post op treatment

Thank you ladies. I was feeling very down yesterday, but your kind messages really helped.

I agree that the early discharge policy has gone too far. My niece had part of her lung removed with a small tumour and was in hospital three days!! A week after she came home she had to be readmitted with an infection. DH had day case surgery the year before last for an inguinal hernia, which is not considered major, but is invasive. As soon as they considered he was able to get out of bed and use the toilet (even though he nearly passed out on the way back up the ward) I had to drive him home - a journey of nearly an hour - through a city noted for its traffic calming measures and I was almost in tears (and so was he) everytime we had to negotiate them! Getting him out of the car was more difficult than getting him in as every movement was painful, so I have every sympathy with you and your DS, Morgana. I think it is appalling that he is not having his dressings changed at home.

The policy of early discharge seems to be well entrenched now. That policy should go hand in hand with an algorithm that covers post-op care and detailed info to patients and their carers as to how they can get the post-op care they need.

Personally I feel that the "bum does not touch the bed" policy has gone a bit far and should be responsive to individual personal and home circumstances. It is frightening to be in pain and at home and unsure what you can and cannot do safely.

Early discharge makes sense if you see the primary purpose of hospitals to do surgery, but after many operations patients need specialist nursing care and I am not convinced by the hospital infection argument. What about the dangers of home acquired infections?

Hospitals have hard surfaces that can easily be kept clean and staff also have personal routines over handwashing, short sleeves etc aimed at hygiene. At home we have carpets, curtains upholstery, pets, children, long sleeves, knitted garments. Our bathrooms and kitchens have all the clutter of day-to-day living and are not easy to keep at hospital cleansing standards.

The problem is that at the time, you are in shock over the event, even for planned surgery, concerned for the care and welfare of your loved one, bogged down in the minutae of care. It is only weeks, months, later when the crisis is over that you realise just how 'out of sight, out of mind' the hospital discharge was.

M0nica - I do agree. The policy of early discharge makes a lot of sense - more operations can be done, less time to acquire a hospital infection etc. But it only makes sense if the proper care at home arrangements are made as a matter of course, and people are not left scrabbling around trying to find out how and where to get dressings, wound care, pain relief etc.

Complaints about GPS should be addressed to the practice manager, and the district nurses should come out to deal with wound care, what happens if people don't have transport?

I had major spinal surgery and needed the dressing changing after i had returned home. I rang my GP surgery and the receptionist gave me the direct number for the district nurse. It was an answerphone but i soon received a call back and after i explained my circumstances she arranged for an excellent dn to visit. You can only ring and ask

Morgana, my sympathy and understanding. We were in the same position after DD was seriously injured in accident. She had three ops in ten days and was discharged hours after the third op with instructions to report to either GP or hospital on different days for dressings. She had a large wound on her arm and a skin graft, which had to be protected from any harm. Getting her in and out of a car and seat belt was a nightmare. She should have been kept in hospital longer, but they needed the bed!

It was just assumed that we would be available to provide the 24/7 care and nursing she needed for the first fortnight, even though neither of us has any nursing background and were given no instructions. We had to take her back to A&E on one occasion when faced with a care problem we couldn't deal with. DH then spent several hours in the middle of the night driving from pharmacy to pharmacy trying to find one with a stock of the prescription drug which she urgently needed but the hospital wouldn't/couldn't dispense.

I think if hospitals are going to discharge immediately post-operative patients then they should not be able to do this without a proper care package that includes medical supervision of family care

Yes I don't know what he would do otherwise. We had to do battle with the G.P. to get the wound dressings organised! Practice nurse was the problem. And guess who complaints have to be sent to!!

I think everyone has got this right - the GP is the port of call in order to organise a DN. Do the folk at the clinic know he is in pain on the journey?

At least the op is now behind him and that has to be good. I have never heard of bowel surgery as a day case - that sounds amazing!

I have lots of sympathy with him - I had my gall bladder removed many moons ago before keyhole surgery and boy did it hurt. I weighed about 7.5 stone and even just breathing in and out was agony! But there was a moment when the pain quite suddenly started to abate - it was a wonderful moment!

Thank goodness he has you there to support him and drive him.

thank you for your comments. I suspected it was the fault of the G.P practice. They have treated him very badly and he will be finding a new doctor as soon as he is feeling better. He does not have to travel far and I try to avoid all the bumps in the road! But he has had quite major surgery and I suspect that in the old days he would have spent days, or even weeks, in hospital after the op. I appreciate that there is less danger of infection at home, but it is very worrying and painful/stressful for him to make that daily journey to the wound clinic. The actual operation went much better than we feared and the surgeon/staff were brilliant.
I just feel so worried and upset.

Distance should not be the criteria in this case, the fact that your DS has had surgery and is in pain should be enough for the nurse to visit. When I was discharged after my bowel operation the nurse visited the following day and thereafter. Ring the surgery.

Probably depends on where you live. From my experience in London, it's usual for a Community Nurse to do daily dressings. Phone your GP practice.

How far is he having to travel each day?

Asking certainly won't do any harm.
I have said so many times the NHS is wonderful at point of treatment or emergency. It is often the aftercare which seems to suffer.