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?

I only have the explanation they gave me about the IV line. I don't trust this hospital anymore, it's not that we have a relationship with a particular consultant cos every time we've seen someone different, so I'm happy to wait a few extra months for another hospital with a better reputation.

herbietea, Paeds a/e doctors are usually very good at getting lines in, and if necessary can put an I/O (Intraosseous- emergency only )line in.

I wonder if the doc trying to cannulate the OPs little man in theatre wasn't that experienced with dehydrated children. It wouldnt be unknown.

Noone can ever get a line in me, and never has been able to, dehydrated or not - I just appear to have no veins

Surely he wouldn't have been that dehydrated after the timings you described above? Perhaps he just has very small veins?!

Cakeforbrains, have you not seen one consultant? Often in clinics, you get to see some of the team, some of the senior registrars or middle grades, but you should stay under the same consultant.

At the very least, you should try to get an appointment with the consultant to try and get an explanation for what happened. PALS can arrange this. Its a shame that you have lost confidence in the hospital as a whole.

I'm sorry your son became so distressed, that you had to wait so long and that the nurses were brusque but YABU to think they have failed you and your son. I only think this, however, as I was seriously ill over three years and was in hospital more times than I could count. It was only through this I began to understand how these things happen. It would be worth going to PALS even if just to get them to help you through the maze that is a hospital.

I've been the fault of operations being cancelled and severely delayed. Unpredictable in both cases. I really understand how frustrating it is to wait and wait without knowing what's going on but there are very good reasons for being nil by mouth which I'm sure you know.

After an operation they can swab your mouth (before you are able to drink). Maybe you could ask if you can do something similar for your son if you are delayed another time.

Next time splash out on new toys/sticker books/waiting around entertainment and you can guarantee you'll be seen straight away! Seriously, though, have you got some baby headphones you could put on an ipod/iphone to listen/watch something?

Really sorry you had such a bad experience, and that the operation was not done. I'm not a Dr, but I can't understand why they couldn't find a vein when he was under GA from gas. DS has had 9 GAs and often comes back with bruises in his hands, ankles, and neck where they have tried to get a cannula in - the conultant explained that that can sometimes be the longest part of an operation, but I'm not sure why they wouldn't succeed.

Unfortunately they will always, of course, cancel all for a lifesaving emergency, and it is especially in emergency situations that they have no idea how long they will take. It's incredibly distressing to be with a tired, hungry, thirsty child, a wretched experience, but thirsty and hungry is different from dehydrated.

I think I would ask for more details about why they couldn't get a canula in, and what the risk of that happening again is, but if the hospital is a good hospital, I wouldn't change to another on the basis of this, grim though it must have been for you.

Oh, thanks for that Nursie999, I didn't realise how much difference it makes. Is it then policy not to put the cannula in until the child goes down for surgery, in case it gets cancelled? With DD the cannula was in a long time before she was called down, so no probs with dehydration. But her operation was an urgent one so no chance of it being cancelled I suppose.

The waiting aside I am really surprised they couldn't get a canular in, and it is that I would be asking about. Ds2 has had numerous operations and been an inpatient when very unwell and they have always got one in. It has on occasions taken ages and needed very senior paediatrician to do it. I wonder if it was taking so long, I mean if he came to hospital very poorly they would manage surely?

As for the wait well it happens, it is frustrating and of course upsetting but if the op had gone ahead today I suspect you would feel much better about it.

Your G.P should be able to refer him elsewhere fairly easily I think.

Sorry you have all had such a rubbish day.

Odeysseus, imagine you are used to having a feed before you go to sleep (7-8pm), and having another one or a nice long drink of milk when you wake up. Instead you are given a few sips water at about 6am, and another small drink of water at 9am. Then nothing until 1.15
You are 18 months old.
Yes, wou will be dehydrated, and worse, will have no idea whats going on..

All kids have little veins, but experienced docs will manage to cannulate easily. Much harder with a dehydrated child (or adult)
Usual rule for kids is 3 goes, then get someone more senior to try.

Yes thank-you for patronising me Nursie I am very well able to manage empathizing with this, as I mentioned, my DS had underwent surgery in June when he was 6 mo. It was very stressful, they mixed up the timing of his last feed so he missed one and was then nil by mouth for 8 hours. Oh yes and then he couldn't feed for 10 days. In the heatwave.

I know EXACTLY what its like, how horrific it is to was your child go through that, to hold them down whilst they are gassed and then leave them to have their face sliced open.

However I also know that every doctor and nurse there did their bloomin best, and that at the end of the day I was not their priority, my son was. They didn't have time to update me every half hour, because they were focussing on him.
I think it's wrong thateveryone jumps in to try and kick the medical staff that at the end of the day, try their hardest.

Sorry OP - not aimed at you, but Nursie.

Having read further responses, it doesn't seem to me that the OP was complaining about her son being bumped off the list because of an emergency, it was about the care her son received from getting to the hospital to the time when there was a failed attempt at cannulation.

In the DG hospital I worked in, there was one main theatre that was designated for emergencies, though they were mostly orthopaedic as they are very common emergencies, so I do wonder which theatre in that hospital had the list bumped for the emergency. That's why I asked whether it was day surgery (where nursing staff have to deal with patients of all ages and all conditions) or a dedicated children's ward going to a main theatre.

As I understand from the hospital I worked in, surgery on young children should be covered by a specialist paediatric anaesthetist, who should have been able to get a cannula in. If that failed, that would raise questions in my mind about dehydration and whether policies for the pre-op care of young children had been followed.

If it were my 18 month old, I'd be looking elsewhere.

I can understand where you are coming from as we have had similar experiences when our ds has had been in for the day for an mri scan - most recently we got told different times for starvation and when we needed to take him in, there was a delay in the time of his scan and it took about six attempts by both a junior dr and a registrar (whilst ds was awake - he too ended up with lots of marks/bruises) to get a a canula in as it's really difficult to find veins in young babies/children. It's not nice to see your child go through this and not be able to do very much about it.

We have waited longer than expected to get dates for ds' mri scans and weeks to get the results and to even speak to the consultant's secretary!

It is all really frustrating, especially the lack of info, communication and co-ordination between staff and different departments.

BUT having spent some time with ds in hospital I know it's generally not because staff don't want to tell you things, it's because they don't have time, emergencies come up and circumstances change and/or take over very quickly from the last piece of info you had or the last treatment your child had.

You're not being unreasonable to be upset by what happened but I think you are being a bit unreasonable to have expected any different - sadly it's just how the nhs works.

I would imagine that another hospital is unlikely to be much different and that to transfer/get a referral may take quite a long time.

Would be a good idea to speak to PALs though - they are there to deal with people's concerns.

Sorry Odyesseus, I apologise, did not mean to be patronising, I have no way of knowing your experiences, I was simply responding to that one phrase/question.

And I completely missed the post about your child's surgery.

I was told that Monday's are best to avoid for ops ad they often have emergency from weekends etc

maybe try for another day in the week instead?

hugglymugly we were on a children's ward, and it was surgery for an undescended testical. Not life threatening but needs doing. I've got no idea how the theatres are allocated but there were at least 8 theatres. We've been seen by the named consultant once, after referral, then by his registrars. The operation was done by another consultant from the same team as the original consultant was on sabattical. If anything, I liked the operating consultant better and she was very apologetic about the situation, she seemed to be blaming the ward staff for a mix up.

You can't usually pick and choose like that, though: a consultant gets a regular morning or afternoon to do 'their list'.

lostfeelings that's really useful to know but they only do this surgery on a monday.

I wouldn't blame anyone for the difficulty getting canula in. I've been black and blue because of difficulty here! In fact they struggled so much once that they filled a bucket with hot water and plopped my hand in it in a vain(scuse the pun) attempt to get the thing in.
Can understand the distress and anger at rudeness of nurses but making a massive fuss seems a bit ott (also don't consultants work in different hospitals?)

All the comments make me think I need to contact PALS just to get a better explanation of what happened - it seems that the ward staff told me one thing but the surgeon had another story. I think I need to know the full reason why the IV didn't work - dehydration seems a pretty important factor which they've not acknowledged, they tried to tell me that cos he's got some 18m puppy fat that stopped them getting the IV line in any part of his body

Yanbu I would not go back. Emergency op aside it was the attitude that sounds wrong. Also the canula thing sounds wrong. I would find another hospital to operate on my son. So sorry he had to go through this.

Far, far worse things happen.

I understand it was unpleasant. Following my own experience, really I do.

But it's not a disaster.

YANBU, emergencies and operations that run over can't be helped. But the nurse should have made an effort to keep you up to date. Your DS was her patient, whether he was pre or post op and she should have taken the time to care for him.