"My child's 28 hours in NHS (for a splinter)"

About: Royal Hospital for Sick Children (Yorkhill) / General medicine

(as a parent/guardian),

I took my 2 year old well son into Hospital and took him home sick, you may wonder what was so seriously wrong that this would be the case and you may be even more surprised to hear that he had a simple wooden splinter.

My journey started at home with a telephone call to our new 111 for advise mainly, it ended 28 hours later.

I was directed to our local Emergency Department, where I waited 3 hours to be told by a Doctor who never even seen my son that he could not attend due to my sons age. Explanation given was that they did not want to distress a child so young by attempting to remove the splinter. A visit to Yorkhill was required. We were advised to fast him of food from 3am and of liquid from 6am and to present at hospital for 8am a good 1 hour from where we live. Given that he has reflux I decided not to wake him for fluids at 6am, knowing that his system cannot process liquid without solids or thickener. I worried that this liquid intake would thus interfere with anaesthetic.

Our journey had begun.

You see what I did not know was that all children are seen at 8am and are prioritised according to surgical complexity. As a result of my sons low surgical complexity he was ultimately left for 18 hours without food and in the end 15 hours without liquid, too minor to demand any nursing attention and so largely ignored on a ward with some very sick kids. By midday and 15 hours without food or liquid I was concerned as my son had become very lethargic and seemed to struggle to focus. The solution; rather than consider surgery due to his contraindication was to offer him unthickened fluid despite my protestations. The guidelines advise that patients can have fluids 2 hours prior to surgery. The result was that my son aspirated during surgery and was returned to the ward poorly, with advise to keep him in overnight for observation and to continue with a fluid only diet. I made the decision to take him home, the hospital in my opinion had done enough.

Only in the NHS can my son be reduced to 'a splinter', where he becomes a mere sum of all his parts. It would seem that 'the system' designed around the needs of the service delivery has lost sight of the patient attached to surgical complexity.

Our NHS is suffering from system failure, where nurses and doctors struggle to balance the relentless demands of the systems, processes and numerous guidelines and at the same time be caring and compassionate towards us, the public. A system where everyone is afraid to think, where free and independent thinkers are not welcome and yet innovation (but not challenge) is expected.

I seek no recriminations as I know that everyone involved in my son's care has the potential now to be a better nurse, doctor, surgeon, anaesthetist. Because the guidelines are just that and individuals are just that and if they share their experience with others as they should, more individuals and less guidelines will be seen and even more people have the potential to be better. We are here to help you be better. Let us.

One question still bugs me - how is it that we can stick sharp needles into babies from 6 weeks old to protect them from everything out there but we think it is more compassionate to starve and withhold liquid from a child for over 15 hours and gas him to remove a splinter?

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Response from Paul Cannon, Head of Administration, Acute Services Division, Greater Glasgow & Clyde NHS

Dear The Splinter

Thank you for taking the time and trouble to provide your feedback. NHS Greater Glasgow and Clyde takes concerns such as these very seriously and in the first instance I would be grateful if you could contact me at paul.cannon@ggc.scot.nhs.uk, providing us with your son's personal details in order that we can investigate these issues further.

Once again thank you for using the Patient Opinion website, it is greatly appreciated.

Kind Regards

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Update posted by The Splinter (a parent/guardian)

I didn't make a complaint as I don't want individuals within your service to be held to account for only doing their job within the system and guidelines that they have. This has the opposite effect to the one I want. This action would put everyone on the defensive and keep everyone hiding their errors. I think there is more to be gained and learned from blame free stories. The system is what I'd like to see challenged. But thank you for your kind offer of a personal contact, I appreciate it and I consider my voice heard.

Response from Paul Cannon, Head of Administration, Acute Services Division, Greater Glasgow & Clyde NHS

Dear The Splinter,

thanks for getting back in touch. I would wish to reassure you that any investigation into concerns such as these are taken forward with the primary focus on learning, rather than apportioning blame or hiding errors. By using patient journeys / experiences like that recounted here we can pinpoint where we need to improve our delivery of service.

We do send these postings to the manager responsible for these services but sometimes it is difficult if we cannot follow a specfic patient, which is why we ask for this detail so we can be sure that we have looked at all aspects of the journey, I do however respect your position not to do so.

Thank you again for sharing your son's experience with us.

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