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Delivery suite, maternity theatres and Argyll Ward

Posted By dottir

"Delivery suite, maternity theatres and Argyll Ward"

About: Derriford Hospital / Maternity care

(as the patient),

This feedback relates to the birth of my daughter some 18 months ago in Derriford Hospital. It has taken me this long to write as I needed time to process everything that happened during a quite traumatic birth and get my thoughts in order! I am hoping that some of my comments will have already been addressed by now but felt it was still important for me to share this. 

I had my first baby at Derriford hospital and want to thank the maternity team on the delivery suite and maternity theatres for their care of me during this time. They were without exception very reassuring and supportive during a birth which went totally off plan beyond my expectations. Particular thanks to Dr Lamb for delivering our baby safely despite some complications and midwife Fiona for being there for me (and staying beyond the end of her shift) in order to make sure baby and I were safe and happy.

There are a few things about my care which I feel could be improved (and I understand Derriford is working on this) - I had absolutely no continuity of care from the midwifery team in the community. Asides from my first couple of pre natal appointments I saw a different midwife or MCA every time I attended an appointment. After I was discharged I needed to attend various children centres around the city (as I was discharged on easter weekend the normal centres were closed) in order to get my baby weighed as she had lost too much weight initially and was put on a feeding plan - after a long labour and quite traumatic birth resulting in me becoming very anaemic I found this, plus having to explain the whole traumatic story to a different midwife each time I attended the clinics, utterly exhausting (physically and mentally) and did not help us to settle in to day to day life with our newborn. It was a huge relief to finally be discharged from the care of the midwifery team in the end. Each individual we saw were very caring and competent but the whole experience was more arduous than it needed to be because of this.

Whilst my care on the delivery suite and maternity theatres was excellent, my husband was abandoned in the maternity theatres recovery area with no one to help him with our new born daughter whilst I was still being seen to in theatres. This was not ideal for him - he would have liked to have done skin to skin with our daughter but had no one to assist him with this. 

I had to stay the night following the birth of our daughter in the delivery suite and then got transferred to Argyll Ward in the morning. I found being on the ward quite stressful, I was extremely weak after the birth due to blood loss but there seemed to be no acknowledgement that I might have required extra help and I was expected to just get on with things. The toilets on the ward not kept in a very clean state. At one point I counted 4 cardboard pans with urine in in one of the bathrooms (obviously from ladies who had been TWOC’d and this needed measuring but these had just been left in there). I was on IV antibiotics and for one dose I had to stop the nurse from giving it as she had not scrubbed the hub of my cannula and was going to just administer the antibiotics with no cleaning. It was also extremely hard for me to care for my baby initially as I had a grey cannula in the back of each hand with extensions attached; I was washing my hands frequently when caring for my baby which made the dressings peel so I had a cannula in each hand flapping around whilst trying to change nappies, get her dressed etc…this sounds like a minor thing but it really affected how well I was able to care for my daughter initially. I did not see why I needed to still have two cannulas in post theatres - also if the cannulas had been in the cubital fossa position instead of the back of the hand this would have made caring for my baby (as well as hand hygiene) a lot easier.

Overall I was happy with my care up until my stay on Argyll ward. I hope that continuity of care for new mothers from the midwifery team is something that has been introduced since my experience as it would have made the whole experience a lot easier. I understand other things have probably taken precedent at the current time due to Covid etc but hope this feedback can be useful.

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Responses

Response from Alison Stanton, Complaints and PALS Manager, University Hospitals Plymouth NHS Trust 4 years ago
Alison Stanton
Complaints and PALS Manager,
University Hospitals Plymouth NHS Trust

Submitted on 23/12/2020 at 16:50
Published on Care Opinion at 16:50

picture of Alison Stanton

Thank you for forwarding your feedback relating to the birth of your daughter 18 months ago at University Hospitals Plymouth NHS Trust. I am so sorry to hear that you had a traumatic birth and do hope that both your daughter and yourself are now well. We are always disappointed to receive feedback such as yours as it means that we have let a patient down in some way. Feedback we receive is viewed as an opportunity to identify areas where we could and should improve our service. I am pleased however to note that you felt reassured and supported during the birth of your daughter despite unexpected complications. I will ensure that the theatre staff and maternity team are informed that you are grateful for their support.

I am so sorry to hear that throughout your pregnancy and after the birth of your baby you did not receive continuity of care and as a result this left you feeling mentally and physically exhausted. It is understandable that you felt like this when having to repeat your experiences to various staff members on several occasions. As you correctly mention within Plymouth Maternity Services we have recently introduced a new model of care which aims to support mothers and their families so that continuity of care can be achieved by a team of 8 midwives. Expectant mothers are cared for by an allocated team of midwives and seen by one of team members throughout their pregnancy, during labour (both within hospital and at home) and after the birth of their baby. However, at weekends and during the bank holiday periods there will be reduced clinics which may result in mothers having to attend another clinic and being seen by a different team midwife. I am glad to hear however that the midwives that you did meet were caring and competent.

You mention that during your time in theatre your husband was left in the recovery room with your daughter without assistance to carry out skin to skin. It is normal practice that a member of staff remains within the recovery area so that support can be offered and encourage skin to skin contact to be carried out by partners if required. I am sorry that on this occasion that this did not take place and have highlighted this to the Central Delivery Suite Ward Manager so that your feedback is shared.

I am disappointed and am sorry to hear that your stay on Argyll Ward was stressful and you felt that support from staff was not provided. All staff members are encouraged to stay within the bays that they are working within so that support can be offered when required. In the event that more staff are required the Co-ordinators on the ward are aware of the escalation process so that further support can be requested. I am also sorry to hear that during your stay the toilets were not in a clean state and that you discovered used bed pans within the toilet area. This is completely unacceptable and staff members will be reminded to ensure that toilets are checked on a regular basis. We regularly review our Trust Ward Cleanliness audits and I am assured that the reports suggest that cleanliness is usually of a high standard. I apologise that during your stay on the ward this did not reflect these audits.

With regards to the care of your cannula I can confirm that there has been an increased focus on training for staff to ensure that all the correct infection control procedures including the importance of cleaning the hub before and after administration of intravenous medication. Indeed there are daily audits that take place to ensure that all cannulas are examined at least every 24hrs and staff are encouraged to remove cannula’s when not in use. As an outcome of your feedback I will reiterate to midwives the importance of ensuring cannulas that are not in use are removed at the earliest opportunity without compromising the safety of the mothers. In the event that the cannula is to remain in place it is normal practice that the cannula and extension is bandaged so that it is protected. I am sorry to hear that this was not carried out in your situation. As for the positioning of the cannula it is usual for the lower arm to be used as opposed to the cubital fossa position due to the size of the cannula being used and maintaining its patency. It is unusual for a large gauge cannula to be used for a prolonged duration. In the event that it is required for a longer period of time we would consider the practicalities for the use of a smaller gauge cannula to be used and reposition in an area that makes it more practical for the mother.

I hope that you are reassured that your feedback has been taken very seriously and have been fully addressed. Once again I hope that you and your daughter are well and thank you for forwarding this valuable feedback.

Kind Regards

Michelle Bull

Argyll and TCW Ward Manager

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