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 really sympathise with the way you are feeling however I can also give you a little bit of 'the other side'.

The staff in theatre/ the ward were probably hampered by the fact that they didn't know when the emergency case would finish. There is a 2hr window after having a drink after which you wouldn't want to give a GA ergo sometimes it seems better to NOT give a kid a drink because they may then not be fasted when you are ready.

Sometimes these on the hoof calculations go a bit awry (I know I gave someone a drink on Friday, the case in theatre finished a bit early, they person I'd given a drink too then wasn't fasted and they ended up waiting even longer).

I wouldn't necessarily predict that a child who had waited 'til lunchtime would be dehydrated and I also wouldn't rush to set up IV fluids on such a patient especially if they were coming to theatre for a gas induction (often chosen 'cos their veins look crap) and didn't have local anaesthetic cream on.

As to why they couldn't cannulate under GA - well sometimes these things are just hard. It would have been a difficult decision, I'm sure, for the staff to wake him up but proceeding without a cannula would have been really dangerous.

Chunky toddlers are amongst one of the most difficult groups to cannulate. There are plenty in my social circle of whom I think don't ever get sick 'cos someone is going to have a nightmare.

In resuscitation circumstances for such children we sometimes stick a special needle straight into their bones to give essential medicines. This is clearly inappropriate for an elective operation.

Thanks gasman, that's really interesting. DS had magic cream on both hands, but they said that they thought it was better to use gas initally for little ones. I see the point about chunky toddlers but he's not that chunky - he's just about the 25th centile in the red book. But it seemed almost like we got lost in the system when they postponed us for the emergency then they suddenly realised we'd fallen off the list - does that happen?

DS had major surgery at 4 months old and we were bumped twice, having starved him etc, due to emergencies. We had had all the risks explained to us, 2% mortality rate (which sounded horrifically high to me), so got all psyched up, then were told it wasn't happening. I'm told that's pretty normal and how things work in the NHS. What helped us through the horror was the kindness of the nurses and doctors. I do think that makes all the difference, and YANBU to expect kindness. Although your situation probably didn't seem like a big deal to the staff, as they are used to people in far worse situations, I guess, they shouldn't have forgotten that it was a big deal to you and your DS and they should have treated you with kindness.

Cannulas can be really difficult to get in. Given the situation described I dont think that there is necessarily anything 'wrong' by the failure to cannulate. Some people are just really difficult (especially small people!), and in a non-emergency situation there are times when the only option may be to try again on a different day.

I can understand you've had a crap time with your son.

My DS1 was an emergency operation one Monday morning, pushed in at the beginning of surgery.

The op was supposed to be a quick one - in and out in less than an hour.

He was 4hrs 50 in theatre.

All the morning patients were pushed back and the afternoons sent home.

I felt shite for them.

It's really interesting that people keep saying that x and y are normal on the NHS, why shouldn't I expect a decent service from the NHS? Just a thought ...

Folk do ocassionally get lost (everyone involved in the process is human after all) but it isn't a normal occurence.

I suspect that the more likely explanation is that the theatre team got absorbed in the operation and didn't keep the ward staff up to date with what was going on (so they couldn't tell you). In addition if things are hectic/ stressful in theatre it isn't helpful to have wardstaff hassling you about when their patients are going. They usually know this so don't hassle so don't have info to give parents.

All a bit crap for you though.

What tholeon is describing is the lottery of the emergency list where you have someone who needs an operation but can wait and when the proverbial shit hits the fan has to wait. I always really feel for the parents/patients in situations like this.

The only vaguely comforting thing is that if it was one of your relatives who needed life or limb saving surgery you would want them to have it ASAP. Even if it meant inconveniencing someone else. It is really bad luck to get bumped twice but it does happen. The only real solution is extra emergency theatre capacity but it isn't very efficient to have loads of theatres & staff sitting doing nothing 'just in case'.

You should. End of story.

For all the people who complain about bad staff attitude, there are loads of paople who say nice things about NHS staff and have good experiences in NHS hospitals.

While the system is not always perfect, (and I'd be the first to admit it) there is no reason for any patient or relative to be treated with anything less than compassion.

the problem in our case was the lack of paed intensive care beds for after the op..It was end of November and they were all busy with winter bugs..

It was a huge trauma..made worse by the extra wait..and I guess the staff that really helped us deal with it were the ones that remembered that and were kind, in spite of the fact that they must deal with horrible situations all the time.

My dd has been "the emergency case" twice and has had 3 operations postponed due to emergencies. It is hard to wait all day, she was starved at 8 weeks from 4 in the morning until 5 in the afternoon and it was awful but she was ok. It must have been hard for you and your ds today but there was someone with a greater need. I wouldn't let one bad experience put me off a hospital but that's me.

Ds1 was NBM from 0630 until he went down for his small elective op (aged 13 months) at 4pm.
When he woke up he was crying - so they sent for me to make him feel better.
Then, when he carried on howling, they suggested pain relief.
He'd had nothing since early morning and a grand total of 100mls n/saline intra-op.
He was crispy. Dry eyes, dry mouth, veins down, JVP down...
he downed the water I asked for in record time.
It did seem at the time rather sad that he hadn't been fluid-assessed well enough to give a bit more fluid. So can see why op upset her little one had to wait.
Do you often see failed cannulation in children, gasman? (curious) the patients I look after (renal) tend to have access issues - quite commonly no remaining central access - but really unusual not to get access somewhere.

Cake - re expectations of the NHS, do you mean wrt the communication and the way you were spoken to, or the provision of spare theatres and teams of medics to cater for emergencies?

It does sound as if you had bad luck all round - emergency, unsympathetic ward staff and then after all that they couldn't find a vein .

Mostly my experience of treatment in NHS hospitals has been wholly praiseworthy, so I wouldn't be expecting anyone to have a bad experience as routine, or write it off as 'what do you expect?'