Good things first, Jamie and Louie are doing really well. At the moment they are wonderful little lads, feed them when they demand and they don’t make a fuss for another 3 – 4 hours, so their Mummy is getting quite a reasonable sleep. They have quite regained their birthweights but another day should see them back to where they started.
It is due to the whole hospital, postnatal experience with daughter and babies that I have become even more disillusioned with the maternity services in general, and this is coming from a midwife. Daughter’s antenatal care was excellent, I really couldn’t fault it but once it became ‘intrapartum’ things went rapidly downhill. I fully understood that the C-section itself couldn’t help but be delayed due to volume of work for the surgeon but from there on in my ‘understanding’ started taking a severe beating. The anaesthetist was rude to son-in-law and myself and he failed to communicate anything to daughter other than barely intelligible orders. The paediatric registrar, or any of the Special Care staff failed to keep daughter and son-in-law informed as to how their baby was doing, only coming to report when, after 2 hours, I went and spoke to them and requested that they explain what was wrong with Louis. Daughter had the babies on the Thursday, she saw Louis in special care for 10 minutes before she was taken up to the ward and the next time she could see him was the Friday morning when I took her, in a wheelchair, to SCBU. Having got to special care we were ‘greeted’ by a nurse who told me to go as it was husbands only. No word of greeting to daughter, just a barked reprimand to me. I explained that daughter’s partner was unable to come as they had a toddler so the ward had agreed that I could take his place, so adhering to the ‘one person rule’. Not good enough for those redoubtable gatekeepers in SCBU, ‘ It’s partners only’ she scowled. Daughter was in the wheelchair, in the corridor, feet away from her baby but old battleaxe was far more worried about barring my entrance than taking any notice of an anxious Mum. I tried again, ‘what about women who haven’t got partners, can’t they have anyone with them the first time they visit their tubed and wired-up baby?’ ‘That’s different. We are trying to stop too many visitors’. Brick wall, head. I exited, leaving daughter with a person who should definitely not be described as caring who just wheeled daughter to the ‘cot’ Louis was lying on and told her to call her when she had seen enough and they would call me back in to return her to the ward. The next day the twins were together, but still having to go down to SCBU for their antibiotics. Daughter was mobile, but in discomfort and tired so I took them to the enclave for poorly babies and scary nurses. Busy, busy. Wait in the parents room with babies and they would get to me. I waited, and waited. I knew that they had just had a poorly baby admitted so I was patient, until I heard voices coming from the staff-room. Two of the staff were sitting in there having lunch. Now, anyone who doesn’t know how these things go would think ‘Okay, it’s their lunch break’. Well, lucky old them, in my NHS world lunch breaks are a rarity. there is too much to be done to sit around, especially if 2 babies have been bought to SCBU to have their medication at the time it’s prescribed. Then we get to the extra dose of gentamycin given to Louis, all the rest might be counted as unfortunate but this is slackness, unprofessional, dangerous practice. This is not because a unit is busy, it takes two nurses to check an IV drug, this is staff who are not adhering to safe practice.
So I thought, and I mused. Then I raged, then I cried, then I decided that there is a common theme, poor communication. From the anaesthetist who had no people skills, through the paediatrician who didn’t feel the need to communicate, to the nurse who had no empathy to the two nurses who were unable to correctly read the prescription.
Who have I left out here? The midwives, are we blame free? Not by a long shot. In the hospital daughter was very much left to her own devices, too busy, short-staffed. Difficult then to cast aspersions, but then she was discharged to the care of my colleagues in the community and once again the poor quality of communication, plus laziness, once again displayed itself. Her first morning at home, the day after discharge, I was phoned at home by my team leader asking me when I could attend an interview with my prospective job-share. I said that I would try and organise a day when we could attend but it was difficult that day as I had to get to other daughters house to care for her children whilst she had minor surgery. By the way had she had the discharge for daughter plus twins? Yes, she had. ‘You heard what happened then?’ Apparently not, all they knew was that she was home with two babies. I bought her up to date on Louis then phoned her back 15 minutes later to say I had arranged a day for the interview and that if she needed to get in touch again to phone me on my mobile as I wouldn’t be at home for the rest of the day. Did my motherly/grandmotherly duties and left daughters at 4.30. Since I had to drive past new Mummy and twins on the way home I decided to ‘pop’ in and see how the first day and night at home had gone. They hadn’t received a midwife visit. I ended up checking them over, and left, seething. Work the next day. Calm, calmness personified I enquired as to why daughter hadn’t been visited. They left a message on her mobile to say that they thought she was staying with me and so I would be doing her care. If they had read the discharge note they would have seen the discharge address, if my team leader had bothered to pass on the information I had given her they would have known I wasn’t around, if they were not such lazy bastards they would have done what I do if I phone and don’t get an answer, go round there anyway. Needless to say, I have done the rest of her care. Communication again, or lack of.
Now we are on to the health visitors. Another profession that is understaffed. Day 13 and they hadn’t contacted daughter. I didn’t want to sign daughter off as twins not yet back at birth weight without knowing that they would be attending, so I phoned them. First of all she didn’t want to speak to me as their secretary told her I was ‘the Mother’, eventually I was allowed to speak to her. Condescending woman informed me that they don’t visit until 10 -14 days, ‘It is now 13 days and since you haven’t yet made contact then it will be over that’. So then she said that they can’t contact until the ‘Red Books’ have arrived. ‘Oh, haven’t you got them yet? Shall I chase them up?’ Yes, they had got them. As this procrastinator waffled away I gave up the diplomatic approach and very slowly explained that I am a community midwife, working locally, who knows how the system is supposed to work and is concerned about the fact that although my daughter should be a priority ( 36 week twins, SCBU, drug error, question of hearing loss in one twin, not re-gained birth weights) they seem content to fob me off with invalid information. It worked, they are visiting tomorrow. Reluctant communicators.
Initially I called this entry ‘Ashamed’, and I am ashamed. I don’t imagine for one minute that my experience of the maternity services has been unusual and I am absolutely horrified as to how quickly the service is dropping it’s standards. Some aspects we can do nothing about, the staffing levels, the resources but good communication is still something that can easily be achieved, and something that makes a difference.