Is is worth submitting a complaint to PALS?

[Burundi88]

Not sure if it's worth considering making a formal complaint about this, or if it's just me being extra sensitive post partum!

I gave birth to my 2nd child recently. I lost a lot of blood, had a 2nd degree tear, and injured my chest (costochondritis) during labour. I gave birth late afternoon, and was moved onto the post delivery suite after 10pm. I broke down a little after the birth and I suspect this was flagged before moving to the post delivery suite (was overwhelmed with everything snd physically feeling very rough). My DH had to go home to take care of our child. The midwives that looked after me overnight were amazing. They took my son to let me sleep for a couple of hours, and were just very caring and considerate.

The next morning around 8am, I had another midwife introduce herself to me. She told me that I didn't have to go home that day, and could stay another night to recuperate, but also to get a chance to speak to the infant feeding team since I was struggling with breast feeding. I had initially planned to go home that day, but I was still feeling very rough, so decided to speak to my DH about staying another night.

Around 9am a lady was moved into the bed next to mine. Her baby was born at 34wks and remained in NICU. I could hear her complaining about having to share the bay with others, and could hear the midwife that came to speak to me an hour previous affirm how awful it was and apologise profusely. Within about 15mins, the lady started complaining about my son crying and how distressing this was for her. She made about 2 or 3 complaints within about an hour. I could hear her very clearly (only a curtain separated us), and I could hear the same midwife promise that she was going to clear the bay for her, and that she was going to send 2 ladies home that day.

Around 10am, the midwife came to my bed with 2 other clinicians. One to administer my anti D injection, and another to give me my discharge information. After this, the midwife asked me to confirm I was going home that day. I'd had very little sleep after a labour that started the night before I was in hospital, I'd lost blood, was still nauseous from the pain meds, and was generally not able to think straight. I was also feeling very uncomfortable about the lady next to me who continued complaining about my son crying. I confirmed that I would by going home that day, but ddidn't tell her when. My husband wasn't even at the hospital yet. My mother and daughter who we planned on visiting me at hospital, still hadn't. And a catering lady had that morning taken my food order for the entire day, so I had assumed I'd at least have a chance to have lunch if not dinner before heading home.

I called my DH and told him to come as soon as he could, so that he could help me pack my things. He arrived just before midday. He held the baby while I got changed. Then I breast fed the baby while he packed up. While he was there, the lady next door made another 2 complaints about my baby crying, and the midwife came twice asking me if I was leaving.

At around 1pm, I got so anxious about staying there and the lady's complaints, I took my son to the common room while leaving my husband to finish tidying up/packing up. At 1pm I asked the midwife if I was good to go and she just said yes. We left shortly thereafter.

I left without any meds or conversation about meds (pain meds, stool softener, anti sickness meds, iron supplements), and before a chance for my mother and daughter to visit me and the baby. No one had physically examined my chest.

Since then, I've had to contact the GP to arrange medication for pain, haemorrhoids, they've arranged a blood test since suspecting anemia, and arranged a chest xray following chest pain and breathlessness (which I communicated to the midwives on numerous occassions). I feel so incredibly let down. I feel like I was rushed out to appease the lady next to me. It was so awkward hearing her complaining endlessly, but even more awkward hearing the midwife promising her repeatedly that she would clear the bay for her.

Is it worth complaining about this through PALS?

Thanks if you've got this far!

I have no idea what PALS might do, but I think you’ve every right to complain about this. I submitted a complaint to PALS and they were very helpful in taking down the information and summarising everything – you can do it over the phone and they will write it up for you. I don’t necessarily expect all that much to come of it but felt it was important to do.

I am not sure what specifically you would complain about to be honest. You were discharged and sent home. The only possible issue would be not being given medications. You can't complain to PALS about another patient, as far as I am aware and I don't see any wrongdoing by the staff. They were not rude to you, they did not discharge you unsafely, there is probably not much "learning" for them in the whole experience. Of course, you can always ring PALS for further advice but I would imagine this would be filed under "one of those things".

I'm sorry you had a difficult time. You agreed to the discharge, perhaps feeling under pressure from the overheard conversation. However it seems that at no point did the same mw directly suggest you go. You could have said no. What outcome would you seek?

She was put under pressure to discharge in order to convenience the patient in the next bed rather than on the basis of her own clinical assessment. She was also made to feel very uncomfortable and distressed by the nurse assuring the other patient she would get rid of OP!

It’s not good care, and it had a clear negative impact on OP, both emotionally and clinically, since in their haste to get her out she wasn’t provided with essential medication. It is clearly very poor.

I think this was on you tbh and you can't complain to PALS about another patient. The nursing team checked you were happy to go home, you said yes. You didn't ask about lunch - the team there can't mind read that you wanted lunch also. At any point you could have said "actually I don't feel ready yet because X Y Z and also please could you ask the lady next door to stop moaning."

Before the lady was moved next to me, I'd actually told the midwife that I wanted to stay another night. I told her I wanted to speak to someone from the infant feeding team, and told her also that I after walking around the ward I realised I wasn't feeling up for going home since I still felt nauseous and weak. This is why I was confused and overwhelmed when she came to my bed shortly after (with 2 colleagues) to administer my injection and discharge me.

Just to clarify also, no one came to ask me if I was happy to go home that day. After communicating my intention to stay for another night, I was asked (/pestered) about when I was going home. I didn't feel I had a choice in all honesty.

I’m so sorry for what you went through.

Instead of PALS consider feedback to healthwatch for your area.

https://www.healthwatch.co.uk/?gad_source=1&gclid=CjwKCAiArKW-BhAzEiwAZhWsIIRcMBqO09FiFwEk4krZeO5YGhaANh96sLUem9tbsbqUTdF3YgQ42BoC4ooQAvD_BwE

This shows how bloody awful and entitled some patients can be - she is in a shared post natal ward of course there will be babies crying.
Perhaps a stfu to this dreadful woman may have been appropriate.

I agree with this to an extent but we also need to be empathetic to the fact that her baby was taken to NICU shortly after birth. There is a lot of anxiety that comes with being separated right after birth.

OP, it's ok to give the feedback. Nothing will come of it but it'll be discussed as a midwife team and learns are just as important.

But also it shows the importance of being able to advocate for yourself or having someone to do so on your behalf when you are vulnerable.

To some extent patients are entitled. However there is significant psychological distress to mothers whose babies are taken to NICU- often Mothers are returned to the postnatal ward surrounded by babies and it may be hours before they can go to NICU to be updated on their baby. The literature surrounding this advises to try and put NICU mothers in a side room or even pre-natal wards to minimise their distress. Much like if someone suffers a loss - it’s not ideal to have them on the post natal ward surrounded by babies.

I appreciate from OPs point of view it seemed unkind however the mother’s focus will have been on her own circumstances. The Midwife was offering re-assurance to that patient who was in significant distress, a lot of it was probably said to appease the patient, the reality is that that bay will be filled with any mother who’s delivered if they need a bed.

OP it’s up to you if you persue with PALs, I think your agreement to be discharged makes it a little complicated. It’s probably something that should have been raised at that point eg: they spoke to you about discharge, oh but I thought I was seeing the infant feeding practitioner before discharge etc. Also the catering team will just take anyone’s order who is present at that point- they don’t delay a discharge as someone wants/ has ordering their lunch- in the nicest way it’s not a hotel, bed manager wants your bed. Similarly they won’t delay discharge to allow your daughter to visit. Again re: meds, not ideal that you didn’t get any but on the other hand this is something you probably should of said before you went home if you were unsure, for example do I need any medications for at home? They don’t routinely prescribe pain medications unless you’ve had a C section, they just anticipate you take paracetamol. Anti sickness isn’t something that would be prescribed routinely, neither is iron.

This actually happened to me when I gave birth over 10 years ago. There was a lady in the 6 bedded bay I was in, whose baby was in NICU, and made it very clear that she resented the presence of me and my newborn baby. I was moved to another area, though, instead of being prematurely discharged.
Yes I would complain, op

I’m sorry it wasn’t a great post birth situation for you @Burundi88 Personally I wouldn’t bother going to Pals as it won’t get you a resolution as it’s happened and it’s unlikely to change practice going forward. But if it makes you feel better to talk to someone at Pals and get it off your chest then do so.

if you’d stayed the food would probably have been awful and a noisy night in a ward with observations is hardly restful. It was probably nicer for your dd and mum to meet the baby at home not in a hospital full of germs.

The important lesson is if you don’t feel physically well stress that to medically teams at the time as sometimes they can be dismissive and you know your own body best so if something doesn’t feel right tell them.

Just adding that you would be discharged the next day in normal circumstances and the midwives need to free up beds once people are ready to be discharged.

This is honestly such an awful and cruel response. I had a baby in NICU and I cannot describe how horrendous it was to be on a ward filled with women and their babies while mine was taken away from me and seriously unwell. Fortunately I was lucky and they found me a private room which helped. This poor woman was probably just trying to push the midwives to find her a space away from other babies while she was separated from her own and honestly the fact that they couldn't do that without pushing the OP out just shows how poorly designed hospitals are for women's needs and mental health in these situations.

I can say from experience that when you are separated from.your baby who is in NICU and you likely don't yet know what kind of outcome they will have it is absolute agony to be surrounded by Mums with their babies. That Mum might not have even gotten to hold her baby yet. Her baby might be very unwell. It is extremely traumatic.

I assume that they didn't have any side rooms or other appropriate rooms available for the other mum.
I think you could complain that you felt pressured to consent, you could also ask for a birth debrief meeting. I'm not sure what they could have done differently if there was no medical reason to keep you in, but it must have been very confusing though and frustrating that you had the impression that you would stay a second night. I think if it's really upsetting you it's worth complaining and seeing what they say. If anything it highlights the issues for mums who have been separated from their babies. They likely already have a process but maybe they could look at any other options / what to do if the ward is full.

Perhaps OP felt harassed into leaving when she had already been told she could stay

I do feel for the lady next to me. My DH has always said that we should be grateful that both me and baby are well and managed to return home.

This isn't to belittle the patient's ordeal in any way, but I have a history of MH issues and my record is flagged at risk of peri and post natal MH issues. I was struggling both physically and mentally and did communicate both to the midwives (before being transfered to the bay, I was found by one midwife crying in the shower- I suspect this may be the reason I was not only offered but encouraged to stay an additional night).

But additionally, and I know I risk being shot down for this, but I believe it may be noteworthy. The patient next to me was English. All the rest of us on the bay were not. There were 4 others including myself. The other 3 others were not native English speakers, and one of these mothers also had her baby in NICU. I can't imagine how distressing it was for both mothers with babies in NICU. But the sudden change in my midwife's manner with me. Hearing her promise the lady that she'd clear the ward of us all each time the patient complained. And worst of all being worried about my baby crying or making too much noise.

I accept I should have vocalised this a little better perhaps.

Thank you all for your responses.

So sorry this was your experience. Sounds awful. Ignore the idiots saying it was "on you" or dismissing your experience.
I'm an NHS manager and I would complain either to Pals or directly with the hospital. You might be able to have a post-birth debrief where you can give feedback although I think they can be mixed in their usefulness.

In my service we think of complaints as the canaries in the mines that let you know there's a problem with our processes.

There's no way one patient's treatment plan should be influenced by another patient.

Why is the other ladies needs more important than the OP.
The OP needed medical care which wasn't given.
The other lady should have been placed in a private room
or gone home. That's what I did as it was very hard listening
to babies crying while yours is not with you.
Unfortunately hospitals are not set up for women having a baby.

Your care sounds awful so I'm so sorry this happened to you. That other lady should have been in a ward with no babies present. My twins died last year in the NICU - stillbirth and my second died at 4 days old and I was in a no baby ward, everyone on my ward either was a bereaved mum or their baby was ill in the unit. I would have lost my mind in a ward with other babies, one of my boys had just been born sleeping and my second was dying in the NICU. It's a nightmare. I'm based in Ireland though so not sure what the set up is elsewhere.

So sorry xxx

Sorry to hear about your awful experience. I had to use PALS recently and they were so busy it took months to get a response. Complaints must be through the roof.
I think you should think about what you hope to gain making a comaint. It's a long and stressful process and you have a new baby.
I didn't hear what I wantd to hear when i made mine just a load of excuses and the whole thing made me feel 10 times worse.
Personally I think you should put this behind you and enjoy the early days of being a mum. You won't get those back.
There will always be selfish nasty bitches in the world. Don't let them live rent free in your head.

I'm so sorry about your beautiful babies ❤

I had to go up to the post labour ward without my baby and was put in a side room - with a woman who had triplets. We came up about 4am and had to turn a light on which woke one of the babies and caused the mum to have a go at me. Thankfully a MW was right behind me as she had realised this room arrangement wasn't ideal and had a word with the mum (who was apologetic). But there was no space to move me.

I slept like the dead for 3 hours and then went to NICU. I only went back to the side room when they discharged me that evening (my baby followed a few weeks later)

My care was atrocious but fancy putting someone who had a baby in NICU in with triplets (reasons for NICU were unknown as well - baby was floppy and didn't cry at birth and didn't feed. She was being tested for a whole host of serious shit, pumped full of prophylactic medication, having brain scans etc). Thankfully I'd had a good labour and was fully mobile and able to function in NICU after a 22h labour / 3 hours kip.

I certainly didn't expect a mother of triplets to be turfed out but there should have been somewhere more suitable for me?

I am so so sorry for your loss.

💐