Vent - thank gosh for nurses, but make sure you have support or advocacy with treatment

GenK

Thankfully resolved, especially with the help of ward nurses, McGrath nurse and social worker. 

Short version, mum had axiallary dissection with partial lumpectomy yesterday, took a long time to get out of recovery and up to ward. Consultant had already said when booking op that she would be in hospital for a few days. This morning, less than 24hrs post-op (and she has other health issues and needed a lot of monitoring and physical assistance last night, lives alone near me and very limited supports especially practically), the z#-%# dr who came in to see her this morning tried to discharge her today. Thankfully I wasn’t present in person or would’ve blasted him, and the nurses flat out said no to the dr. This wasn’t the consultant, whilst I’m not sure what level he was obviously maximum a registrar (interns in my experience are less likely to try this so I suspect junior registrar, though generalisation as some are fabulous). Thank gosh for nurses! I had to stand up to doctors when I was practicing and if they hadn’t been there or hadn’t got through I would’ve gone in and insisted on joint call with consultant who would’ve definitely over-ruled and kept mum in. She’s in and doing as well as can be hoped given her other health issues. Having the advocates to support mum and me as carer has made such a difference, but that definitely caused mum panic and made me furious. What an id#$&t! 

Ok rant over, just in those rare instances, make use of advocates like nursing staff, McGrath, or a relation who is comfortable standing up for you or your loved one. 

Keeping_positive1

I hope your Mum is recovering well.  To my knowledge in the public hospitals (unless it has changed over the last couple of years), they only allow one overnight stay for one breast (either lumpectomy or mastectomy) and two overnight stays for two breasts (either lumpectomy or mastectomy).  I had two overnight stays as I had surgery on both breasts.  Thankfully the nurse pushed for your Mum to stay another night and considering her health conditions is wise.   I believe if there is a good Nurse Unit Manager then they will push for you.  

I first had some treatment including chemo at the Austin Hospital in Melbourne and was never offered any Emla numbing patches, in fact I never was told even to purchase them myself either.  Port access without numbing the area was painful.  When I moved to a smaller public hospital closer to home the Nurse Unit Manager really pushed for the patients and got funding to supply Emla patches for those who had port access for chemo.  One nurse "teared up" when she realised I had never been offered nor knew of the numb patch while having treatment at the previous hospital.  Some NUMs are great and will really push for the patients, yet others are more concerned about staying in good with those higher up the food chain.  

It does make me shudder when I hear these kinds of stories from others, but so glad you can support your Mum.  Did they offer HITH for your Mum?    Take care and thankfully your Mum is home safely now.

Zoffiel

You have to wonder sometimes.
I know young doctors are under an immense amount of pressures and the senior ones can be dictatorial without being prescriptive, so it's really no surprise that shit like this happens. Or could happen if there isn't some sort of cop on the beat who puts a stop to things that even a lay person would see as unreasonable.
Your Mum is lucky to have you watching out for her. Keep up the good work.
Mxx

GenK

Keeping_positive1 depends where you are, we’re in Sydney and there’s so many variables but even when I did my training 15yrs ago it wasn’t set re whether it was day surgery or overnight, and still isn’t now. First op was supposed to be day surgery but anaesthetic response and late list meant overnight which helped me push for ComPacks home help for 6wks to take pressure off me and support mum, and this time they would discharge over the weekend but with the drain and needing assistance with mobilising safely and managing drain she’s in until Monday so we can get community nursing, so will be 5days and it’s one breast/axillary dissection, not double.
The Elma isn’t common in most adult wards, but standard with kids onc, I did my final semester in kids onc (inpatient and a little in day patient and nurse educator taught me as student nurse about accessing ports, as a student nurse I was very lucky in opportunities). They are fabulous, creams/patches and should be the norm, but as with ComPacks and ACAT, not every clinician is aware of them nor offers them (one McGrath nurse said there wasn’t a way to get ComPacks extended for mum but I spoke with Social Worker as I knew for a fact it could be extended and now it has been, so different people and clinicians).
thank you ladies. Mum’s doing as well as can be expected and I have a couple of days respite this weekend so it works all round. It’s intimidating for so many to stand up to Drs, and often interns are highest workload and less confident, residents have egos, and consultants stay in the background and are over-specialised. Of course generalisations, but learning to deal with ward/hospital politics was definitely a learning curve in my training and early nursing, now I deal with exec enough that we’re educating Drs on things so it’s easier for people like me, but it shouldn’t be like that. Anyway, one step or day at a time. Thanks again ladies x