doing I'm not sure what to discharge us. The doctor's (sarcastic?) offer of being walked to the car never materialised so did the deserted hospital grounds by myself. Got home at 330 am, unable to get DH up from his death sleep (chain on door), Ds crying in the car while I frantically banged on the door / rang him / prayed / eventually got in around the back with my kitchen key after climbing over the gate.

WIBU to complain? i'm really not a complainer (lazy) and have am very appreciative of the nhs but am not sure if that's clouding my view - I can be grateful for their help but still displeased with this, can't I? I don't really want to be in this position next time, and don't feel it's right for young kids with chest problems to be forced out in the winter at that time and wonder how many other people on their own with LOs this happens to. If we'd known this was going to happen, DH would have waited and pulled the car up to make it as least disruptive as poss for DS.

Sorry so long - would appreciate perspective!

[FarFromAnyRoad]

I think that's piss poor behaviour - esp on the part of the doctor and yes I would definitely raise the issue. Your poor DS too - I know that when breathing is difficult the very last thing you need is extra stress. If nothing else comes of it I'd hope that there would be some extra training for the staff because it's really not ok to speak to you or your DS like that. Let us know how you get on.

[ImperialBlether]

This happened in our family at Christmas. My mum had an accident (she's in her 80s, my dad is in his 90s) and they wanted her to go home past midnight. I'd never heard of this before - what on earth's going on that they are sending such vulnerable people home in the middle of the night?

[Hoppinggreen]

Yes that's pretty shit.
When my DD was admitted with something similar we stayed overnight because by the time she was stable it was 11 at night and they didn't want us to leave that late ( despite us living 5 mins away)
You could complain but if you think you will be back there regularly is it worth it?

[brighthouse]

Definately complain that is terrible behavoiur especially on a child that has breathing difficulties. I wonder what the doctor would have done if it had been he own son?

Hope he is feeling much better today.

[Gileswithachainsaw]

That's terrible your poor ds. I realise it's not a hotel but he managed one stint of approved time which tells them nothing with regards to how he'd manage the rest of the time.

and ffs who thought releasing him half asleep into the cold in the middle of the night would do a damn thing to help his chest.

[holidaysarenice]

Actually you want to stay in hospital with your now healthy son, at risk of catching something just so your hubby can have a good sleep?

YABU

Short stay children's is just that, for a few hours monitoring and nothing more. It's incredibly busy and suddenly you can go from one or two kids to 8 in the space of an hour, and then there's you clogging up a bed.

Your child no longer needed to e there so you go home. If you need help to the car you ask. Or you bring the car round to the door and then go up for dc who would have been perfectly safe. During the night no one will mind you parking nearer a door.

[MrsTawdry]

They must want the beds for the morning...how shit this is. complain. Hope DS is ok today.

[Gileswithachainsaw]

mind you we have had similar questionable treatment. such as the nurse who decided that the best thing to do for my dd who had been wheezing and coughing all evening to the point of vomiting, was to wait for her to dose off in triage then wake her up to shove a syringe full.of calpol down her throat. no surprised there when she promptly coughed and vomited not all up again then spent the next few hours coughing again

[loopymoomoo]

That is completely unacceptable behaviour and I would definitely report this incident to the hospital - do you know the names of the dr's / nurses involved?

I hope your DS is feeling better!

[MonkeySeeMonkeyDooo]

I have never discharged a patient at night. If someone chooses to stay we let them go first thing in the morning. This is on a children's ward btw.

[milkyway1304]

It's not wanting beds for the morning usually, often there is a queue of people in the emergency department waiting for the bed. It could certainly have been handled better, but it's not unreasonable to discharge the patient once well.

[BarbarianMum]

We've had this with croup a few times and I have to admit it's always seemed reasonable to me. But I've never worried about being out and about at night and much prefer to be asleep in my own bed with ds beside me than propped up by the side of the bed in an observation ward.

[ImperialBlether]

Holidaysarenice, what on earth do you think you're saying? "Actually you want to stay in hospital with your now healthy son, at risk of catching something just so your hubby can have a good sleep?"

Do you really think that's what the OP is saying?

[TheFecklessFairy]

I think people are finally beginning to realise the crisis that the NHS is in. It's easy to ignore it unless it smacks you in the face.

The NHS is in severe severe crisis, and every bed is at a premium, no matter what time of day it is.

I have been waiting months for a procedure on both of my legs. I went in on Monday and was told they had no beds at all. However, they would do the lesser procedure and send me home that afternoon provided I had someone at home with me in case I started bleeding after the op (from a femoral artery!!!!). And out I was popped at 1.45 to come home, bruised, battered, and groggy. But I was still sincerely grateful that it had been done.

[Gileswithachainsaw]

I have an asthmatic dd. time between requiring inhaler can vary. no way would one gap of four hours be indicative of whether or not it dd would last the next time.

[YesIDidMeanToBeSoRudeActually]

I hope he's feeling better. It's v stressful having a DC in hospital, no matter for how short a time!

I'm sorry but I think you were a little YABU. I don't think vulnerable or elderly people using public transport unaided, for example, should be discharged in the middle of the night, but your DS was judged well enough to leave, you had a car and DH at home. Having to walk to the car on your own and your DH being asleep isn't really worth complaining to the hospital for. I can never wait to leave hospital, always think it's nicer for DC to be back in their own cosy bed and able to sleep in rather than being woken fr obs etc. The sad fact as well is that the bed is needed, perhaps for someone in worse condition so I would feel grateful to be able to leave tbh.

Hope you all feel better after a good rest.

[ThatsNotAKnifeThatsASpoon]

OP that's shocking. Definitely complain.

Holidaysarenice what a shitty comment. The child is just 20 months old and had breathing difficulties just a few hours previously. FFS.

[ginmakesitallok]

Yabu, if your son is well enough to go home, and had someone who can safely look after him then you should be discharged, that way you and he both get to go to your own bed and get some sleep and the hospital bed is available for someone who needs it.

[NoStrange]

I think you should complain.

I am a huge supporter of the NHS and understand that it is over-stretched, but if people don't complain about this sort of thing, the hospital (and government) aren't forced to look into these issues. It just isnt right to discharge a baby with a history of breathing difficulties in the middle of the night. No way.

I was discharged at 5am once when 8 months pregnant, after being in hospital for 12 hours being monitored for lack of foetal movement. A trace showed my baby's heartbeat was fine and the doctor told me I could 'go home' - despite being in central London, miles from home and with no tube running at that time, and despite the fact I still couldnt feel movements AND had an appointment at the same hospital at 11am for a blood test related to a high risk pregnancy condition I had . The doctor was so rude and made me feel that I was some sort of princessy prima donna for being worried about my baby.

I was so stunned I just left and went and sat in the (closed/not serving tea) hospital cafe downstairs until my DH could get there a few hours later. I wish I had complained. I had a c-section the following day because my baby was in distress. Luckily, she was OK. Wish I had complained about it, though!

[hawaiibaby]

Thanks all. Yes DS is much doing better today still needing inhaler but that is normal for another day or so.

Holidaysarenice Err, no, that is not what I'm saying at all, but thanks ever so for such a nice comment. Staying in another 5 hours is not likely to have resulted in DS catching something, but did cause a lot of disruption in the circumstances (unless you're used to climbing over gates in the middle of the night while your child screams on their own in the car unwell and upset). This is our 4th admission in 5 months, we do all we can for DS but life does have to go on, people have to work - we made a sensible decision when ASKED, taking into account the circumstances. The fact that this was withdrawn is what caused the upset.

I think I was / am worrying my being upset and tired is impacting, so am taking on board the YABU comments. Of course prefer to be at home, and we both slept once we got back and also know the nhs are stretched. I guess the main issue (although I do think it's a bit weird to discharge at that time, when there are beds), is that DH would have hung around if they hadn't given us the choice to stay. And it was never a definite 'you will be able to go at 2' and we chose to stay - it was a 'you MIGHT be able to go at 2, depending how your son is at the time.' So we had to make a call, taking into account that A&E thought he'd have to stay and that previously that day he hadn't made it longer than 2 hours in between inhalers.

I want to complain I guess to highlight the impact it can have on people and how it made us feel, more for staff training I guess. But then I do wonder if I'm over reacting and if that's how it is, that's how it is. It made me feel like shit in an already stressful situation, and I did find the doctor very rude. Can't decide if I should just suck it up or not, hence the MN jury request!

Nostrange How awful and stressful - what a cow. So glad all was okay but not a nice end to your pregnancy.

[Mandatorymongoose]

I think yab a little bit u.

You didn't actually get kicked out, you could have stayed, they just warned you that if they desperately needed the bed they would have to ask you to leave - which seems kind of fair enough. They can't really keep sick people in the waiting room or the hall because you don't fancy going home at night even though your DS is ok can they?

The Dr does sound rude though. I imagine they were frustrated by you being told one thing by one person which didn't make sense to them and put them in an awkward position, they shouldn't have taken it out on you.

The rest of it is neither here nor there - you could have asked for a hand to the car, no one could have known if it was worth your DH staying or not so that doesn't make much difference, they had to wake DS up for obs and the discharge paperwork has to be completed before they can let you go.

[Heels99]

Dr wasn't very empathetic. But who knows, he could have worked a 30 hour shift, a child could have just died in his care, he may have multiple emergencies on the way in etc etc etc. it was 2am and the niceties went out the window. It was unpleasant and inconvenient for you. Glad your son is ok now. Drs do a tough job in sometimes horrendous circumstances and I guess sometimes they are too exhausted to put a nice spin in things.

[Sleepytea]

I agree it's not fair to your ds that you should have to leave in the middle of the night but...
I have heard DH (a surgeon) negotiating over beds in the middle of the night. He frequently has patients who he can't admit to the hospital because they have no free beds/nurses. I always feel sorry for the patient who frequently ends up at the other end of the country because it's the nearest bed. It's a very careful balancing act for the doctors trying to do the best for everyone. So whilst for you it was inconvenient to get your child home in the middle of the night, for another family it may have meant a long drive to get their child the care they needed.
I hope your ds is feeling better now.

[lillibeta]

I think the facts of the case aren't as important as the poor communication from the doctor. If she'd said something like, "I'm really sorry, but my colleague was mistaken. We actually do need the bed. I appreciate it's difficult for you, but I'd be really grateful if you could help us out...." etc etc, you'd still have been a bit pissed off, but you wouldn't be thinking about complaining. Sometimes it can be helpful for doctors and nurses to have their communication skills highlighted - you don't even have to call it a "complaint", just say you want to give feedback.

[ImperialBlether]

Sleepy, I don't think anyone would mind in those circumstances, though. If someone said, "I'm really sorry, I know it's the middle of the night but someone has just arrived by ambulance and they will need a bed in the next hour. There's no other bed available. Would you mind if you took your son home now, given he's stable?"