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Hospital pressures and early discharges

HoppyNurse profile image
8 Replies

Last night I self discharged from one of the most traumatic hospital stays I’ve had!

A bit of background- I was diagnosed asthma in may - raised eosinophils and FeNo. Started on relvar and all appeared to be good, fast forward to October 16th I suddenly developed this tight cough, struggled to to catch breath etc etc. Saw gP and started on Steroids, 2 days later at work (I am an ED nurse) really struggling I was admitted for the first time, Needing magnesium infusions etc. I have now had 7 admissions since that date all presenting the same - sudden onset of SOB, tight chest and unable to speak. All treated with magnesium IV in ED and a second infusion 24 hours later.

So this current admission happened on the 6th January - 3 days after my last discharge - which I felt was too soon but they were pushing for beds!

I was blue lighted to resus, given the usual B2B nebs (5 in total), IV hydrocortisone and magnesium. Although sats were good on monitoring my gas was terrible so oxygen therapy also started. I was then admitted into a makeshift ward that was part of the ED. And there I remained for 5 days! I saw a respiratory specialist once during that time - and their plan was to wait for a plan from Guys hospital. So I sat tight continuing on nebs and ivs, not much else being done. The ward - I use that term very loosely - was not an ideal place to rest and recover. Being part of the ED meant it was bright, noisy and busy all the time - tannoys going off all through the night. One toilet for the 9 ladies placed there plus other patients in the ED and not to mention the ambulance staff who used it too! They didn’t offer a full menu service so my family had to bring I food for me - I am gluten and dairy free! Also bottles of water had to be brought in as there were no jugs of water for patients.

5 days after I was admitted I was transferred to the AMU - still not the best place for me but a little bit better than the ED, there I sat all weekend continuing on nebs and IV hydrocortisone as still awaiting respiratory plan - I had only seen the respiratory doctor once that was the previous Tuesday!

Sunday night wasn’t a great night, I was tight all night long, up coughing needing nebs every 2-3 hours, medical doctor refused to see me, the nurse looking after me (fortunately an ITU nurse doing a bank shift) was pushing to get me some magnesium prescribed but the doctor wouldn’t do it as my sats were ok! - nothing new there! Come ward round Monday morning my medical team saw me - agreed that I needed magnesium, and prescribe an infusion - it may have taken 4 hours for them to do it but at least it got done. We spoke about a medication to help relax my chest muscles - which feel like they are in spasm after all the coughing and they were going to discuss with respiratory and get t back to me.

At 5 pm - whilst I am having the magnesium the DR comes back to me and says that respiratory are not going to review me and I should just attend follow up as planned on the 20th January. He said I could go home once the infusion had finished- my team always says 24 hours off nebs and ivs prior to discharge! I highlighted this to him as I had previously failed discharge after the same thing. And he agreed I should be switched to inhalers and reviewed in the morning. An hour later my medications arrive for discharge - very strange as I was not started on any new medications so didn’t actually need anything to go home with.

9pm arrives I was just getting ready to sleep to be told I was being transferred to the discharge lounge to await discharge in the morning and I should pack my things - this is 4 hours after the magnesium infusion! I stated that this was not the plan discussed with Dr and is not the recommendation from the specialist team. I was told they needed my bed and the discharge lounge was like a ward. I decided that I would be better off at home so left the hospital last night. Then nursing team didn’t seem bothered at all there was a complete lack of compassion and understanding. They didn’t even discuss it with a doctor - they just let me leave!

I completely get that the hospitals are under so much pressure there is a lack of beds, and they are making wards to accommodate patients I am grateful for the treatment I receive but I feel that the care and compassion is being forgotten about - the patient is not the centre of car anymore is about finding bed spaces. Had I been reviewed by respiratory more than once I may not have needed to be there the for 8 days, not taking up a bed space that was needed for someone else!

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HoppyNurse profile image
HoppyNurse
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8 Replies
EmmaF91 profile image
EmmaF91Community Ambassador

Ugh. Just ugh to it all. Do you have a contact number for Guys to ask for advice (or to ask to be escalated if you’re on the waiting list)? Or do you have a contact way to contact your local team (ANs/RNs/consultant ms secretary etc) to tell them what’s going on and maybe bring forward appt (especially if you’re still feeling rough)?

I hope you start to feel better or at least listened too soon! I completely get your frustrations!

HoppyNurse profile image
HoppyNurse in reply to EmmaF91

I’ve managed to speak to the team at Guys today - they’ve advised that I am being discussed tomorrow at their MDT and hopefully will be approved for biologics. They informed me they had been discussing with the local team - I should not have any more steroid treatment as they gave me kenalog injections whilst I was there and this should be enough cover. Makes me think if they actually listened as they discharged me with a weaning regime of steroids to continue to take!

Kitty2823 profile image
Kitty2823

At georges hospital in tooting deals with these problems

HoppyNurse profile image
HoppyNurse

So after my 48 hour review with the GP - I am back in the ED! The GP wasn’t happy with my peak flow or chest!

EmmaF91 profile image
EmmaF91Community Ambassador in reply to HoppyNurse

Sorry to hear this. Hope they get you sorted this time and actually listen!

strongmouse profile image
strongmouse

Sorry to hear that you are back in hospital. Hope that you are getting better treatment this time round and the medication helps.

I sent an email to my MP a few days ago to ask him to put pressure on the Government to sort out the current strain on the NHS service. They are currently discussing how much funding and ways to increase number of doctors - I think number of beds should be increased too.

If any of you have a chance to write or email your MP then please do. It does make a difference if enough people express their concern as an MP can say "I have had a number of comments from my constituents who say x, y and z"

Shellc profile image
Shellc

I have asthma and I regular take magnesium along with vitamin d and k2, I helps me tremendously

lucie982 profile image
lucie982

It seems to still be happening. I was addmitted twice in 36hrs. Discharged with sats of 92 as i was no longer wheezy, then second time discharged 6 hrs after a magnesium infusion with 1 day of steroids. Its really playing with my head as i feel so unwell still even now im onto another course of pred

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