Monday, 28 November 2011

Weekends on NICU

I got involved in a bit of a discussion about this article today on the BBC news website. In a nutshell it says statistics show that there is a spike in death rates at the weekend in NHS hospitals. I would love to know if such figures are available for NICU but doubt there are. The main reason for this is that there continues to be a culture of "normal hours of work" for senior consultants, Monday - Friday 9-5.

I find this baffling and somewhat infuriating, that younger, newly qualified doctors, are supposed to do all the difficult hours, with little experience, and often little sleep, and few opportunities for quality supervision, whilst the consultant who has "done their time" can work "normal hours", medicine just isn't like that.

I remember always feeling nervous on Friday afternoons, when the unit was slightly less staffed, and there were less experienced doctors around. I always hated it when blood tests would come back on a Friday and Joseph would need a transfusion, or new antibiotics, I could just see things going pear shaped when there wasn't anyone experienced around to sort it out.

And indeed, I recall a weekend where things were dreadful (and the consultant came in immediately I might add) but there weren't the additional support staff around and some facilities were closed, and I could see the registrar becoming more and more stressed. On this weekend it was all hands on deck, helping one another out.

And one of the doctors on Twitter suggested that consolidating services in large hospitals is the answer, instead of having lots of small units dotted about, and that the problem is that "we the public" see closures of units and consolidation as "cuts" rather than improvements.

I do accept consolidation and modernisation is necessary to a degree, and our local hospital has been a victim of this, and the unit where Joseph was born and raised will be closed. His (@DrGrumble) feeling is that in larger units this will change, and there will be more experienced staff on duty at unsociable times, which I truly hope is the case. However I have some serious concerns about this "bigger is better" philosophy and wonder if its truly what will happen. I guess for our area we will only know once it starts unfolding.

However, weekends in NICU wasn't all bad. Often times I'd be given more freedom to get Joseph in and out of his incubator on my own. I would get "forgotten" about and Joseph would have longer kangaroo cuddles. An obvious benefit of weekends was that my husband was around, and we could tend to Joseph's needs together, and have time out together, I wouldn't have to sit on the Kylie Hodges memorial bench, outside the nurses quarters!

Every weekend I still spend a minute or so reminiscing about our time on the unit, and the excitement of driving up together to see "our magic boy". 


6 comments:

  1. My son became very poorly on a saturday after negligence from a doctor that "wasn't from our hospital, he is not permanent here"... My son had an emergency transfer to a different hospital in the middle of the night... In the new hospital everybody was shocked, they couldn't understand why the doctor failed to stabilize him and allowed the situation to progress...I still remember how he would say everything was ok with my son... how his lungs were fine...and then he told me that they decided that my son would be transferred to another hospital (LAUGHING!) and that I couldn't go with him and would have to find a way to meet him there...And my son was only transferred because a consultant came in the night and said his lungs could collapse soon and he needed to be transferred asap....I honestly think that if it wasn't for the night consultant I wouldn't have a son now...
    When I complained all I heard was "He is not from our hospital...I am so sorry.. I never saw him before..." Well not good enough! I hate weekends when it comes to hospitals/nursing homes etc...I am against the monday to friday 9-5 working pattern...

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  2. Very good article as always.

    Gemma always used to get sick on a Friday night when in the Childrens hospital and it always worried me. The on call general doctors (rather than specialised GI) always did the bare minimum for the GI to sort on the Monday!! Often an x ray and stop feeds 'just in case' which was very frustrating and meant back to square one. Felt just covering there backs, I always asked on a Friday if any of the GI regs or consultants were going to be in so could request them if anything happened because apart from anything they knew her as was in there over 5 months.

    She was in NICU for 3 months, the weekend cover was luckily much better and never had a problem. The night before her big NEC op was a big problem as the surgical reg saw her at the childrens hospital and said that she needed operated on but consultant surgeon not available until the next day (Saturday), we were lucky he did it on the Saturday as she was very ill and took hours to stabilise her on the Saturday morning to transfer back to the Childrens hospital. With hindsight, why didn't they just keep her at the Sick Kids as the transfers cannot have helped.

    Like you say weekends were also good because daddy was there to share a coffee and fresh air with!

    Lilly Vieira - oh my god, that is awful. The 9 to 5 pattern does not work. The GI team said they used to work shifts to cover weekends and bank holidays but it was stopped, presumably to save money.

    Sam

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  3. I hated the weekends too and the bank holidays were a complete nightmare. We were in from Dec until May so you can imagine how many holidays we had to go through. I would be completely on edge until 'normal' service was resumed. As it was, I spent the whole of Easter weekend telling staff that my daughter was unwell, only to be ignored, and then came in on the bank holiday Monday just as they were transferring her to intensive care. The most awful times of my life. Sadly we lost our daughter in May, just after another bank holiday!

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