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saizine
03-16-2013, 01:48 PM
Hello! It's me again, with more (probably very obvious) questions about hospital stays in the UK! I've been lucky enough to never have been admitted to hospital in my life, despite being thrown from a couple of horses, so I really want to check my facts. These are probably details that most readers wouldn't bat an eyelid at, but I'd prefer to be accurate!

I have a character (mentioned in previous threads) who has been shot. The bullet entered his side and caused hypovolemic shock, internal bleeding and slight organ damage. He is transported to hospital quickly and has been operated on, both to remove the bullet and repair the damage. At this point in the story he has regained concioisness and is learning about his condition.

(1) How long can the hospital be expected to keep him in for observation? I imagine for the type of injury and the fact he's undergone surgery/GA he'd be kept in for at least a night, but how long can I realistically keep him in hospital?

(2) Would he wear a hospital gown for the remainder of his stay? Again, I'd imagine he would, but this question kept niggling at me as I'm writing these scenes and I'd like to be accurate!

(3) What would be the protocol on washing/showering? I imagine that the incision and wound would limit it, but (evidently) I'm not sure.

(4) Would he be kept on IVs for long, and if so, which ones? Painkillers, I imagine, but as my character is perfectly capable of taking pills I'm not sure what method would be likely. Drugs work differently given via the bloodstream, so that's something to keep in mind, I guess. Drains are also a consideration, as well.

(5) This character also happens to be a doctor (GP, though, not trauma/ER). After being discharged, would he be permitted or encouraged to change his bandages/dressing himself or expected to go back in to the doctor's surgery for those sorts of things? He'd have to go back in for a follow up, eventually, too, I'd think.

Thanks in advance for your help! You've all been so lovely and very helpful in the past, and I apologize for being a bit useless about this topic! I've been discovering I have a lot of vague knowledge about it but not much in the way of concrete facts...

mirandashell
03-16-2013, 04:23 PM
I can tell you from experience that a drain is damn uncomfortable. You have to be careful how you move cos it will pull. And you won't be able to have a shower while it is in. And I don't think they do bed baths any more so after 3 days he will start to stink. And yes, he will be in hospital for as long as he has the drain and probably a few days after that for observation.

If he's able to take drugs by mouth, then that is what he'll do. The nurses bring the drugs around 3 times a day, if I remember right, on a trolley with a list of who has to take what.

As for the hospital gown, he'll only wear that while he has the drain as it's easier than trying to get the drain under normal clothes.

As for when you've left, it's not a requirement that you go back to the hospital to get your bandages redone. They can be changed at a GP surgery by the nurse or, if you have problems getting around, the district nurse can come to your house. This happened to me after an appendectomy. As a GP, he could probably do it himself if the wound is somewhere he can reach easily.

Remember that the NHS do try to get people out of hospital as quick as they can but won't usually risk the patient's health too much. Especially after surgery as all kinds of complications can kick in.

waylander
03-16-2013, 10:52 PM
How long do you want to keep him in hospital?
If you want a couple of extra days then have him react badly to the general anaesthetic or pick up a hosptial-acquired infection.

Shakesbear
03-16-2013, 11:51 PM
The police should be informed if some one arrives at a hospital with a gunshot wound. No idea how this would effect your story, just thought I'd share.

saizine
03-17-2013, 12:11 AM
How long do you want to keep him in hospital?
If you want a couple of extra days then have him react badly to the general anaesthetic or pick up a hosptial-acquired infection.

I was hoping for anywhere between three or four days, and it's looking like that's feasible.

mirandashell, as far as the drain goes, is there a general timeline for how long he'd have it in? I assume it'd be for as long as it's needed, but I have no idea about how long that would be. I'll do a little searching.

Thanks for the replies! :)

mirandashell
03-17-2013, 12:26 AM
A drain is usually to take away any fluids that shouldn't be there. So as long as it takes for that to happen. Mine was in for 3 days, I think.

crunchyblanket
03-17-2013, 12:59 AM
And I don't think they do bed baths any more so after 3 days he will start to stink

We still do bed baths. Although most hospitals will allow mobile patients access to a washroom.

saizine
03-17-2013, 05:58 AM
The police should be informed if some one arrives at a hospital with a gunshot wound. No idea how this would effect your story, just thought I'd share.

I've already factored this in to the story, but thanks!


A drain is usually to take away any fluids that shouldn't be there. So as long as it takes for that to happen. Mine was in for 3 days, I think.

That sort of timeline works with what I'd hoped/already planned. Did they keep you in for observation after they'd removed the drain or were you sent home with instructions to call/come back in if there were complications?

I'm thinking 3 days in hospital with drain and 1 without is looking realistic (enough).


We still do bed baths. Although most hospitals will allow mobile patients access to a washroom.

Would post-operative patients with recent incisions be allowed use of the washroom/shower if they're mobile, as long as they take reasonable care? I'd think that since this character is a GP he'd have a general idea of what to do and what not to do, so that would be taken into account.

shaldna
03-17-2013, 01:00 PM
I have a character (mentioned in previous threads) who has been shot. The bullet entered his side and caused hypovolemic shock, internal bleeding and slight organ damage. He is transported to hospital quickly and has been operated on, both to remove the bullet and repair the damage. At this point in the story he has regained concioisness and is learning about his condition.

(1) How long can the hospital be expected to keep him in for observation? I imagine for the type of injury and the fact he's undergone surgery/GA he'd be kept in for at least a night, but how long can I realistically keep him in hospital?

If he's had surgery, especially for a gunshot wound, then he's likely to be in for a while. As he had GA he's going to be in overnight for sure, but when he is actually let out depends on the extent of his injuries, any complications or risk of infection, whether he spent time in ICU or not, what his mobility is like, if he's going to need rehab before he leaves and if there is going to be anyone there to help him when he goes home.

A week at least would be normal, maybe longer if there is some complication etc.


(2) Would he wear a hospital gown for the remainder of his stay? Again, I'd imagine he would, but this question kept niggling at me as I'm writing these scenes and I'd like to be accurate!

Probably not. If he was rushed in as an emergency for surgery then he'd be given a gown until someone brought his own clothes from home.


(3) What would be the protocol on washing/showering? I imagine that the incision and wound would limit it, but (evidently) I'm not sure.

The bathrooms/shower rooms are communual and if he can wash himself he would. However,after surgery he'd have dressings etc that he couldn't get wet, so he wouldn't be allowed a shower. Chances are though that he might not be allowed out of bed, in which case he'd have a catheter put in to deal with the toilet issue, and someone - most likely an orderly - would help him to get a wash.


(4) Would he be kept on IVs for long, and if so, which ones? Painkillers, I imagine, but as my character is perfectly capable of taking pills I'm not sure what method would be likely. Drugs work differently given via the bloodstream, so that's something to keep in mind, I guess. Drains are also a consideration, as well.

It depends. He may be put onto fluids if he's not eating/drinking well, and if he picks up an infection he may be put onto anti-biotics. Additionally he could recieve painkillers via an IV too.


(5) This character also happens to be a doctor (GP, though, not trauma/ER). After being discharged, would he be permitted or encouraged to change his bandages/dressing himself or expected to go back in to the doctor's surgery for those sorts of things? He'd have to go back in for a follow up, eventually, too, I'd think.

crunchyblanket
03-17-2013, 02:17 PM
Would post-operative patients with recent incisions be allowed use of the washroom/shower if they're mobile, as long as they take reasonable care? I'd think that since this character is a GP he'd have a general idea of what to do and what not to do, so that would be taken into account.


He'd be given proper guidelines on wound care/dressing care before being allowed to use any kind of washing facility - general guidelines would be 'don't get the dressing wet'! Depending on the location of the wound, we sometimes advise patients to put a plastic bag over the dressing, or some kind of waterproof covering. If the wound's somewhere difficult to cover (i.e torso or upper body) I'd imagine he'd be limited to a 'pits and bits' type sink-wash rather than a proper shower. The nurses will generally check the dressing afterwards for safety's sake.

crunchyblanket
03-17-2013, 02:19 PM
It depends. He may be put onto fluids if he's not eating/drinking well, and if he picks up an infection he may be put onto anti-biotics. Additionally he could recieve painkillers via an IV too.



IV fluids tend to be given as standard for any post-op patient, at least in the first few hours of recovery. Given that he's suffered hypovolemic shock there'd definitely be IV saline, at the very least. Painkillers are usually only given intravenously if the patient is unable to take them orally, or if a stronger dose is required. I'm not 100% sure on this detail (I've never had a gunshot wound patient in my time at this hospital) but broad-spectrum antibiotics might actually be given due to the nature of the injury.

mirandashell
03-17-2013, 06:39 PM
We still do bed baths. Although most hospitals will allow mobile patients access to a washroom.

Really? I didn't get one. I didn't get a wash for a week. I was so desperate for a shower that the first one felt like heaven.

ebbrown
03-17-2013, 07:36 PM
Hello! It's me again, with more (probably very obvious) questions about hospital stays in the UK! I've been lucky enough to never have been admitted to hospital in my life, despite being thrown from a couple of horses, so I really want to check my facts. These are probably details that most readers wouldn't bat an eyelid at, but I'd prefer to be accurate!

I have a character (mentioned in previous threads) who has been shot. The bullet entered his side and caused hypovolemic shock, internal bleeding and slight organ damage. He is transported to hospital quickly and has been operated on, both to remove the bullet and repair the damage. At this point in the story he has regained concioisness and is learning about his condition.

(1) How long can the hospital be expected to keep him in for observation? I imagine for the type of injury and the fact he's undergone surgery/GA he'd be kept in for at least a night, but how long can I realistically keep him in hospital? Without any further complications, he could be discharged in less than a week. If you need him to stay in longer, he could develop many issues. Most common post-trauma issues would be Sepsis(massive infection); PE(Pulmonary Embolism) a blood clot to the lung-also very common in post-surgical and bedrest patients; or C-diff diarrhea (my least favorite. It stinks, it never stops, and it's all-around messy.)

(2) Would he wear a hospital gown for the remainder of his stay? Again, I'd imagine he would, but this question kept niggling at me as I'm writing these scenes and I'd like to be accurate!Yes, the staff would strongly encourage him to stay in a hospital gown. It provides easier access, it keeps the patient from having personal clothes ruined, and we like to see your butt hanging out.

(3) What would be the protocol on washing/showering? I imagine that the incision and wound would limit it, but (evidently) I'm not sure. While in the hospital, he would likely get bed baths. Once he could stand up, they might let him take a shower, but the wound would need to stay dry. It could have sutures, staples, and any combination of the 2 in addition to steri-strips over top. These would need to stay clean and dry. There may or may not be a bandage over the site.

(4) Would he be kept on IVs for long, and if so, which ones? Painkillers, I imagine, but as my character is perfectly capable of taking pills I'm not sure what method would be likely. Drugs work differently given via the bloodstream, so that's something to keep in mind, I guess. Drains are also a consideration, as well. The patient would need a maintenance fluid, most likely would be something such as D5 1/2 NSS, which is just half normal saline solution with dextrose in it. This is okay for short term use to keep a patient hydrated and give him electrolytes. They will gradually increase his oral diet as tolerated according to his condition. As for medications going through his IV, he would be on several doses of IV antibiotics rotated on a schedule. He may also be put on a PCA (patient controlled analgesia) which is for pain medication. Commonly used narcotics are Morphine and Dilaudid. This pump would have a button the patient could hit when he has pain. They are programmed/locked so he can not overdose on it.

(5) This character also happens to be a doctor (GP, though, not trauma/ER). After being discharged, would he be permitted or encouraged to change his bandages/dressing himself or expected to go back in to the doctor's surgery for those sorts of things? He'd have to go back in for a follow up, eventually, too, I'd think. Yes, he would be given teaching on changing his bandages. He will need to follow up with his surgeon or PCP. Or he might hire a nurse to come to his house to change his bandage for him, they do that sometimes.

Thanks in advance for your help! You've all been so lovely and very helpful in the past, and I apologize for being a bit useless about this topic! I've been discovering I have a lot of vague knowledge about it but not much in the way of concrete facts....

ebbrown
03-17-2013, 07:40 PM
We still do bed baths. Although most hospitals will allow mobile patients access to a washroom.

Of course, if a young man with two working arms says "nurse, where's my sponge bath?", I send in the tech.
His name is Mike. He's 6'2" and veeeerrry pretty. ;)

crunchyblanket
03-18-2013, 12:39 AM
Really? I didn't get one. I didn't get a wash for a week. I was so desperate for a shower that the first one felt like heaven.

Ooh, I sense a strongly-worded letter in the making ;)

mirandashell
03-18-2013, 12:41 AM
LOL! I was feeling too rough to think much about it until about the fourth day when a visitor mentioned I stunk!

debirlfan
03-18-2013, 08:45 AM
I don't know about the UK, but here in the US, they've been known to send patients home with drains still in place. I know someone who went home with drains after having a breast removed - her husband had to tend them.

saizine
03-19-2013, 03:09 AM
Thanks so much for all this wonderfully detailed information! I feel much more confident in these details now. :)