I know that there are other (many?) horror stories about NHS, but this is my NHS horror story.
Disclaimer: All characters in this story are real, but I will use fake names to preserve their privacy. Except, of course, the name of the hospital, West Middlesex University Hospital.
It all started with a broken collarbone, and a decision to have surgery and insert a metal plate to straighten it. Painful, yes, but not horrific. We humans are weak like that.
I went to the hospital on the 21st of December at 07:30am as requested, with the premise that the surgery would be made, and I would be discharged on the same day. Wishful thinking.
Spoiler: I stayed at the hospital for 4 days.
After waiting for 15 minutes by the door, that was closed, someone came and told everyone waiting (me and 4 others) that the door had been broken for 2 days, so we were at the wrong entrance.
Weird start. And it only got weirder…
We were moved to the correct entrance, and I was checked in, and got tucked into a bed that, unbeknownst to me, would be my home for 4 days. I was told about the risks of the surgery and had to sign a responsibility waiver, which at the time, felt slightly odd. We all know there are risks in a surgery, but the surgeons will do their best not to kill you, right? RIGHT? Hmm.
Because my condition wasn’t life-threatening, A&E surgeries always have priority (I understand that), so my surgery started at 2 pm.
Day 1 — Aftermath
Woke up in Recovery — as expected, dizzy and tired.
Nurse A was there to help me wake up. She was very nice and polite, and immediately started checking my vitals.
I found out that my surgery had taken 2.5 hours. I was told before it should take 90 minutes. But “the surgeon was very thorough” was the answer I got when I asked about the duration. In hindsight, maybe that’s not all that happened.
After a couple of minutes, Nurse A starting increasing my oxygen intake, as my SsO2 (splanchnic oxygen saturation) was low.
And it kept getting lower, even with the maximum amount of oxygen per minute being pumped up my nose — around 14L per minute.
The SsO2 kept lowering, so Nurse A called for help. A mobile Xray cart was called, to quickly take a look at my lungs. More nurses — and now doctors, too — started converging around me.
Right before the Xray cart arrived (took 10 minutes), out of nowhere I started coughing. One of the doctors looked at another, and they didn’t say anything. For me, that was the first sign that something was wrong.
The Xray was quick, and I hear it for the first time: “One lung is 50% collapsed”. My SsO2 was at 81%. Now I know that this number should always be above 95%.
I was taken to a room — the anaesthesia room — and suddenly, I’m surrounded by doctors and nurses. Around 10.
Now I was really worried. And looking at their faces, they were too. It’s the last thing you want to see — doctors looking at you and being worried. I slightly freaked out, and said: “I’m feeling nauseous”. After 5 seconds, I puked some drugs that had been administered to me before the surgery — Fentanyl and something else. Bummer, and I always thought I’d enjoy Fentanyl.
Someone was rushed in to insert a chest tube — a needle attached to a syringe into my chest cavity. A container was attached to the tube, and it stayed with me for the next 96 hours.
I told everyone that seeing them freaking out freaked me out too. Quickly, someone pushed something to my catheter and suddenly I’m calm again. I later found out it was 5g of Midazolam. Good ol’Mid, an old-time acquaintance.
Nurse A was, again, stellar, and let me quickly call my better half to tell her I wouldn’t be going home that day.
I was moved to the Day Surgery Ward (where I spent most of the day waiting for the surgery), and I was told the lung would take 24–48 hours to recover. I started taking liquid Morphine (OraMorph) every 4 hours, and my SsO2 would be monitored every 1–2 hours, even during the night.
Long term oxygen therapy (LTOT) started, and I would inhale posh oxygen for 4 days. Started at 8L, then down to 2L. But it became another reason that confined me to my bed — I couldn’t wander around, as the oxygen was coming from the wall plug. Whenever I was moved, I had to be supplied with an oxygen bottle just for the 5 minutes the trips took.
I then got ready for my first night.
Day 2 — Can someone tell me what’s happening?
I have a light sleep. I am in a hospital. So it was not a surprise that I didn’t sleep much, for 2 reasons: the loud snoring from all my “neighbours”, and my anxiety over what happened.
I googled a lot. “Collapsed lung” and “pneumothorax” were words I had not encountered before, so I tried to do some research.
So… in my case, the collapsed lung happened because my lung was nicked during surgery. Yes, my lung suffered a cut. And THAT was one of the risks that were mentioned on that pre-surgery form I signed.
Ok, I get it, it’s a known risk. But wasn’t detected during surgery? Ew. Now I understand why a surgeon said “but we didn’t see any air coming out” when I was having my tube inserted.
Fine, it happens. But then… it’s not discovered until my SsO2 lowers into the life-threatening territory? Not great.
The surgeon visited me briefly and confirmed the lung takes 24–48 hours to recover. So I should be released tomorrow.
Meanwhile, I’m peeing into a cardboard bottle, because I’m in too much pain to move, AND I have the container attached to the chest tube, and the container is attached to the bed. Way more cumbersome than a urinary catheter. Also, the oxygen therapy — for now, I’m stuck.
Day 3 — I’m still here
I was officially in bed rest.. or bed-cure.
At 10:40 am, Dr. H from the Ortho team (the team that “referred” me to Surgery in the first place) says that the next step would be an Xray to confirm the lung recovery, then I’d be on my merry way.
He wasn’t very verbose. At all. I felt I could be given a better explanation not only to what would happen next, but what happened before.
Half an hour after he showed up, I’m taken to the Xray and I spent the whole day chasing staff asking for when would a doctor look at the results.
Time goes by. 4 pm, 5 pm — still nothing about my Xray. I start asking around, but no one knows anything. The OnCall Ortho Doctor is nowhere to be found. Hey, isn’t he/her “on-call”?
Around 8 pm, I was close to freaking out — I felt good, I knew my SsO2 levels were good from the regular HeartRate scans, so I ask an orderly if I can self-checkout.
In less than 2 minutes, as if by magic, a doctor shows up. But not to help me. Just to tell me why I can’t self-checkout.
As it turns out, the removal of my chest tube is not like removing a catheter or a bandage. It’s considered to be a mini-surgery, so the only team who can do it is the team who inserted it — the Surgery team.
He also told me that he looked at my Xray, and it was ok. Again, no one told me until I created an event that forced staff to tell me. When I asked, no one knew.
At this time, I feel that I’m being given incomplete and erroneous information. I do not want to blame anyone specifically, so I will generalise — NHS was not being honest to me.
When I asked “so, when can my chest tube be removed?” I got a shitty reply back: “Staff has gone home for the night, this can only be done tomorrow”.
So, my chasing and nagging during the day — went nowhere. They just went away and I would have to stay imprisoned (that’s how it started feeling) another night.
More hospital food, more peeing into a bottle.
Again, I’m feeling like everything is not progressing as I was being told.
Also, I was moved to the ITU (Intensive Treatment Unit) Ward — no one told me why. I chose not to question it, but as an unexperienced hospital patient, I would have liked for someone to tell me why, even if there was no reason to. But ITU is frightening close to ICU — am I ok? No one told me.
As of today, I feel they evicted me from that ward because of my self-checkout failed attempt.
Day 4 — I want out
My neighbours’ snoring wasn’t as loud as the day before, but I still didn’t sleep well. It’s now Xmas Eve and my anxiety is at its peak.
I was moved between 3 different wards in 3 days. I guess that free beds are needed in a hospital, right? So why am I waiting for more than a day now for someone to look at an x-ray to send me home?
Every time there’s a handover, information is lost. Delays happen. And I’ve had 3.
My bedsheets and gown were just changed. Amazing, I’ve only had them for 4 days.
Add 2 unexplained nose bleeds to the picture. My sheets and gown were bloody. As far as “white trash” goes, I was it.
Asked around for an update — again, nothing. No feedback.
Called PALS (Patient advice and liaison service) at 12:15. They quickly heard my story and said they will reach out to the ward boss.
Nurses keep saying they are trying to contact Ortho but no answer.
The ward chief comes by — thanks to PALS, I’ve managed to get some traction and word got around — I felt abandoned and imprisoned. She told me she’s trying to know what’s going on.
12:45 — a nurse says ortho will come, unsure when.
13:22 — PALS no longer answers even though they told me I could call back — they went away for Xmas break it seems — PALS never answered again after 12:15. So I just wrote them a long email.
They never replied.
No idea of what is the deadline to have any hope of being released today.
14:37 — Ortho doctor showed up, said that it has been impossible to get an answer from the surgery team.
16:25 — Ortho doctor says that it was, in fact, the Ortho team who inserted the tube! This means that they are the ones who are supposed to remove it.
So these 30 hours chasing the surgery team were a complete waste of time and resources — just a bad assumption.
He then said he would now try to plan the following chain of events:
- tube removal
- X-ray to check lung is still OK
- My discharge
Tube removed by himself at 16:36 (it took 2 minutes), x-Ray to check if everything is ok will happen after 2 hours.
I do understand the 2-hour process, but one thing I know — if the lung would collapse again, I’d be dead in less than 2 hours. So I really do not understand the wait. But ok, I’ve been here for 4 days, I can wait 2 more hours.
After I had the tube and container removed, I had my first bowel movement in 4 days. It never felt so gratifying to “simply” go to the toilet.
Note: at this time I am sure that I spent 30 hours in the hospital waiting for something that could have been done in 10 minutes. NHS owes me 30 hours of my life for bad assumptions, bad processes and general havoc in their methods.
18:30 — I start asking when my X-ray will be done. I’m told “19:00”, and I say “No. You’re wrong. 2 hours have gone by. Do it now”. At this time, I wasn’t sounding too friendly, and they booked it immediately.
Another note: They let me go from ITU to the X-ray by myself. And the hospital is a bit of a maze, I could have just wandered around. I felt like at least 20 processes and safety rules were being broken. But hey, I wanted the X-Ray done, so I just rushed.
20:00 — There was one piece of the puzzle still to figure out — why did the Ortho team think it was the Surgery team who inserted my chest tube and spent 30 hours to find out? I mean, the ~10 people who witnessed it knew about it, but with so many staff shift changes, the truth “was lost”, but.. this should have been written down somewhere, right?
I took a closer look at my patient record, that was always placed by the feet of the bed.
Lo and behold, this is what I found:
There’s a lot of shit happening here:
- Date/time was edited. Someone was more nervous than me.
- Insertion Site — “Inserted”? Really?
- Indication — “In theatre” — insufficient information
- Ward/Dept — BLANK
- Practitioner inserting the cannula — BLANK
- Signature — BLANK
And here we have it — the reason why no one knew who inserted my chest tube and cannula and took 30 hours to find out: lack of documentation.
Seriously, I’m glad they didn’t let me die after almost killing me, but this is just shoddy professionalism.
21:00 On-call Ortho Doctor STILL did not review the x-ray to check me out.
Are you fucking kidding me? Don’t tell me everyone will go home like yesterday and I will have to wait another 30 bloody hours.
I went to reception and asked about my X-ray review.
“Oh, Doctor is busy”
I asked “Please call him, get this done”
The nurse and the Doctor were having a conversation by phone in front of me, so I overheard everything. Apparently, the Doctor told the nurse the checkout release info was in the system. But she didn’t see anything.
Then he said “Oh, I started it, but didn’t finish” — so he was lying 1 minute before.
She then puts him on the loudspeaker and asks “when do you think it will be done?”
And then he says….
“It can take 5 minutes, it can take until midnight”.
“You rude knob”, I thought. The hospital owes me 30 hours, and he’s just trying to assert his dominance of “it’s done when I do it, everyone has to wait for me, I’m calling the shots”. I had been told previously that a “good lung x-Ray” takes 1 minute to look at.
That did it — I asked for the self-checkout forms. My chest tube had been removed, so I knew I could do it. And I did.
This is a clear situation where money just won’t fix enough things that need to be fixed.
It’s like the “Digital Transformation” I keep reading about in the Tech world — you can’t just throw money at things and “transform” them. There is no golden recipe.
Staff was amazing (except for that doctor I mentioned) but the system is broken.
I keep hearing about “underpaid, overworked”, but hey, that’s not my problem to fix — I pay my taxes and I was treated like shit.
Update: New Year, new me... :