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!

[itsnotmeitsyou1]

Hi OP, hope your little boy is feeling better today, sounds like you had an awful evening. To those saying you are being unreasonable, I bet they've never had a family members with breathing difficulties, especially a child. It's terrifying and the worst thing is, things can change in a drop of a hat, even if they seem 'fine' after a couple of hours. It would have done no harm to keep him in until early morning, at least to make absolutely sure he was over the worst of it. There was bed space after all.

I'm a supporter of the NHS, however they have to work to keep beds empty and seem to be forgetting to actually give care anymore. Care means more than giving a few pills and sending you on your way in the middle of the night.

[AllTheNamesIWantHaveGone]

Similar story here OP. DS had bronchilitis just before Christmas (then 11 months) and was admitted with breathing difficulties. Was woken up and discharged at 1am still with fast breathing (albeit that they had done a number of tests/treatments and were satisfied that he was fine to go home). Luckily DP was also there so could go and get the car (which was parked streets away) and bring it right to the door as it was freezing !

It wasn't a bed issue (there were empty beds around us) but I did suspect it was a staff shortage issue .... although leaving the discharge issue aside they had been fantastic with him so it would have been harsh of me to have complained.

Hope your son is feeling better soon xx

[Mumm300]

This was awful experience for you but not all the nhs fault, its unfortunate you could not get into the house when you got home but not nhs fault.

The nhs really is in crisis at the moment, unless you have been affected you would not believe how bad it is. They got your son out of danger when needed and they may need to do so again. Once out of danger the priority goes down.

With hindsight could your dh not have gone home but left the door in a way you could get in more easily in case you came home because the bed needed for another child?

You must be completely exhausted I can understand why you feel so awful. I hope you all feel better soon.

[Hakluyt]

My very frail 90 yewr old mother was discharged at midnight after being in hospital since 9 that morning back to her care home. They didn't ring anyone in advance - thank heavens it was a lovely care home who really looked after her as she was exhausted and weepy and generally in a state and hadn't eaten or drunk since lunchtime........:(

[holidaysarenice]

Yes I'm well aware of what I'm saying.

The fact you were climbing over gates in the middle of the night is NOT the hospitals fault. It is yours. Why did you not ring your husband and say we are on our way home, can you open the door? That you either knew was locked from the inside or that you had no key for?

Secondly, you have a child who has had breathing difficulties before, so either you were content he was much better and safe to come home in agreement with the doctor. Or you felt he was unwell and needed hospital care, in which case you needed to say so, to have further assessment or reassurance. You say you have been there many times with viral wheeze so I assume you know how unwell/well he is.

Additionally you said you would leave if the bed needed so you didn't consider him unwell. An a an e doctor looking at a screen to see if paeds have a bed for an ill child, won't know this. They will see paeds is full and potentially have to blue light a child to a hospital possible 60 miles away for a bed. All because you wanted to leave your son sleeping. I'm glad I'm not that mother last night.

Your doctor followed protocol for treatment exactly. You and your husband choose to prioritise his nights sleep over being able to get your son home easier. You choose to climb a wall in the middle of the night.

[PtolemysNeedle]

So they tried to discharge you at 1 because your ds was ok, you said you wanted to stay so they let you stay.

Then at 2 you decided all by yourself that you wanted to leave, so you had to wait until they could discharge you and you're passed off that you had to wait to be discharged even though you had the option to be discharged an hour previous?

Sorry, but you are being incredibly unreasonable and you have nothing to complain about.

[BertieBotts]

I think it's terrible. If they are going to discharge people in the middle of the night (which I accept as a possibility), they need to be sure that the patient, especially if they are still unwell, has the means to get to safety.

Giving you the "option" meant that you didn't set anything up and hence had difficulty. That was irresponsible - OK it was a misunderstanding, but why not cleared up earlier?

[grannytomine]

holidaysarenice, she has said they weren't full so any doctor in a and e would have seen that.

I can't believe it is helpful to take a child with breathing problems into the cold night. I wonder if anyone has assessed if children are more likely to be readmitted after doing this? Might block more beds in the long run.

[PtolemysNeedle]

If it wasn't helpful for the child to be taken out into the cold night, then the OP shouldn't have chosen, out of her own free will, to do that.

She could have stayed at the hospital overnight, she chose not to.

[holidaysarenice]

granny it was a follow On from my previous post where I said about how quickly a few empty beds can be filled.
If we don't discharge children into the cold that rules out most of winter to be honest, when it's often colder during the day than it is in the middle of the night in July.

The op had a car, that she could prewarm, so it literally is a few seconds from front door to the car I she brings it round. Or alternatively if she can't cope she calls her dh, the other parent to come and get them. And bring appropriately clothing, scarves etc if she doesn't have it.

[grannytomine]

Wasn't a straightforward choice though was it, she was made to feel bad about staying. Now me I would have stayed but then I have been threatened with the police once when a Sister insisted I couldn't sit with my son aftersurgery. I told her to go ahead and if the guys at the local nick had nothing better to do they could come and have a chat. She turned a funny colour. I don't know if she phoned them but they didn't turn up. I thought the idea of the police dragging a mother out of the hospital for sitting quietly by her childs bed was a trifle strange.

[grannytomine]

Where I live it is usually colder at night than in the day. I think it has something to do with the sun.

[holidaysarenice]

I we want a 24 hour 7 day nhs service, the same care in the middle of the night as the day etc then patients have to be discharged 24 hours 7 days when they have a safe place to go.

This child had two parents at home well used to a breathless child and clearly capable of summoning help when required. Perfectly safe.

[Viviennemary]

The NHS has to prioritise patients. And the doctor felt your child was well enough to go home. Hospitals aren't hotels. Why did you not just ring for a taxi which would have picked you up without you having to go across a car park. But it was annoying to have been told one thing and then a change of mind. I think doctors can be abrupt but I wouldn't do their job for the world. They are dealing with life and death in hospitals so you wouldn't be a priority in her eyes.

[grannytomine]

I note you ignored my question about whether anyone has looked at readmission when patients admitted in the night.

[holidaysarenice]

Really? I'm pretty sure a July night is warmer than a snowy February day?

[grannytomine]

You aren't likely to be discharging a child during the night in July if they have come in with breathing difficulties in February, are you? I honestly think if you have kept them in for five months you should plan the discharge better than that.

[Titsalinabumsquash]

Something similar happened to us several years ago now, I've not quite got over the bitterness when we come back to this hospital because of it.
I was a young Mum, just been told my DS1 had a life limiting degenerative condition, he'd just had scary surgery and was in PICU, I also had a newborn baby and bugger all support from my now ex.
We got transferred to a specialist hospital 3 hrs away from home, I didn't know where we were or how long we'd be there for.
I had no belongings and I was terrified.
After 4 weeks of being bombarded with tests, info and statistics a Dr arrived in the middle of the night and discharged us, we were told to get the tube home, with 2 babies, a few bags and loads of new medication and equipment.
Luckily I managed to call my Dad who drove to get us and we waited in the lobby of a dark, deserted hospital for 3 hrs until he arrived.
I hate coming here now, with a passion.

[PtolemysNeedle]

Maybe they didn't make her feel as welcome as they could have done, but they aren't working in hospitality, they are medical staff who tried to send a child who was fine home, then let them stay when they realised that going home would be an inconvenience to the patients parent.

The OPs choice might not have been that easy considering the circumstances, but that isn't the hospitals fault.

The only issue I can see is that possibly the doctor wasn't as polite and understanding as she could have been. Everything else was a result of OPs choices.

[grannytomine]

Titsalinabumsquash that is awful. Thank heavens for dads. I can understand how bitter you must feel.

[holidaysarenice]

I note you ignored my question about whether anyone has looked at readmission when patients admitted in the night.

Because I haven't looked the databases to find you an answer. And I doubt many people have done RCTs to find out? I'm sure you could suggest it tho.

[holidaysarenice]

Now titsalinabumsquash that is grounds for a complaint and shows how safe the ops discharge was!

I hope you told them how horrific it was! New medical equipment, had you even been shown how to use it? That could have endangered life!!

And you hadn't a safe way to get home, no tube at night! That's awful.
I'm angry on your behalf!

[holidaysarenice]

You aren't likely to be discharging a child during the night in July if they have come in with breathing difficulties in February, are you? I honestly think if you have kept them in for five months you should plan the discharge better than that.

Haha granny that's hilarious interpretation! Love it x