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"10 hours delay before getting emergency surgery"

About: Forth Valley Royal Hospital / Accident & emergency Forth Valley Royal Hospital / General surgery Forth Valley Royal Hospital / GP Out of Hours NHS 24 / NHS 24 (111 service) Scottish Ambulance Service / Ambulance Control Centre

(as the patient),

I had my son phone for an ambulance for me as I was in excruciating pain. I had a huge hernia suddenly develop in my right groin and was vomiting and after an hour I couldn't cope with the pain any longer. Ambulance control took the details from my son who is 15 and decided that I didn't require to have an ambulance at that point, that I wasn't an emergency and that despite my symptoms and being unable to get to hospital any other way that they would phone back in 1-2 hours and told my son to hang up the phone and get off the line.

I had to then in between having excruciating spasms and vomiting get my son to phone my aunt who was out and my daughter who was at work to come to my house which took over 20 mins, My aunt then phoned NHS 24 who after about 15 mins of going over and over my symptoms finally offered to send a doctor to come out and assess me in 1-2 hours. It took me screaming out in pain and shouting over my aunt talking that there was no way I could wait that long and I needed an ambulance now that the eventually agreed to sending an ambulance for me.

Within 5-10 minutes Tracey the rapid responder arrived and assessed me and I could not fault her kindness professionalism and care. She could see how much pain I was in and very quickly ensured I was given I.M. Morphine and Entonox. When the ambulance crew arrived they had me transferred to hospital very rapidly with a suspected strangulated hernia that could not be reduced.

I arrived in A&E around 10.30 pm and had had to have 38mg of I.M. morphine to try and get on top of the pain which failed to give any form of relief from the pain. I was then assessed and left in a bay with my family after being told that it did indeed look like I had a strangulated hernia. I was given IV antibiotics and IV fluids and told that I would be going for an X-Ray and then for emergency surgery.

At just after 2.30 am I was eventually taken for an X-Ray however, instead of going for surgery, I was taken to surgical admissions ward and left in pain to wait for the ward round in the morning and my family were sent home at 2.45am.

I was seen by a doctor between being admitted to the ward and the ward round at 08.45 whereby they tried to reduce the hernia without any success and without any further analgesia. Finally, when the consultant saw and examined me on the ward round the decision was made for urgent surgery. After talking to someone on the phone and the surgeon who would be carrying out the operation they remarked that it was ridiculous that I had been left overnight and that this should have been dealt with through the night and they didn't know what the Dr from the previous night (whose name I didn't catch) was playing at.

I was then seen and was in theatre by half past 10/11 am. I have no complaints regarding theatre or my aftercare in ward B11, I couldn't have had better care.

My overriding concerns are that I was denied an ambulance when it was urgently needed, and left in pain for so long, and due to delay in surgery not only did they repair the femoral hernia but they also had to remove a 20cm length of small intestine that had due to the delay had died, putting me at risk of sepsis. There was also part of the bladder that was also in the hernia and that could also have left me with further problems had the surgery been delayed any longer.

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Responses

Response from Shona Lawrence, Clinical Governance Lead, Nursing and Care, NHS 24 5 years ago
Shona Lawrence
Clinical Governance Lead, Nursing and Care,
NHS 24
Submitted on 08/11/2018 at 12:50
Published on Care Opinion at 14:06


picture of Shona Lawrence

Dear concernedoverdelays69

Thank you so much for sharing your experience on Care Opinion. I was sorry to learn you underwent surgery to repair a femoral hernia which had associated complications. I appreciate this will have been a worrying time for you, and for your family and I sincerely hope you continue to make a good recovery.

The Care Opinion team has shared your experience with NHS Forth Valley, the Scottish Ambulance Service and with staff here at NHS 24. I am sure my colleagues with Forth Valley and the Scottish Ambulance Service will wish to explore your care further.

With some additional detail from you, I would be pleased to arrange for the call which was made to NHS 24 to be reviewed. This would enable us to determine the management of this. Please don't hesitate to contact me on 0141 337 4582 or by email at patientaffairs@nhs24.scot.nhs.uk

Thanks again for sharing your experience, at what, I fully appreciate, will remain a difficult time for you.

With kind regards

Shona

Shona Lawrence

NHS 24 Patient Affairs Manager

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Response from Alan Martin, Patient Experience Manager, Corporate Affairs and Engagement, Scottish Ambulance Service 5 years ago
Alan Martin
Patient Experience Manager, Corporate Affairs and Engagement,
Scottish Ambulance Service
Submitted on 08/11/2018 at 14:51
Published on Care Opinion at 16:54


picture of Alan Martin

Dear concernedoverdelays69,

I was very sorry to read about the problems that you had getting an ambulance when you were unwell. It must have been very distressing to be in so much pain and not be able to get a response.

We do assess calls to make sure that we send the right resource every time we are called, and we do pass some calls to NHS 24 for a more in-depth clinical assessment. They manage any calls that they receive by giving self help advice, by sending a health care practitioner such as a doctor, or by asking us to send an ambulance response.

I really want to understand how the call that your son made was handled when you needed help. If you wish to, please could I ask you to email me at scotamb.feedback@nhs.net.

I do hope that you are recovering well.

Alan

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Response from Patrick Rafferty, Head of Nursing, Ambulatory & Investigations, NHS Forth Valley 5 years ago
Patrick Rafferty
Head of Nursing, Ambulatory & Investigations,
NHS Forth Valley
Submitted on 08/11/2018 at 16:56
Published on Care Opinion at 16:59


Dear Concernedoverdelays69

Thank you for taking the time to get in touch to tell us about your recent experience, it must have been such a distressing and worrying time for you and your family.

On reading your story you have highlighted some concerns that I would really appreciate the opportunity to investigate further, can I ask that you to get in touch with me via our patient relations department on 01324 566523 or alternately you can email me on patrick.rafferty@nhs.net.

You mention in your story that the care from theatre staff and ward B11 couldn’t have been better, I have shared these lovely comments with the teams who were grateful to you for taking the time to pass on such kind and lovely comments, and pass on their very best wishes.

It must have been such a relief to you getting your surgery, I really do hope that you are making a good recovery.

I look forward to hearing from you.

Kindest regards

Patrick

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Response from Chris Rodger, Clinical Director, Surgical Specialties, Surgical Directorate, Forth Valley Royal Hospital 5 years ago
Chris Rodger
Clinical Director, Surgical Specialties, Surgical Directorate,
Forth Valley Royal Hospital
Submitted on 08/11/2018 at 18:14
Published on Care Opinion on 09/11/2018 at 09:31


Dear concernedoverdelays69,

Thank you for taking the time to tell us your recent experience which sounds very distressing. I am sorry you have had to go through all of this and I hope you are now on the road to recovery.

I appreciate you highlighting your concerns about your care in the emergency department and the surgical admissions unit. There are a number of things you raise that concern me and in which I would expect us to do better. I am sorry that your pain was not fully addressed before your surgery and I am sorry to hear that you had to have a bit of your bowel removed. I will look into this further to see how we can improve things and prevent someone having a similar experience.

If you wish to get in contact with our patient relations department on 01324 566523 or contact my secretary on 01324 567973, I would be happy to get back in contact with you to get some more information and talk about your concerns.

I am glad to hear that your experience in theatre and ward B11 after your operation was a positive one and I will pass your feedback onto them.

Once again, thank you for bringing these concerns to our attention and I do hope you are recovering well now.

Regards.

Chris

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