Waiting for an ITU bed

The national headlines recently have been alarming.

Hundreds of patients have had operations cancelled, many more than previous years as the NHS Crisis continues.

The John Radcliffe Hospital cancelled all non-urgent operations in Jan 2017 and is quoted as one of highest pressured Trusts.

These are just statistics and each data point represents a patient and their personal circumstances. As a NHS, we cancel patients every day and just shift them along a few days or weeks. These are difficult management and clinical decisions but must be taken as the NHS juggles elective and emergency care in the under resourced and under bedded NHS. However these patients are people and the NHS should not be in this position.

We try and ensure that patients with a cancer diagnosis are not cancelled nor patients with special circumstances or who have been cancelled before but the NHS cannot guarantee that this has been 100% delivered this or last year.

I do not have a Cancer, I am not an urgent or an emergency so I could wait if necessary. And I will if needed and I will understand. And the anxiety will increase just like any other patient. At best I will be cancelled one week, at worst…

And there is a huge personal cost to this wait, that is hidden from the NHS deficit. Each patient carries a personal cost, which is relatively small, but added up across the nation, must be huge.

Personally, I have suspended my work and have only just managed to finalise the business cases, delegated tasks and ensured I have handed over both clinical and managerial duties. I have planned a return to work date and the Trust are paying for a locum to cover me. Any delay with the date of surgery pushes that return date back as well as increasing the cost.

My husband has booked a week off work and has planned operations and appointments on his return. If my surgery is delayed, then these patients will either need to be delayed or a plan made for others to cover if possible, often on goodwill but potentially at a cost. He has booked somewhere to stay for a week and has paid up front. This is not available the week after and he will need to rebook and pay a further cost and will lose the money for the first week.

My sons have given notice at University for one week and have booked tickets and accommodation.

My sister has delayed a business trip and has planned to be around me initially and has arranged accommodation with my brother. She has arranged flexible leave with her company and will travel as necessary. My brother is flying in from abroad and is here for two weeks. He cannot rearrange his flight without a cost to him. He has also had to plan his work around his absence for a few weeks. All are using their precious annual leave. They don’t need to come but we lost our father last year and mother many years before that. As orphans, siblings bond even closer together and we have always been a great family unit.

I can be delayed safely and will not publish this until after my surgery as I do not want any special treatment.

I was supposed to phone at midday today but got a phone call at 11am telling me there will be a hospital bed. I am overjoyed as this is the first step. I can be admitted at 4pm and need a further CT scan to ensure that there is no change since my last scan.

I have naseptin, a nasal antiseptic containing chlorhexidine which causes an acute sniffly nose and I am sneezing everywhere! I am worried I might get cancelled by the anaesthetist but she sees me that night and tells me not to worry.

I am seen by the on-call registrar who informs me that there are 6 ITU beds for the morning and although he cannot guarantee a bed, things are looking good.

Lying in bed on the eve of surgery is scary. There is no going back once the operation is done. I will need to work hard to rehabilitate and get my balance and appetite back. I have read all the literature and have kept myself as busy as I can so I don’t think about it. I have washed in the special soap and will stop eating at midnight as well as stop drinking at 6am. I am dreading the surgery but know it needs to go ahead, so have signed the consent form.

I will not know whether there is a bed until tomorrow morning. I don’t know if any of you have seen the television true series called ‘the Hospital’. A gentleman was taken to theatre and was prepared for theatre with the access lines, catheter, monitoring etc and was cancelled at the last minute. My heart went out to him and his family as this is just not fair. I know that even if there is a bed that this could be cancelled at last minute and this fills me with fear.

I will wake up early and have a shower. I will follow all the instructions given to me and behave like a good patient. I have plenty of time now as I have nothing else to do. It is an odd time as the family are not here, I am a patient in a bed with nurses and patients around me. I am an ordinary person, stripped of all identification of who I am, waiting patiently for an ITU bed that will allow my surgeon to go ahead with necessary surgery.

I feel sorry for the staff, surgeons and managers who have no real ability to manage this bed resource as it depends on the acuity of admissions overnight. Is the NHS funded correctly, are we using this resource wisely, is there enough social care funding to allow flow through the hospital, should we separate elective and emergency care? I don’t know but there is a NHS Crisis right now and I am now on the other side seeing it for myself.