I was fairly young at 23 expecting the birth of our first child. It had been a warm summer and my wife had struggled with the heat during our first pregnancy and I was a naive young guy who knew everything was going to be fine!
That day, I was stressed, wanting to get our new kitchen that I was fitting finished. Our 1 year old Labrador had also found a wasps nest and her swollen face confirmed the wasps had not been happy about this. I was busying myself with the kitchen when my wife Sarah said her wrists were sorer today. I noted that she looked…. well …. “bigger” and “puffed up”. As a man, it is impossible to think how to phrase this to your wife even if she is pregnant and indeed dangerous to do so to a pregnant wife on a hot day. I advised that she seemed a wee bit puffy and should go and see the doctor.
By midday after seeing the GP we were in Cresswell watching a monitor which showed that Sarah’s blood pressure was sky high. By 1pm a Registrar advised that an ambulance was coming to take Sarah up to the Queen Mother’s hospital in Glasgow, she was concerned that Sarah may have pre-eclampsia. I wasn’t able to go in the Ambulance and arranged to rendezvous in Edinburgh Road and follow them after I had been home to pack a bag. For the few minutes I waited, I sat in the car wondering what pre-eclampsia was and panicking, why had I not paid more attention at the pre-natal classes?
The Queen Mother’s was an old hospital, a big grey concrete post world war 2 cold looking building and nothing like the warm modern new Cresswell back home. We were placed in a room on the third floor and we were left by the friendly midwife who had travelled with Sarah from Cresswell. I noticed straight away that the Queen Mother’s staff spoke around us, not to us, and after all the rush to get to Glasgow we sat for an hour or so before anyone came back to see us. It’s hard to explain why however we both felt instinctively that we could not ask questions, the staff demeanour seemed to convey “I’m too busy to speak”.
Over the next few hours I watched as Sarah’s blood pressure continually rose, occasionally staff came (and even more occasionally) said a word or two to Sarah, ignored me, recorded observations and went away again. No one was telling us what was happening and we didn’t want to bother them, so it was best to be quiet. In the evening one of the nurses said “you look more oedemic and puffed up” and said we were being moved to another room because “it was nearer to theatre”.
At 10pm, I was getting pretty upset, the whole day had been a shock, someone had mentioned pre-eclampsia before we had came up the road, and now Sarah had something called oedema? To top things off, I was now told I could not stay in the room after 10pm. I was advised by the grumpy nurse, who wasn’t looking forward to the rest of her nightshift, that I could sleep on the chairs in the main waiting area on the ground floor. My wife was very unwell, we didn’t know how this was affecting the baby, I was going to have to leave Sarah and our unborn baby overnight in this state, the staff were aloof and dismissive, we didn’t want to bother them with questions and I now felt more alone than any other point in my life.
As I was about to leave, and putting on a brave face whilst choking back an overwhelming need to cry, another nurse came through to do observations. This nurse asked where I was going and once I explained, she shouted the nurse who told me to leave and asked her to bring in a “zed” bed so that I could stay. Grudgingly and clearly embarrassed Staff Nurse “I hate nightshift” brought this and bedding into the room, making the excuse “I forgot we had these”. The night passed with a routine of the blood pressure alarm sounding, staff coming through to check but telling us nothing and my wife becoming increasingly unwell. Still no answers, still no knowledge, still not able to ask.
In the morning about 7am things changed. A middle grade doctor came to see us, she asked our names and if it was okay to call us by our first names, she acknowledged we were a long way from home and it must be really stressful for us. She could not believe we had no idea what was happening and said the doctors who had seen us on lateshift and nightshift should have explained this all. I said that we had not seen a doctor on the nightshift? It turned out that one of the “nurses” who appeared a couple of times on nightshift was a doctor, the problem was we could not tell as everyone was wearing scrubs.
The middle grade explained that what my wife was experiencing was pre-eclampsia which was the reason she had “puffed up” due to the build up of oedema (fluid) in her body. She explained that there was no known cause of pre-eclampsia but it was thought to be something to do with the placenta, we would need to wait until she had spoken with the Consultant but the baby may need to come early.
The middle grade returned after an hour or so with the Consultant who advised that things were not going to get better, the baby would have to come today by C section.
Around 11am we were being taken to theatre just as our parents arrived, I had been strong up to this point but seeing my parents obviously worried set me off and I realised at that point how worried I actually was.
Theatre was chaos, chaos to me for only one reason, I didn’t know what was going on and there seemed to be a cast of thousands on the other side of the green sheet that had been put up as a curtain. I was scared, Sarah was now incoherent and despite all the people around I was now really on my own, the Anaesthetist appeared not to be aware of my existence despite sitting beside me.
At 11:21, on 27 August 2003, (around the exact time that the Madonna with the Yarnwinder was being stolen in the robbery at Drumlanrig Castle) Abbie was delivered, all 2lb 13oz of her, she was tiny. We saw her for a few seconds and she was taken away to an incubator in the Special Care Baby Unit (SCBU) and we were taken back to the room where Sarah fell into a well earned deep morphine assisted sleep. I was then told I could go down and see Abbie.
The SCBU felt like a different planet in comparison, the midwives were excellent, talkative and re-assuring. They spoke to me constantly and told me everything they were doing, what the tiny cannula’s were for and the tiny nasogastric tube for feeding Abbie. Abbie was in an incubator and I could not cuddle her, all I could do was put a well disinfected hand inside and cup her head and rub the back of her tiny neck. The tiny skinny baby, slightly bigger than my hand was the most beautiful thing I have ever seen
It was a day and a half before my wife could go down to SCBU on a wheelchair, pushed by me, to see Abbie properly. After a week of the Queen Mother’s and its other issues we were transferred back to Cresswell where care and communication were excellent, the staff were amazing and over the next few weeks, until Abbie was considered a “full term baby” and allowed to go home, we were looked after extremely well.
The point of this blog is not just to moan, I am actually trying to reflect on why this happened and why it was such a negative experience. I had to be signed off work after a few weeks of Abbie being back at Cresswell as the stress of the 26th and 27th had caught up with me.
In reflection, I think the problem was that the Queen Mother’s was a big extremely busy maternity hospital and we were just the next couple on the never-ending conveyor belt. Apart from the SCBU, the majority of staff we came into contact with had became transactional and lost the link with each individual’s personal patient experience we were the next package to be sorted out and sent on its way. I think there was also an assumption that we knew what was happening. In honesty, I was expecting someone to come in and tell us what was going on and kept expecting this to happen shortly. I will never now know what the root cause of all of this was.
I have to ask the obvious question, “why the hell did I not do more to ask questions?” Now that I have been with the NHS for over 5 years I realise that doctors, nurses, midwives and all other staff are in the main very approachable. My problem at that time was that I had an old fashioned view that these were extremely busy people who had enough to do without me annoying them by asking questions, which I was worried I should have known the answer to. I didn’t want to compromise our care by doing this. I now realise and strongly believe that I should never have been in a position where questions regarding such a huge life-changing event were necessary?
Values based reflective practice (VBRP) is centred around sharing stories and using VBRP methodology to help individuals share their experience and to allow teams to learn. I wish I had known of this back then.
Peter Bryden is Patient Experience and Safety Facilitator at NHS Dumfries and Galloway