Should I complain? Hospital related

[MrsPotts18]

Sorry this is long but I'll try to be brief. I'm so confused.

• last Sun became unwell around 5pm with what I thought was gastro bug. Vomiting, spasms etc. Managed until 1.30am when I got a sharp pain in my right hand side and was in agony. Took more painkillers but was worse by 2.30am so went to triage (30weeks pregnant)

• got the by 2.45am and was seen immediately. Bloods done and seen by midwives. Dr eventually came after 2hrs as they were v busy and initially thought gallstones. Got adequate pain relief at this point as was in agony. CTG on baby was great thankfully.

-6am was transferred to antenatal ward. Slept on and off all day and was on morphine, dihydrocodeine and paracetamol at this point. Various bloods ran all day and was suspected gallstones and ?cholestasis. Had ultrasound Monday pm which showed normal gallbladder/liver.

Tuesday Am rounds consultant comes and says she's discharging me. Says the pain on my right side is pulled muscles from being sick and I've had a gastro bug. I'm still being sick at this point but only after very small meals. She says CRP (infection markers) are 168. Anything over 100 would suggest bacterial but she def thinks I've been unlucky with a gastroenteritis infection. Tuesday night I beg to stay as I'm still in horrendous pain and cannot eat at this point. Reg agrees. I ask for antibiotics and was told 'can't find original source of infection so what's the point'. I'm too weak to discuss more.

-Wednesday 1.30am. I wake up in total again. I was sobbing and couldn't breathe. Midwives get SHO who refuses to call consultant. I beg for pain relief or to be knocked out. Pain was only on my right side under ribcage again. They tried for 6hours to get blood from me. 28 attempts later (even from my feet) only 1 was successful. Refused to call anaesthetist or senior dr. 8am and SHO finally decides to call the surgeon.

-Wednesday 9am. Surgeon comes. Spends 5 mins with me and I'm in MRI with surgeon personally doing it by 10am. Was told by 10.45am my appendix has perforated and I have pus pockets everywhere. CRP is now at 268 and I need to go to theatre. Everyone is worried and preparing for c section as told early labour is almost guaranteed. By 1.30pm I'm in theatre. Overhead brief conversation between surgeon and obstetrics and he told them it was basic negligence but I can't be sure of exact conversation

Thursday - in HdU. Finally round from op but GA has aggravated my asthma and I'm really ill. Baby is thankfully amazing and didn't need to do a c section. Staff in HDU are amazing!!!

Today spent all day in HDU due to no bowel sounds but finally got those moving. Kidney function returned to normal. Now back on original antenatal ward.

Had a slight debrief with surgical team (im still a little out of it). Had an open appendectomy and have 24 staples in situ. Op that was meant to be an hour was 3.5 due to complications. My appendix was black and gangrenous and the infection had spread much further. They had to go into my bowel too and repair due to infection.

The surgeons have been amazing. I have never felt so safe since they came on board Wednesday morning. But from Sunday night to that point I feel neglected. Things wouldn't have got this bad if they had run the appropriate blood tests or even called the right team. On the other hand should o just be grateful that I was got to in time and my baby is healthy. It could be so much worse and all I keep hearing is how lucky I am. I'm so emotional tonight hence this post and just need a hand hold I think.

@TittyFahLaEtcetera thank you that is so helpful. I think a constructive guide like yours will allow us to write a complaint effectively.

I'm not after compensation etc. Ideally I would like an apology but most of all I want to save another person going through this. I think my mental health has taken a hit and I'm still in the very early stages of this.

I was left extremely traumatised after a period of shit/borderline negligent care on a postnatal ward. I’ve never felt more vulnerable nor more at the mercy of people who didn’t really give a shit. I’ve often wondered whether it was borderline PTSD. So please keep your mental health in mind and reach out for support (when you can get it) either before or after the birth.

You have gone through (and still are going through) a really traumatic ordeal.

I think you should tweet pals about the ward and your lack of pain relief. ‘I’m an nhs hcp and never ignore requests for pain relief or leave buzzer out of reach after major surgery. Is ward xx always like this? HDU was so different’ please help!

You definitely need to put in a formal written complaint. Do it before you have your baby. Do you have any friends who are lawyers? If not, I’m pretty sure people here could help.

Part of the problem, of course, is that if you hadn't been pregnant you would probably have been diagnosed much faster. And if you weren't pregnant, you would now be on a surgical ward, where post-op care for even a nasty appendicitis is pretty routine, rather than on an antenatal/postnatal ward where the midwives may well have been direct entry (rather than also trained as nurses) and may well never have looked after someone after a nasty appendicitis before. Often it can be difficult to get anyone other than O&G to see pregnant women in hospitals, due to the assumption by other specialities that it must all be due to the pregnancy. And so women are disadvantaged.

Add in that Wednesday was junior doctor changeover day...bit of a perfect storm.

This isn't me trying to persuade you not to complain. Because you should. In fact, they ought to be telling you about how they've already completed an incident report about events, and how you can be updated on this if you want, and here's the PALS information if you want to complain. Because from your description this was rather a near miss, so it is quite likely that it ought to be investigated as a Significant Incident, which is rather a bigger deal. But if they're doing that, then they ought to be telling you under Duty of Candour.

I guess it's possible that they're thinking get another day better, and you'd better be able to absorb explanations. I certainly hope so. Because it's poor form just to ignore the whole situation. And a decent root cause analysis could well improve the pathway for another woman.

(Conflict of interest - hospital doctor, but neither O&G nor surgeon)

How awful.

Glad you & your baby are pHysi ally ok. Goos luck

What might have happened doesn't bear thinking about. I read these five articles in yesterday's Guardian about sepsis, and your description of what you went through reminded me of these. Your post screamed at me that this could have been you. You've had excellent advice on here; I'd just add to ask the surgeon who operated on you whether sepsis had been considered (as mentioned in one of those articles), and put it in your complaint.

Thank heavens your child is still safe.

sepsis - the truth about this hidden killer

symptoms of sepsis in children

care workers, sepsis, deadly illness care workers

sepsis - how parents and professionals can spot the symptoms

sepsis - deaths in overcrowded understaffed hospitals rise by a third

Wishing you the very best for your recovery.

Thank you all for the messages. I'm taking time to read them but today is a bad day and I'm very emotional. Not to mention the pain is horrendous. I did shout as I couldn't buzz and managed to sort out pain relief. Finally got a lovely midwife who was mortified when I told her I couldn't reach my buzzer. She explained that they have no general patient experience just midwifery so this is all new to them too. She also said she's never had surgery and cannot imagine the pain I'm in. I broke down at this point, I'm just exhausted.

I'm really surprised they did not take you from HDU to a surgical ward but to a ward with no nurses or surgeons although I do understand they need to check on baby.
Could you ask to be transferred to surgical ward?
Yes you should complain.

I hope it gets better for you.
Bollocks they have never has a post surgery patient, what do they think a c section is?

Absolutely complain now and request that your surgical/anaesthetics team meet with obs team to sort out your care.
Being in pain isn’t ok nor is it neccesary.

Having recently experienced antenatal and post natal wards where staff flat out lied about whether I had had pain relief (I was written up for meds2 staff didn’t want to give so they said I’d had them and wrote up ‘refused’. My being able to read a drug Chart scuppered them.) I would not worry about questioning your care at all!

I’m so sorry this has happened to you. Ask to speak with the head of midwifery today and request to be transferred to a surgical ward. A midwife can visit you to listen in/perform a CTG daily. Explain about the failings in your care so far and discuss with her the best way to make a complaint going forwards.

You should absolutely make a complaint. That is shocking.

Bollocks they have never has a post surgery patient, what do they think a c section is?

This.

Also, don't they all do general nurse training? besides which, I have no medical/nursing experience whatsoever, but even I'd know that you need to offer a lot of support, pain relief, etc to someone after this sort of operation (more so if pregnant ).

I think I would address this in a few ways: take pics on notes, call PALS to discuss current arrangements and care (or lack thereof) and take up the bigger complaint of negligence in 6 months time. I know that’s a long time - but I complained straight away after negligence with my newborn: I was too exhausted to respond to their feedback which was awful and didn’t address any of the issues at all.

I would also make your initial conversation with PALs after you’ve taken copies of notes, and I’d follow the phonecall with brief email.

You're in hospital because you're recovering from appendix surgery not because you're pregnant so agree you should be on a surgical ward.

That is horrendous. I hope you get proper care today. Please do submit a complaint. I nearly did when my little boy was in hospital (not nearly as serious as yours) and regret not doing it now.

Definitely photograph all your notes.
Then contact PALS.
When I made a very serious complaint the notes were mysteriously lost for 5 months.
When they turned up they had been altered.
The doctor in question actually stood up and lied under oath.

I’m so sorry you have had such an awful experience. You absolutely must complain, there is loads of learning for the staff involved here. There are three key things here for me - no antibiotics with a CRP of 168 in a pregnant woman (broad spectrum antibiotics could have been prescribed initially), lack of further observation/investigation with attempt to discharge home with CRP of 168 and a huge delay to seek senior support

It used to be that you needed to have general nursing training before doing midwifery.
Usually midwifery schools preferred a year's staffing experience first. So most newly qualified midwives would have around 4 to 5 years practical experience.
That has all changed now.

Oooops posted too soon! - huge delay to seek senior support when struggling with unwell, pregnant woman. 28 attempts to bleed/cannulate is utterly unacceptable.

I agree with previous posters, midwifes are often direct entry trained with little or no training in managing unwell adults. HDU will have been working with a ratio of 1 nurse to 2 patients, the antenatal ward may be working on ratio of 1 midwife to 8 women. It is often difficult for patients to adjust to the difference in level/quality of care when stepping down from itu/hdu to ward.

I strongly suggest you or your partner/mum do the following

ask to speak to the head of midwifes
ask has an incident form being completed pertaining to aspects of your care
ask has a 72 hour report been written
explain that you do now wish anyone else to have a similar experience

For me, on the information posted here, this would be a serious incident that would require investigation in my Trust, I would be raising this immediately and would be starting to look at this to understand why and how this happened and what safeguards/actions could be taken to prevent this happening again.

I hope you feel better soon x

You poor thing. I just wanted to say that you're doing so well coping with this, and don't be afraid to ask your mum, MIL, and husband to stay with you for support. You need looking after, after everything you're going through. Ask your husband to photograph your notes and makes notes of his own on your care, or lack of it. The more detailed, the better. Ask your husband to request that you are moved to surgical after care. But leave those jobs to your family for now and go easy on yourself my lovely.

You absolutely must complain, there is loads of learning for the staff involved here. Yeah you see that's my problem with this sort of thing; if staff have gone into medicine with this attitude, bearing in mind most people of average intelligence could realise someone was in pain and needing help, then I am not sure what sort of "learning" they need. Good kick up the arse perhaps?

Your treatment is a joke OP, don't be grateful, be angry - I'd expect my dog to get better care at the vets. And find somewhere else to have your baby.

That’s horrendous, OP. Poor poor you. Complaining in this situation is a must.

Hoping you recover soon

I agree with previous posters, midwifes are often direct entry trained with little or no training in managing unwell adults - presume they have some sort of idea of decency and compassion though? You normally achieve that by the time you're 18 - you don't need training in managing unwell adults to know you are acting outrageously.

Bless you, this must be awful for you. I had my appendix out a few months ago. I don’t know what they put in anaesthetic but it made me a complete emotional wreck for about two weeks. Take things really easy and look after yourself, you will get there but it will take time