Consultant v GP

I am in an awkward situation here and really dont need it at the mo!!

Basically i escaped from costa on saturday after a 10day admission including a 3 day stay in HDU. My pfs and sats are still low for me and im needing nebs every 3-4 hrs, any ivs i was on were stopped on wed and i came off o2 on thurs. Both my GP and my community matron have expressed major concerns re my discharge and want me back in but my con has basically said that as they werent doing anything now that i cant do at home then thats where i should be.

I have been asked what i think and of course i said home (would i really say anything different!!) but i have niggly doubts about this being the right decision as am not coping but at least i get some kip at home!! i dont feel that i should have the final say as a) im not medically qualified and b)im n emotional/physical mess at the mo!!

has anyone else been in this situation (or not) views and suggestions greatfuly recieved.

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Sorry your having such problems at the moment. I hope your chest picks up soon.

I ahve had a simialr situation to you a fewadmissions ago and like you when asked i will always say home rather than being in hospital often even when i know deep down i should be staying. My community matron works very closly with the hospital and the nurse and drs who normally look after me when i am in. Does yours? becasue maybe she could speak to them and explain that you are stuggling and have doubts about being at home although your con thinks you are ok to be at home. They may be able to speak to your con as they see you more than he would.

I find the community matrons are really good as they see you when your good and when your bad and when your in hospital so they know what is normal and not etc.

I have two cons i trust them both but the con at my local who noramlly deals with my whilst admitted can sometimes be hastey with discharge etc whihc i am pleased with as it means i get out but at the same time sometimes i know my chest is not right.

sorry i ahve rambled a bit and dont know if it is much help.

hope lungs pickup and you get it all sorted

olive

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THanks for your reply Olive its nice to know that im not alone with this My community matron is meeting with my con as i type to work out what to do next and she is fab . She visited me when in and even read the riot act out to the nurses who had let me have a ridiculous number of nebs before calling for the dr (i ended up in hdu but if she hadnt arrived i think it would have been worse)

I will respect her decision whatever it is as like u say they see us when both good and bad.

I just wish it hadnt come to this , my local con is normally quite good at not discharging too early but i hate to say it but i think he did this time.

What was the outcome of your situation?

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Hi hops,

It's a difficult one, isn't it, and I would agree that when you are ill and feeling vulnerable you are not really equiped to make the decision for yourself. I have often been asked to make decisions for myself when I've been pretty unwell (probably because I'm a doc) and always find it really hard.

I am not really sure what to advise, but if there is one particular healthcare professional that you particularly trust and respect, perhaps you could let them decide and then stick to that decision.

I can see your consultant's point of view about them not really doing much for you that you can't do at home, but I think consultants forget sometimes that being at home is intrinsically harder work than being in hospital, quite apart from the safety aspect of it.

Hope you get some answers soon

Em H

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Thanks Emh

You said it perfectly - being at home IS harder than being in .

My community matron pointed that out to my cons apparently today and he said ""that that particualr area wasnt his problem!!!""

I ahve decided to stay at home for the mo after alot of weighing things up but my community matron will be visiting twice a day an also keeping my GP up to date.

If any of my obs deteriorate anymore than its out of my hands and im back in. hubby has also been given an ultimatum and rigid guidelines as when to call the green men if needed, so for now im split between the pc , sofa nd bed!!!

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Quick update

I ahve managed to stay at home with alot of support namely my super nurse and a very good GP and am just about staying afloat providing i do nothing basically!

We have arranged that at my next appt with my local con that my nurse will come with me and between us we will write a protocol both for admission and discharge, and my Gp is writing to the con too stating his views and at what level i should go in/come home from his point of view, so hopefully we wont have a repeat of thsi week.

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I'm glad things are stable, at least, if no better, Hops.Do you have any help at home? If not, it might be worth considering, even if it is only intermittent when you first get out of hospital. Hope things improveEm x

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Hi Em

Im lucky that my hubby does shifts(hes a fireman) so is home for 4 days at a time, my parents only live 15 mins away and i have some very good friends who all help out .

Hubby is very domesticated (washing, cooking, cleaning etc all to a decent standard!!)

My mum now stays when hubby is on nights as we were advised that i shouldnt be alone at night at the mo as that is when im most likey to mega splt(itu typ spalt as i go from asleep to unconcious occasionally - does anyone else do that ?)

Unfortunately there is no way i can afford any extra help so im not so dependant on the usual gang (which i hate being) but thank goodness for internet shopping!!

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Hops

You shouldnt have to pay for care , if you make some enquires through your local socail services team or it may be another avenue in your area ( matron will know) you are more than likely to be entitled to something called direct payments. Basically you are assessed for the level of help you need and then they give you the money to employ someone of your choice. The only down side of it is the book keeping which again there are organisations that help with it and can come out of the direct payments fund.

Its not as complicated as it sounds, I know many people who use this service.

Several of my friends have this set up as well as a friends daughter who would not be able to live away from home at uni without it.

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I have care and my area is not on the Direct Payments scheme, so I have social services employed carers - well, actually, it's now going over to a subcontracted private company, because I've been having it for more than six months (bit nervous about the switch, as I've got used to my carers a bit, but oh well).

When we had the original financial assessment, Alex was still a student and my only income was DLA (because of extreme delays in getting my Incapacity Benefit processed). The assessment is means tested, and on that basis, we ended up paying nothing for the care. They do consider number of dependents and out-goings as well as income.

Even if we had had to pay, it would only have been a contribution, and off the top of my head, the maximum we would have had to pay would have been about £80 a month, which given that I was initially having 2 - 3 hours of care a day (and could still have that much if my condition deteriorated and I needed extra help) is a pretty good price.

Obviously, now that Alex is working, we will have to have another financial assessment, and we will end up paying some, if not all, of that, but it's still far less expensive than the actual cost of the care I am getting.

I don't know if it varies from area to area, but in my area, care is always free for the first six weeks after a hospital discharge, in any case - so you may find that you could get some care for free for a while anyway.

I think it's certainly worth asking for a referral to social services - even if you only get a couple of hours a week of care, it does make a real difference. I find that one of the best things (and something that initially made me feel really guilty) is that we get the washing up done and an hour of cleaning a week, as well as my personal care. This might seem unnecessary, but it is actually really important to our quality of life - basically it means that Alex and I can spend his fairly limited time off having quality time together as a couple, rather than him exhausting himself coming home after a long day at work as a junior doctor to a pile of washing up and housework.

Hope you're doing a bit better, anyway, and take care

Em