to not want to take DS2 back to this hospital

[cakeforbrains]

DS2 was in hospital today for an small-ish but essential operation. We had to starve him from midnight last night, he was allowed a few sips of water before 6am and then nothing to drink. He's 18months and still breastfed so starving him was pretty hard work.

We got to the hospital as requested at 7am, then sat around for an hour waiting. They then rushed through all the paperwork and checks and said we'd be going down approx 9am. Then at 8.55 they said they'd been a delay due to an urgent operation, and he could have water until 9am. We then waited until 1.15 before they were ready to take him down to theatre. I asked several times for an update on timings and pointed out that he was getting distressed due to the lack of food and drink and just having to hang around. Several times I was told that they were too busy to find out when the op was scheduled for, and one nurse told me that as he'd had water at 8.55 he couldn't be dehydrated and I should stop moaning. By 1.15 DS2 has fallen asleep, but they told me to wake him to take him down to theatre. Then we sat outside theatre for a further 30mins, with DS2 screaming the whole time as he was starving and tired.

Once we were in theatre DS2 was given gas to put him to sleep and I left. 30mins later I was sent down to recovery and told that they'd not managed to get a canula into him and so they couldn't proceed with the operation. DS is covered in marks and bruises from their attempts to get the canula in. I'm quite sure that getting the canula in would have been easier if he'd not been dehydrated and distressed. Had I been told at the start of the day that we'd had to wait until 1.15, I'd have walked out. But they refused to give me any information. Now they want DS to come back in a few months for them to have another go

So ... if you got to the end of that ... AIBU to not want to take him back to that hospital, and also to complain about the way he was treated. I have no problem with them prioritising the emergency case, but I am unhappy about the poor communication, the attitude of the nurses and the general disregard for DS's wellbeing which was not far off cruelty. And does anyone know how to change to another hospital at this stage?

No, I wouldn't take my child back there without massive assurances that there wouldn't be a repeat. There may have been genuine reasons but still not acceptable for any of you to be treated like that.

First get in touch with PALS (patient liason service)

Then go back to your GP and ask for a referral to a different consultant/hospital

question - if the operation is essential, why can it wait a few months. You need to put all this in writing to the hospital's PALS office. You will probably find that next time around they will take care not to upset you rather than to take it out on you. I would also take some pictures of the brusing and the marks. Try also to find a few positive things to say but be very clear that some of this was unacceptable, precise about what was unacceptable and why. Offer to meet with the director of paediatric nursing to discuss your concerns further.

To be fair, the delay was due to an urgent operation.

I understand your frustration, but I wouldn't hold it against them.

I'm not sure what you should do but I agree, if I'd have been in your position I would have been really upset for such a young child having to be starved for so long and being so distressed. Is there no one you can speak to about this and get someone to talk through your experience and the lack of communication and make sure this doesn't happen again? PALS maybe?

onceamai the operation has to be done at some point in the next couple of years, but the consultant wanted to do it now because he felt that by doing it younger he'd not have any memories of it later.

The hold up was emergency surgery. How would you have felt if they had said "sorry your child/husband/father can't have an emergency procedure because there is a young child who needs a routine procedure"

I understand your frustration but it is part and parcel of the system, emergencies take priority.

Heathcliffe I totally understand that urgent cases happen, but I think they should have estimated the time delay and told me so that we could have reached a joint decision on whether it would have been better for the operation to be rescheculed. If they'd said at 9am that the operation wouldn't have been until 1.30, I'd have asked to leave and come back another time. But they kept fobbing me off by saying 20 minutes or telling me that I was unreasonable to ask, that's what I have a problem with.

I'm afraid that it's not nice and just totally adds to what's an already extremely stressful situation, but if an urgent op came in first then that has to take priority, and they can't always give estimates of how long these things will take.

I do understand your frustration, but I don't think going to a different hospital would be any different. They can never promise what time an operation will happen for definite because the lists can change on the morning, if a patient is too ill for the op, or an emergency comes in. And your DC has to be starved for the whole time (not nice) so they can go up whenever there's a slot.

I think on balance you may not have much to complain about other than the manner of the nurse who told you to stop complaining. The staff sound like they were doing their best, working all day to fit in emergencies and their scheduled patients. They weren't to know that they would not be able to get a canula in your DS, not for sure. If they hadn't tried, and had sent you home saying "he's been waiting too long, we may not be able to get it in" you would have been very angry about that I would think. No win for the staff who are just working all day to do their best for everyone.

Also, surgery does involve physical handling and this can result in marks. Surgery is tough physical stuff and not pretty. I looked like a car crash victim after my CS but I knew they had had to be quite 'rough' with me to get everything done they needed to in order to keep me and DS safe

I am rambling now - but maybe what I would do is phone PALS and ask for an appointment so you can talk things through; and see how you feel as time goes on.

The delay can't be helped - people get bumped for more urgent cases all the time. The cannula thing is a bit weird though, it should be pretty easy to put in - they do it to tiny prem babies all the time so should be easy enough to do to a bigger child even if dehydrated etc.

'I'm afraid that it's not nice and just totally adds to what's an already extremely stressful situation, but if an urgent op came in first then that has to take priority, and they can't always give estimates of how long these things will take.'

You took the words straight out of my mouth.

I agree that another hospital probably wouldn't change things.

I also still wouldn't hold the situation against the hospital.

I do understand that it must have been difficult - had a similar situation when DD1 was getting her tonsils out. But it's not easy for the healthcare staff either.

I would ask for an appointment with the consultant (through PALS if necessary) to talk through your and your son's experiences - just in case he didn't know what was happening.

Was your son on a day surgery unit or in a dedicated children's ward? If in a day surgery unit I'd go further and ask whether the staff there understood the difference between an 18 month old and an 18 year old, especially in terms of dehydration.

YABU, I am afraid. Hospitals are places that exist to treat sick people first and foremost, and in a toss up between saving lives and keeping you updated, they will save lives.

At 18 months old, going without water for 3 hours between 6am and 9am is not going to harm him, nor dehydrate him significantly, and the four hours between 9am and 1.15pm is also not unreasonable.

Cannulas are vital with any surgery. Without them, a small complication can become life-threatening. The last thing you want when a patient is compromised is inadequate access to the venous system. It simply isn't safe to continue without a cannula in situ, and it would be negligent to do so. They will have persevered to avoid having to put you through the whole thing at a later date.

Your DS was not distressed when he was having the cannulas sited - he was under a general anaesthetic.

I am not being unsympathetic. I have been there. DD1 has SN and needed an MRI scan under GA. She was starved from Midnight, and we waited and waited, until at 1 pm she was given her gown, then the radiologists phoned to say that the scanner was broken.

I have also had occasion to take her for an emergency appointment at the hospital, then the Senior Reg was caught up for 6 hours on emergencies, so we just had to wait.

It's life. But it is easy to accept because I am a Nurse (or was, haven't nursed for 3 years) and I have seen it from the other side.

In an ideal world they would keep you updated. But if they are so busy with sick patients that to keep you updated meant that their other patients suffer, they have to prioritise.

YANBU.

I hope next time everything goes much better.

I take all the points about prioritisation, but I think I will go ahead and complain through PALS because it seems to be the only way of getting a response. I feel that the attitude of the nursing staff was unkind. I will also ask the GP for a referral to another hospital, because I've lost faith in the first hospital being able to care for DS2 adequately. Writing it down has helped, so thank you all.

not always easy to get a canula in.

when dd3 had surgery she was sceduled in for 9am. she wasnt in theature till well after lunchtime due to emergencies coming in. thats the way it goes. she was starved as well, and yes it was hard work, but just had to get on with it.

the same could happen in any hospital.

Hmm, normal practice for children and adults is to be nil by mouth for fluids for 4 hours prior to surgery. (this is unavoidable unfortunately)
If there is a delay, usually, an IV cannula will be sited to prevent the child from becoming dehydrated.
I think you should put your concerns in writing, (speak to PALS) and I bet the consultant will guarantee that you will have a better experience the next time.
The delay was unavoidable, (I'm sure you understand that emergencies will always take priority over elective cases) but it sounds like the communication was pretty poor, and I am surprised your child was allowed to become dehydrated. (If I am reading this correctly, it is one of the reasons they couldnt get a cannula in?)
These are the points you should make a fuss about.
I dont think changing to another hosital would benefit you in the long run though.

I do think that if the nurse was rude to you then that is unreasonable, but if she was just brusque - then that's more understandable.
DS had an op in June when he was 6mo, and whilst we had similar experiences in terms of timings, fastings etc - the staff were magnificent which made everything bearable.
Good luck for when your DS does have his operation.

herbietea you are not 18months old tho ...

The problem with emergencies is they don't always go to plan - they may have thought they'd be finished soon but something may have happened that they didn't expect and tbh keeping you up to date will be the last thing on their minds if it's a matter of life and death.

I don't think YABU to feel frustrated but if your DCs op was that important they would have kept him in and found a way around the problem with the cannula.

I'm confused as to why they couldn't put the canula in? You say it was because your DS was dehydrated and distressed, but I thought he was under GA at this point? I'm not a doctor/nurse but when DD was in hospital at 15 months she had to have a canula in which ended up being replaced several times. Not nice, but never a problem to do- and she was always awake, which would presumably make it harder? It just seems like a strange reason to cancel the op, especially if he was already asleep?

pozzled they said they couldn't find a vein, even tho he was asleep. He's got marks on both hands, both feet and his arm where they tried. I do not understand either.

Absolutely AuntMaggie, but usual practice for children is to avoid dehydration.
Kids are always prioritised over adults for emergency theatre lists, and if they get bumped off for another child, it is usual and very important to avoid dehydration. A few sips of water before 6am and a small amount of water at 9am would not be sufficient.

I think the OP should go to PALS and discuss the issues; they are usually very good at getting patients/relatives voices heard. And as I said before, the biggest problem here seems to have been communication.

Pozzled, dehydrated kids are a nightmare to get IV lines into.