"Poor communication"

I was admitted to Knapp ward at 7.30am in May 2024 for a planned TURBT. Because of my location, to make my appointment this entailed getting up at 5.30am. I had my surgery between 11.30am and noon. By 1.30pm my wife was surprised to receive a message to say I would be ready for collection by 2.30. When she came to the ward a nurse explained to her how to change the catheter bag. At that stage there was barely 50ml of bloody urine in the bag. We were given the telephone number of Abbey ward and told to phone  should there be any problems. We drove home and I started to drink plenty of water, stand and walk about. By 7.30pm it was clear that only 100ml of the 2 litres of water I had drunk was in the catheter and the rest was collecting in my bladder. By 8pm I was at intervals releasing pools of blood and urine onto the floor. My wife called Abbey ward but was told procedures must be followed and I could not return to the hospital and needed to call 111.

111 made an appointment for me at St Leonards at 9.30pm. We attended the appointment and met the out of hours GP who spoke to the surgical team at the RD&E. They then told us the surgical team were expecting us and that we should go to the A and E department but would not have to wait too long in the general admissions queue.

We arrived at the A and E department at 10pm. The receptionist phoned through to the surgical team, confirmed they were expecting us and told us to wait. We waited. We saw the triage nurse. They were concerned by my medical history, I am in my 80s,  with Leiden factor V who had been taken off warfarin to prepare for his surgery, 2 previous DVTs, 2 previous PEs, a heart condition and having had a general anaesthetic less than 12 hours before. We waited again. By 1am one leg of my trousers was fully wet and we were having to mop the floor as best we could. I was very tired having slept badly the night before surgery and apart from the time spent under general anaesthetic I had been awake for approaching 24 hours. Sitting on a chair in A & E I was unable to raise my legs and was concerned about having another DVT. I was reluctant to drink any more water because of the consequences.

We were then called into another room and told the surgical team were aware of my predicament but they were still awaiting confirmation that Abbey ward had a bed for me. When asked we were told they had no idea how long this might take and it could be hours before this happened. They were also very concerned and trying to do their very best to help us. My wife pointed out that I had been released from Knapp ward into their care and what had happened since was the exact opposite of the recommended rest, some movement, keeping my legs raised and drinking plenty of water.

I was finally taken to Abbey ward at about 1.30am. We were surprised to see that the ward was only 50% occupied. My bypassing catheter was removed the following morning.

I had a TURP in Guildford 15 years ago and the post operative care I received there was markedly different. I was not allowed to leave the hospital until it was clear that water was passing through my body and into the catheter. When on the urology ward all patients were encouraged to drink water and decaffeinated fluids such as chamomile tea. I was astounded that this was not the case on Abbey or Dart ward. It is well known that caffeinated tea and coffee can irritate the bladder and increase urgency and trips to the toilet.

Without exception all the RD&E staff we met were helpful and considerate. My experience has been that the time of the out of hours GP and all the A and E staff we met was wasted dealing with my post operative complication when I could have gone straight to Abbey ward for assessment / treatment. If Knapp ward discharges patients before checking that the catheter is working appropriately when the patients drink, stand and walk then other patients may suffer as I did.