AIBU to feel totally traumatised by what happened in hospital last night

[BrightonExGoth]

Long post - sorry.

11 week old in hospital for 2 weeks receiving IV antibiotics. My ex isn’t on the scene so I’m here alone.

One of the antibiotics he’s on (gentamicin) involves a once daily 40ish minute drip through his cannula along with daily, painful heel-prick-and-squeeze-out-the-droplets-for-10-mins painful blood tests.

Last night the cannula he’d had for a few days failed (as they do) so we awaited the doctor to come and do another. For the record, although I hate to see him go through all of these procedures I’m very good at keeping calm and upbeat while they are going on, as sometimes it rubs off on the baby and he doesn’t cry. I think it makes it easier for him at any rate.

When she arrived the room was calm, and dark and quiet. I’ve managed to keep the baby asleep for some of the more invasive procedures before including a cannula insertion, and I was kind of hoping for the same (it was also circa 1am).

Doctor arrived, marching in, flinging door open, talking loudly to assistant, slammed on the light (this part is fair enough she has to see what she’d doing).

I asked her to keep her voice down, but she said loudly in a bullish manner that he was getting a cannula in and was going to wake up anyway. At this point he woke and I couldn’t keep him very calm for the procedure but it was over in a few mins. Dr asked her assistant ‘do you think that’s in properly’? Assistant confirmed yes, and off they went. Nurse made a passing comment to me about the doctor being the ‘head doctor’ (I think when she’d expected someone further down the hierarchy to come and do a procedure like this).

Nurse started the drip, I questioned why a different machine to usual was being used. I think she said something along the lines of the usual machine being ‘too sensitive’ but I may be remembering that bit wrong.

Immediately baby was unhappy. And very quickly became really unhappy. Angry, angry painful screaming. I picked him up, put him down. Tried to feed. Went out to nurses station. Tried to calm again. Alarm went off (this happened a few times and every time I had to put the baby down and get up push the call button myself to get the nurse to come). He grew more and more and more distraught. Nurse came in a few times, and I went out once. Machine alarm went off twice for ‘occlusion’.

By this time (about 20 mins into the procedure) the baby was fully distraught. I’d never seen him like that before. Alarm went off again. Again pushed the call. Nurse came in and I asked if she was sure something wasn’t wrong. That he was definitely in pain. She checked his cannula. His vein had blown and the antibiotic had been going into his tissue (we were on to the flush by this point so a fair bit had gone in the wrong way). His wee arm was bright red and ballooned up to his elbow. At this point she stopped the treatment and I picked up baby to comfort, he kind of ‘passed out’ immediately on me through trauma. I do this - if I’ve been very very upset I often immediately fall into a very deep sleep so I wasn't alarmed, but could see how much he'd been through.

By this point I was visibly upset (for the first time since we have been in hospital). The baby began to calm. A different doctor came in and said they were going to need to reinsert another cannula. By this point I felt like running out of the hospital with my baby, but desperately tried to get a grip. I requested (insisted) that there was calm and quiet in the room this time. Different doctor managed to get cannula in with me holding the baby and him not waking, which what what I'd been hoping for the first time but anyway…

His wee hand was still ballooned. I asked about it, and they said to ‘keep it elevated and keep an eye on it’. I asked what that meant (given that I am not medical and it was now 2am). Was told the nurse would come in to check.

At this point they left me, crying in a chair, in the dark, clutching my baby in the middle of the night.

After a while on my own I put him back in his cot (he was still in a really deep sleep) and made a little device to keep his arm elevated with a towel and some hair bobbles. I then had a meltdown on my own.

The nurse eventually came back and checked his hand at 0430 (I know she didn't come before this as I was still awake and watching him).

On top of all of that, googling on my own in the dark (never a good idea but by now I’ve lost all faith in the system) I’ve discovered that gentamicin has a pretty high incidence of a side effect of irreparable inner ear damage, hearing loss, and damage to the vestibular (balance) system. This has never been discussed with me. There is also anecdotes of people relating it to autism. Am trying not to listen to those.

No observations were done after the event (not sure if this would be standard but he had obviously been through a lot) nor have been done yet actually even though they are meant to be twice daily at 8am and 8pm.

So

AIBU to feel completely traumatised, weepy and shaky? I can’t actually look at the baby (guilt) and am completely unsure of what to do next.

I feel I wasn’t listened to the Dr in the first place when I asked for quiet and calm. I feel both myself and the baby weren’t listened to by the nurse when I questioned the different (less sensitive) machine being used and then again when we were both trying in our different ways to tell her something was very wrong, I feel we were deserted by all of them in the middle of the night after a really horrible experience and I feel like the fairly high incidence of damaging side effects very not discussed with me.

And I don’t know what to do now. I have no medical knowledge. Do I ask for a new antibiotic? He's got a bad infection and it needs to be treated.

I feel completely weak, undermined and powerless and can't even imagine talking to the doctor this morning, never mind being managing to be assertive.

[BrightonExGoth]

Goodness me, apologies for the typos!! Breastfeeding!!

[BrightonExGoth]

To be honest, most of the treatment has been outstanding. There was just a little catalogue of unrelated things last night which came together and completely knocked my confidence. Am feeling much better having put in my requests and spoken to the Dr today (they did report the blown cannula and complete dose).

[idontlikealdi]

Brighton dts were in nice for 6 weeks and on gentamicin for a while, one through a cannula in their head it was the only place it would go in.

It's horrible to go through but I don't think you have anything to actually complain about, shitty that it tissues but not something unfortunately that you can prevent and asking for quiet in a hospital ward isn't always achievable due to the very nature of it.

Do you have any support at the hospital? Are you able to get out of the room for a break?

[BrightonExGoth]

I do have some support. Thanks everyone. Am going to go for a run round a local industrial estate later. Glam.

[OopsDearyMe]

Gentimicin can burn very badly is sited incorrectly, if it tissued then its unlikely to cause the effects youvare worried about. I understand how awful it must have been, I had a similar issue with doctors who think its not possible to insert cannulas without causing pain, it is wholly possible and you did the right thing by requesting the room be calm.
Firstly, the doctor was probably out of practice and full of his god complex , you need to complain. If he was a consultant he should know better.
The nurse should also have stayed in with you to watch the first free mls of the infusion, to ensure they can remove a badly sited cannula should it happen.
The fact you were left distressed and alone ,is I'm afraid the reason I left nursing. I laughter when its called the caring profession. Because the times I asctualy tried to talk with my patients I was told off and that I ought to be tidying the sluice, even though I had finished that job already.
I hope however that you can dismiss the lack of compassion to ensure baby is getting better , go home and try to put it behind you.
Make those complaints tho it might just make them think next time.

[OopsDearyMe]

Those that complain that the NHS has no staff part of the problem is that older generation staff, dislike newer members who bring a different approach with them. On my course of 12 , 3 qualified and not one stayed 12 months.
There is a massive gap in what you're taught and what ward staff expect. As for the children's ward I worked on, I found it so badly organised and the culture was so ingrained no one could make the necessary changes to improve things. The speed at which staff acted was slow, and staff complained of being busy whilst stood leaning against the nurses station, doing nothing.

[Justaboy]

One poor lady Doctor here where it was all too much for her:-(

www.cambridge-news.co.uk/news/cambridge-news/junior-doctor-rose-polges-cambridgeshire-12343456

[Serialweightwatcher]

I have no proper advice to give but I wanted to say I'm so very sorry you and your little baby are having such a rotten time - I really hope your baby has a complete recover very soon and that you are able to relax and enjoy him

[roundaboutthetown]

I think the problem you had last night, OP, was that you expected to be treated as a member of the team caring for your baby who was more knowledgeable than anyone else on how your baby reacts to treatment. Instead, you were treated as an annoyance getting in the way of people ploughing on rather brusquely and uncaringly with their job. It is unlikely they did anything wrong in the medical treatment sense, but their lack of sensitivity in the way they disempowered and frightened you makes it totally understandable that you reacted to what happened in the way that you did. It would undoubtedly have taken up less of their time if they had had a better bedside manner in the first place, but working late at night doesn't bring out the best in anyone, unfortunately - you probably wouldn't have reacted quite so strongly yourself, or told the doctor off for being noisy in quite the same way, if the same sort of thing had happened during the day, even if you had also been on your own with your baby, then. Everything seems more serious in the early hours of the morning.

[Toddlerteaplease]

Ask for some sucrose solution to dip his dummy in. It's works a treat for painful procedures. If it was a very senior doctor doing a procedure that the juniors do it probably means they were extremely busy and may also explain his poor bedside manner. The blood tests for gentamiacin are to make sure he is on the correct dose and that the levels of the drug don't become toxic.

[shinynewusername]

I will defend heel pricks. They went out of fashion for a while, in favour of blood tests from veins (as for older children/adults) but, IME, these are more traumatic for a baby and also damage the veins, which then makes it difficult to get a cannula in.

If it helps, OP, I did thousands of heel pricks when I was a hospital doctor and often the baby slept through or only woke for a second, whereas they hardly ever slept through a normal blood test. I'm not saying heel pricks don't hurt but - based on my experience - I do think they must hurt a lot less than a normal blood test.

[Foldedtshirt]

How utterly horrendous. Your DS is very very lucky to have such a competent and strong mum to advocate for him.
DD now 18(!) had gentamicin at a week old, I remember the cannula and later hearing screening- it did the job and she suffered no after effects.

[ellequick]

Draylon thanks for your take on what happened in my personal circumstances which you know absolutely nothing about, you are wrong.

I understand that the NHS is really, really struggling and that we are incredibly lucky to have it. I do not agree that people should not raise it when things go wrong. This is how improvements are made. Mistakes are not always just a busy person doing their best in difficult circumstances, they may well be areas that can and should be improved. For everyone.

Anyway, no desire to derail this anymore than it has been. Wishing you strength OP.

[Headofthehive55]

IT depends where the cannula was put in. Hand, very painful, elbow not so much. So I don't think it's always about which dr!
You can't always tell if the cannula tissues straightaway. Sometimes they are a bit "iffy" the machine bleeps a couple of times, you are wondering whether to start again with a another cannula, with the wait for the dr etc, and patient not getting the antibiotics when you move the hand and hey presto it now works. So it's not straightforward.

[Toddlerteaplease]

As a peads. I would be very worried about a baby that didn't cry when having a cannula to be honest. Crying although horrible means they are responding fairly normally. As a PP has already said the cannula tissueing Is bad luck and nothing to do with how it's put in.

[jnh22]

*Oops and *Shiny
I agree completely. There is also a tendency of not accepting responsibility in the NHS. Mistakes, bad attitude, poor clinical skills, poor people/communication skills, poor organisational and leadership skills are all excused by saying "we're too overworked" or "under too much pressure." I find it a rather bad working environment.

[shinynewusername]

I think that rude/inconsiderate behaviour is sometimes an overloaded, extremely stressed HCP snapping after repeatedly being pushed beyond endurance, but that sometimes being busy is used as an excuse for rudeness. I have met HCPs and support staff who are rude with no provocation, though such people are greatly outnumbered by caring and polite staff.

More of a problem than intentional rudeness is desensitisation. As the paediatricians on this thread have explained, it is impossible to do procedures on children without causing them some distress. It is horrible but you do have to get used to it to some extent, otherwise you could not do your job. The trick is to get the balance right: not to over-think what you are doing to the point where you are distracted, but also not to get desensitised to the point where you forget what a big deal the procedure is for the parent and child. I don't think any HCP gets this balance right every time - all we can do is try our best.

[paediatricsaremything]

"Firstly, the doctor was probably out of practice and full of his god complex , you need to complain."
I can only speak for the paediatricians I work with none of our doctor resiting cannulas are full of "the God complex" nor out they out of practice. Its these attitudes that completely demoralise exhausted over worked staff.
"Because the times I actualy tried to talk with my patients I was told off and that I ought to be tidying the sluice"
I don't know whether to laugh or cry. Tidy the sluice!!!!! In my dreams maybe but not when I'm at work. Oops you are clearly, completely clueless with how most paediatric wards are currently functioning, I don't even have time to go to the loo during my 13 hour shift let alone tidy the sluice.
Ooops *I can tell you after 30+ years of being involved in babies being cannulated is not possible to inset a cannula in a baby without inflicting at the very least discomfort more likely some pain. We use sucrose in tiny babies it has some effect but it doesn't make it painless.
Ooops I can't comment on the paediatric ward you worked on but the feed back from our children/parents is excellent/very good as is the report from out recent CQC inspection we do not have an "ingrained culture". We are not "slow to act' nor do the vast majority of us prop up the desk. But the CQC did state that their are insufficient staff on every shift. We work under increasingly impossible situations hence so many are leaving or thinking about leaving because we are increasingly concerned for the children in our care who the vast majority of its really genuinely care about and our registrations, we all increasingly feel we're sitting on a ticking time bomb and that one day a child will die because of the ridiculous way we and our medical colleagues are now being expected to work.
There will always be the odd doctor who's not good at his job or who could have better communication skills, ditto nurse but most of us are dedicated, caring and completely exhausted and demoralised.

[Toddlerteaplease]

Peadiatrics. I could not agree more with all of your posts.

[Toddlerteaplease]

I also completely disagree with oops.