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!

[grannytomine]

Maybe I will suggest it, afterall if middle of the night discharge leads to readmission and ultimately a longer stay then that isn't helping with bed shortages. Short term thinking leads to such inefficiency as well as distress.

[holidaysarenice]

Suggest it and offer to do the data collection for it, it's just sitting at a computer. More likely to get it done that way. All you need is to be a hospital volunteer so DBS check and some references to be allowed access to admission data which won't have hospital notes.

I doubt it would be higher admissions but it would be interesting and evidence is what leads to change.

If anything my thoughts are that more Sickly children are discharged by day, when a they appear better and well slept and senior help is more readily available and parents can contact gps etc

[Aeroflotgirl]

Yanbu at all, unfortunately it's the sad reality of these times. People do get discharged in the early hours. I woukd complain to PALS about the handling of it though.

[grannytomine]

As I am about to retire I might just do that.

I think it is even worse with the elderly. My uncle was in his 80s, colon cancer, dementia and anaemic and they kept discharging him after midnight. He must have been taken into hospital six times in under three months and every time discharged in the middle of the night. At first my aunt would collect him but she refused in the end as she was also in her 80s and really shouldn't have been driving. No way was it safe to wake her up and expect her to drive to the hospital to pick him up so on one occasion it had been snowing heavily and she just said no so they got an ambulance.

He would arrive home cold and not properly dressed, they didn't bother helping him to dress but sent him home with his clothes in a bag and just one of those cotton gowns open at the back. I reported it all to safeguarding in the end and the ambulance service backed me. I did ring to let them know he had died shortly after his last discharge.

[LeSaor]

If the NHS were some magical bountiful land of free beds and staff attention then YANBU.

As it stands you were taking up resources and staff and a bed because of a 2 minute walk to the car and wanting to have a good kip. It's not the fault of the NHS that your husband locked you out.

YABU is that even a question

[NeedABumChange]

Sorry I get that you were stressed but still think YABU. And it's hardly the doctors fault that your DH out the chain on the door. Don't understand why he wouldn't sleep with phone on loud next to him when his son is in hospital though? Can you imagine if everyone wanted to stay in just a few hours more. You no longer needed to be at the hospital so were right to be discharged. Yes an inconvenience but illness always is.

[YesIDidMeanToBeSoRudeActually]

Actually, thinking a bit more about this, never mind the hospital, if I had a DC in hospital and couldn't raise my DH, I would be furious with him. Bad enough he left you outside calling him frantically but if you had needed him urgently at the hospital? I think I would be directing my anger at him, not the hospital.

The thing about hospital treatment is, it runs to their time, not yours. DHs meeting, need for a nights sleep etc is nothing to do with them, and shouldn't impact on the treatment on your DS. The DC and hospital treatment is the absolute priority and things have to work round that - not always ideal, particulary when they are busy or short staffed, but I generally think NHS staff do an amazing job in difficult circumstances.

And as someone says, someone complaining their DH is asleep and their car is parked across the hospital grounds etc, to someone who has been dealing with life and death situations (a and e) all night, might get a more abrupt response than they expected.

I don't think you have grounds for complaint really. I usually come out of hospital just grateful to be discharged with a DC (or myself!)well enough to go home.

[YellowYoYoYam]

Yanbu.

The doctor wnbu either.

The only unreasonable thing is the bastarding government who pile pressure and demands on frontline staff without even providing them with enough beds or facilities to care for people properly.

I don't believe that doctor thought when they became a doctor, I'm going to kick poorly kids out of their bed into a cold night.

I don't know what we can do about this, it such a shit situation.

[saoirse31]

yabu. you're seriously upset you'd to walk across car park with child? I would be unimpressed with your dh not being wakable. ...otoh maybe he wasn't worried cos it was relatively routine situation and dc would be fine with treatment....

[musicinspring1]

OP My DS has viral wheeze. Instead of traipsing to a&e I've been using my Drs a lot more - they have a nebuliser and can prescribe predisolone (sp?) as well as listen to chest etc . obviously only an option in surgery hours. (and of course go to a&e for severe breathing difficulties disclaimer! )

[musicinspring1]

plus yanbu. We had 9 admissions last winter and never were discharged at night.

[soontobemumofthree]

YAB a bit U.
They did tell you in the evening that he may be fit for discharge at 2am. Sounds like they just said that again at 2am. You weren't forced out, you could have stayed as long as a new admission didnt arrive. The key/DH sleeping/climbing gate is not the wards fault. Sometimes anyone has to stay up all night with a sick child, sometimes you have to drive them to A&E at 3am.
It may be nice for them to be able to say, you are fit for discharge but you can both get a sleep before you leave.
If you needed help getting to the car tho they should have helped. If the Dr had gone off to do something else, sometimes security or a porter can help you to the car park at night.

Also I dont think transferring a child from hospital to car, then car to house is dangerous at night. For all anyone knows the weather could be colder temperature-wise the next day.

[Sirzy]

The doctor was a bit rude but at this time of year children's wards tend to be so stretched that they are in a no win situation.


On a side note if he is having that many admissions get to your gp to sort his preventative medicine to try to stop it getting to the hospital point as often

[lunar1]

We quite often have to do the mad dash to the panda unit between 11&2am over winter with ds2's breathing. We are always discharged in the early hours once the steroids kick in.

We don't have a car so it's not easy but I've never thought to complain. I'd rather leave ASAP than hang around while he couldn't breath because everyone was waiting for daylight to leave.

I would however be fucking furious if my husband was uncontactable in this situation. I'd place my anger where the system failed , in your case that is your husband.

[HJGranger]

Three of my four children have asthma and frequently are admitted to hospital with breathing problems. We have been sent home from observation at various times during the night and it is a pain, especially as I don't drive.

It depends on the circumstances though I think. If you were confident your child was well enough to come home, capable of getting him home then I think that's fair enough, although in all honesty I wouldn't have wanted someone to walk me across a deserted hospital and car park, the one time I did ask I was assaulted by the porter! I would rather take my chances alone.

We have been told before around 2am that my son was fit for discharge, he was 18 months at the time and had gone 4 hours without inhalers, but I wasn't happy that he was well enough and I know how quickly he can go downhill, so I've explained that and been told I'm welcome to stay another 4 hours to be on the safe side. I don't think they would send anyone out into the night who was genuinely concerned about the well being of their child - I would hope not anyway!

[JudgeRinderSays]

Observation is short term!
If he had gone into A &E with say a cut or a fracture, you had a long wait and the was finally patched up at 2 am, would you expect a bed for the night?
It is not a hotel.You will presumably happy if next time you go in worried with your sick child, they tell you to sit in the corridor all night because they do not want to wait up a well sleeping child.

[Lucked]

Yes complain.

I assume it was a junior doctors and her manner and communication skills were appalling. I would make my complaint about this and her sarcastic manner. Ask that your complaint is copied to her educational supervisor as it will have to be raised in her yearly appraisal and will be taken seriously, we are required by the GMC to treat patients politely and considerately. Regardless of the ins and outs of nighttime discharge she did not behave in an entirely professional manner.

[hawaiibaby]

Right - unreasonable it is. Fair enough and thank you.

Fully concede the doctor reluctantly and conditionally agreed we could stay eventually, as before, it was more that we were asked if we wanted to stay, made plans based on that, then it changed. But yes just one of those things and not worthy of a complaint because of a breakdown in communication. And yes I was pissed off and stroppy (did say that earlier) but that sometimes happens when stressed, upset, anxious and without sleep. As before, we have been discharged in the early hours so it wasn't that per se, though it's interesting that a lot of PP in similar situations aren't.

I'm not going to answer every post because quite frankly I'm too tired and though am fine to be told unreasonable, I do object to getting a bit of a pasting. I asked if I wbu to compain. Answer = yes, fair enough. But otherwise, not sure what I've done wrong. I'm not a difficult person, and as pp have said I absolutely would have moved and quickly if the doctor had asked / explained this was what was needed. We are both very 'yes of course, thanks for your help, grateful for support' type people. I didn't realise that meant I couldn't feel upset at how the night unnecessarily panned out. It's great for those that are cool as cucumber and completely un-fazed by this kind of thing (if indeed you've been in a similar situation) but it's not like that for everyone.

Thanks to everyone who managed to give their verdict - whichever it was - without being completely rude

[MissDuke]

I agree that this doctor was very unpleasant to you!

However I agree with other posters that you should have stayed. You had stood up to the doctor and negotiated a stay so I don't understand why you then went. You may have just woke, but you say it took half an hour for them to prepare the discharge, so you had plenty of time to change your mind.

[Sirzy]

Hawaii - hope your DS is better now. Does he have a preventer inhaler?

[YesIDidMeanToBeSoRudeActually]

I hope you don't get another eight million posts saying YABU after your gracious update!

It's always stressy having a DC in hospital, no matter how long or short a time. Is he feeling ok today?

Incidentally, what did you say to your DH about being uncontactable? I would have gone berserk.

[hawaiibaby]

Sirzy - sorry forgot to respond last post. He's under paediatrics and started on montelukast granules a month ago. No difference as yet in frequency but doc said he may recover quicker this time because of them. Do you have experience?

PS The reason I went home (other than stroppiness ) was the fear of finally resettling ds (takes a long time in noisy hosp) and then have to go anyway an hour later because they needed the bed. That is after all what the doctor helpfully threatened told me.

[RabidFairy]

I won't weigh into the debate as you've said its resolved now, OP, but I wanted to say that it sounded like a very long and difficult night. Hope your DS is feeling better and that you all get a good nights sleep

[GraysAnalogy]

It's extremely bad form and something the NHS have tried to reduce, but to be honest you didn't need that bed anymore. Someone else may have.

[GraysAnalogy]

Ah crap, sorry missed your update.