Wednesday 8 April 2015

The difference between adequate care and exceptional care

So yesterday we saw the reflections midwife at our local hospital and I have to say I left pretty disappointed.  I think the problem is having seen Kim the epilepsy midwife we had just set our expectations too high.

So I guess I need to start by reflecting on what went wrong last time and that can be broken down into four key parts:
  1.  I ended up going into hospital at 9cm dilated – my waters hadn’t broken so there was still the opportunity to put an epidural and after over an hour of trying they finally got it in. I then didn’t deliver for another 12 hours because the epidural mixed with taking clobazam slowed everything down.  When I finally did deliver Riley was dragged out with forceps because we had both become distressed.
  2. Rich was forgotten just as things were getting really stressful – he got told to wait in a side room while I was taken off to theatre – he wasn’t told anything.   He didn’t know what was happening to me, he thought I had died.
  3. After delivering Riley they forgot to administer pain relief and I was in huge amounts of pain and they then did internal examinations on me.  Of the whole labour for me this was the most traumatic part, I had given birth, it had taken over 24 hours but I didn’t get to hold or even see Riley for what seemed to me to be hours, instead I was in immense pain and having people poke and prod me.
  4.  I had to stay in hospital because I was on IV antibiotics and during that time at night when Rich had to leave Riley was placed in the cot with me to feed for hours on end because she wouldn’t stop crying.  The neurology team had dropped my medication levels straight down from 650mg to 450mg overnight (I have since found out I should have been weaned off them) and I hadn’t slept for 3 days – the risk of me having a seizure was high and I was alone in bed with a newborn baby…
So the first thing the reflections midwife did was say she wanted to talk to me on my own – looking back I should have refused from the beginning but she said that was how things worked there and I didn’t want to set off on the wrong foot.

We talked through what happened last time and I kept saying, it was hard for Rich too, highlighting that he had been left not knowing what was going on (similar to what was happening again right now!) and she kept saying she’d talk to him after we’d run through everything.  I also kept saying that I couldn’t really remember the details because of the clobazam making everything a bit muddled up and I definitely couldn’t remember time scales and it would probably be best to check with Rich about the details. 

Towards the end I was close to tears, when I mentioned how hard the first few months were and whereas with Kim it felt OK to cry – this time I felt like I just needed to pull myself together and it was at that point I knew this woman was a means to getting things down in writing so it could be different this time, I wasn’t going to get anything deeper out of it.

When I was finally able to go and get Rich he was understandably upset and there wasn’t really much more to say.  The thing is it’s not that she did anything wrong – the whole way through she agreed that everything that happened shouldn’t have happened and things needed to be different this time around and we agreed we’d write a clear care plan which at the end of the day from a practical point of view is all I needed it’s just we had hoped for a little more.

As my blogs title says I guess it’s just the difference between acceptable healthcare and exceptional healthcare.  In London they’d always included Rich in my care – always looked at the whole picture and Kim well she was beyond amazing – talking to us both, giving us so much time, empowering us together. 

We are lucky to have my consultant and Kim involved in my care and at the end of the day making the biggest decisions – and that’s what I need to hang onto.  If it wasn’t for the appointment we had with Kim I think I would be feeling a lot more worried but as it is I know what I want and I just need to make sure that’s communicated to the local hospital.

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