"Post Operation Care and Advice"

About: Hairmyres Hospital / Ear, Nose & Throat

(as the patient),

I recently had a nasal polypectomy at Hairmyres Hospital Day Surgery Unit. While I am delighted with the success of the operation, I was disappointed with the lack of information given to me regarding my post-op care. Verbal instructions were minimal, or perhaps not properly understood due to me still not being fully alert after a general anaesthetic. The written/printed instructions for the use of the medications supplied were unclear, resulting in me having to call NHS24 the following day. The advice given (by a pharmacist) was non-specific and I could have drawn the same conclusions myself.

I also got the impression that the some of the staff in the recovery area were maybe not aware of why I was there and/or had insufficient knowledge of the potential risks/side-effects of a nasal polypectomy. From the minute I came to I felt dizzy and slightly nauseous. Having a history of vomiting after surgery I initially refused the sandwich offered for fear of being sick. When my condition did not improve it was decided that I should try and sleep it off. When I awoke for the second time I was again offered food and drink. This time I agreed to try some biscuits but the nurse brought only water. I waited for her to return with the biscuits but she never did. Later, after 2 or 3 cups of water I still felt lightheaded. A nurse said, quite sharply in my opinion, that I felt that way because I hadn’t eaten anything. Well, I hadn’t eaten anything because I hadn’t been given anything to eat! I believe that nurse had assumed I had, like the other patients beside me, had only sedation, not a full anaesthetic.

Despite eating regular meals at home, I was dizzy for a further 10 days. My GP diagnosed labyrinthitis – which I understand can be caused by blocked tubes or as a result of a trauma. In other words the dizziness was most likely a direct result of the surgery. I believe this type of operation is performed at Hairmyres Hospital on a weekly basis so it is incredible that the recovery room staff did not know to look out for post-op symptoms like mine.

I was given very few details of what to expect after the operation so I don’t know if what I am experiencing is normal, or how long I should wait before consulting my GP again. I consider myself to be fairly intelligent. If I am confused about what actions and medications I should be taking what chance do more vulnerable patients have? I think every patient should be given full written discharge instructions – specific to their operation or procedure – including care, medications, what to expect, when to seek help or further advice (beyond the first 24/48 hours) and from whom (eg consultant or GP).

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Responses

Response from David Hume, Director of Hospital Services, Hairmyres Hospital, NHS Lanarkshire

picture of David Hume

Dear Polly Pectomy,

Many thanks for this and I am pleased that the procedure itself seems to have gone well, but I can see that we need to do more regarding the communication with patients following this, or similar, procedures.

I think the need for more written guidance is clear from what you have said and I will take this up with the day surgery unit staff and management team.

I hope you continue to recover well.

Best wishes

David

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Update posted by Polly Pectomy (the patient)

Dear David,

Many thanks for your prompt response and for your proposed actions.

I should also have said previously that at one point I thought the surgery would not go ahead because on the day of the operation Hairmyres did not have the results of my pre-op assessment which had been carried out at Monklands 3 weeks earlier. The pre-op assessment time had been given as a favour to me because I had a dermatology appointment at Monklands the same day, and I was very grateful, but it was disappointing that the results had not been received by Hairmyres, either on paper or electronically, 3 weeks later.

Since I first posted my story I have also discovered another problem with communication. As I said previously, the instructions given to me regarding the medications – both verbally and written – were unclear and inadequate. On a visit to my GP yesterday it became apparent that the instructions on the discharge form I had to give to the GP differed from those on a letter subsequently received by her from the hospital. As a result for the past two weeks I have been taking two lots of medication when I should have been taking only one. Hopefully this will not have done me any harm.

In fairness I should also have said that most of the staff at the hospital were very pleasant and efficient.

I look forwarded to your further response.

Yours sincerely,

Polly

Response from Susan Friel, Chief of Nursing Services, Hairmyres Hospital, NHS Lanarkshire

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Dear Polly Pectomy

Thanks for your feedback re our response. I am replying as David is now on leave.Firstly I just wanted to assure you that we take patients experiences - good or bad, very seriously.

The team have now discussed the issues you faced re the post operative information you received, with one of our senior ENT consultants - He has agreed to review the current information we use and ensure that this is improved across NHS Lanarkshire. I'm sorry that this information was less than helpful to you at the time. We have also shared your comments about your post operative experience with the Recovery Room staff so that they understand the impact that this had.

With regards to your follow up comments; I'm so sorry that there was a mix up with your pre-assessment information. This should not have happened, and I have asked that this is highlighted to all preassessment staff to enure that this does not happen to someone else.

With regards to your comments about your discharge information; I would be happy to review what happened if you would like, however I would need you to give us a little more detail. If this would be something that you want, please get in touch with our patient Affairs Manager on 01355 585 325.

Many Thanks

Susan Friel

Chief Nurse

Hairmyres Hospital

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Response from Susan Friel, Chief of Nursing Services, Hairmyres Hospital, NHS Lanarkshire

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Dear Polly Pectomy

Thank you in touch with my colleague, Michelle (our Patients Affairs Manager), as this will allow us to ensure that we pick up the specific issues you experienced. We can then try to make sure that we can prevent anyone else having the same problems.

I appreciate you taking the time to share your story and experience with us. I am keen that we provide the best service that we can, so we need to know what we get right and what we need to fix.

I hope your recovery continues to go well.

Many Thanks

Susan Friel

Chief Nurse

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