Thursday, 30 June 2011

Pregnancy - Dealing with the NHS

So my last post was about my Toxic Pregnancy and was inspired by Karin at Cafe Bebe and the problems she is currently experiencing. I want to run through a few points might help others in similar situations.

I'm not a nurse or a doctor, but I have worked in advocacy and in allied health roles on and off for 20 years. 

Trust your instincts - I strongly believe that with all health matters, you should follow your instincts. If you think something isn't right, act on it. To be perfectly honest at 26+6 when I got my husband to drive me to delivery at 3am, I though I was being a complete idiot and that I was so worried  about the potential for pre eclampsia, I had created this headache in my mind. But I wanted to be certain. I am so glad I trusted that instinct to get checked out, and my baby was born the following day. If I'd waited longer, we both could have died, and that's fact, and was told to me by my final consultant who delivered Joseph.

Be resourceful, but try not to Google - with medical matters I don't believe Google is always your friend. If you do have to Google, try and stick to reputable health websites. Patient UK is endorsed by the NHS, and Bupa have a fantastic free to use website on medical matters that is well researched and reliable. Tommy's the baby charity have endless resouces and a free midwife service.

Keep notes - I would suggest having a piece of paper inside your pregnancy notes (which stay with you until delivery) to make a note of any symptoms your concerned about, and reflections on your appointments, and anything your concerned about. We all know how it is, you get to your appointment, you do a wee in a cup, have a listen to the baby's heartbeat, leave and think "oh you know I forgot to ask about my swollen ankles etc". If you have it written down, your less lightly to forget.

Don't delay in raising a complaint - I hate the word complaint and much prefer concern. I have heard so many people say "when this is over (pregnancy or NICU stay) we'll make a complaint". I think this is misguided, because although its good, for learning and correction, in terms of your own care, its important that action is taken when things start going wrong, because everyone still has a chance to pull things back.

Utilise PALS - As far as I am aware PALS is only in England, if you are in one of the countries in the UK you will have a different process. PALS usually have two arms, one is based in the hospital, and also one to cover community. Midwives usually fall under the hospital even if they are working in the community, so I would start with you local hospital and they can direct you accordingly.

By contacting PALS you are not necessarily making a complaint. In my case I rang and said "I'm not sure if I am right or wrong to feel upset can I run this past you" they then gave me a range of options. PALS are great because they often know the consultants personally and can take action without having to go down formal channels. You won't get a "bad name" or poorer service as a result. Medicine is based on informed opinion and sometimes opinions are incorrect. Also the NHS is a learning environment and sometimes people get things wrong. That's why PALS are there, use them.

Keep your GP in the loop - A suprising number of GPs are very well trained in managing pregnancy. My own GP was an obstetrician and gynaecologist as well as a GP though he doesn't practice in this. He was a lot more available than my midwife, and would link in with her and the hospital as appropriate. It was great to have him on board. As it turns out, he is the father of three premature babies, and I am not sure what I would have done without him!

I'm very grateful that I'd had experience challenging doctors and consultants, and in advocacy. Being an advocate for someone else is much easier than being an advocate for oneself, however. But, I am glad I am an empowered patient, and a pain in the behind. I strongly believe it saved my life and that of my baby.

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