Pneumonia and hospital stay.

[b37d45]

Hiya. I am writing a fic where my main character has pneumonia and could do with some help on a few technicalities. It is set in Oxford,U.K, in the not too distant future. About 30yrs. I'm aware that things could have changed by then but I'd like to get an idea of what it's like now to build on

Comments

[lilacsigil]

It's important for pneumonia patients to be at least semi-seated so he will be propped up at all times, even if he's too weak to sit unaided. Likewise, the staff will try to have him up and walking around ASAP, even if it's just bed to chair and back again; he will also be doing a lot of physio and exercises (mostly coughing!) to help clear his lungs. He will be assessed as to whether he is safe to walk with just a stick, or needs other support - most likely he'll have a frame and then a stick, but be taken on his bed or in a wheelchair to have scans etc. He will not have muscle wastage after 5 days in ICU but he will feel very weak: he should be able to do everything he normally can, but in very short bursts with a lot of effort. Generally people on full ventilation are unconscious, so while that won't be setting off his PTSD, the oxygen mask and then nasal cannula afterwards might.

Wards could have anywhere between 2 and 16 patients (usually 4-6) depending on the set-up. They try to separate by gender but it doesn't always happen. If he's in a very, very large hospital it's possible they could have a specific ward for lung issues, but most likely it will be a ward with all sorts of patients. The other patients will mostly be old people because that's who is in hospital, mostly, but there could be a few younger people too. People in hospitals tend to be a lot sicker these days because the aim is to get you out as soon as possible (both because it's cheaper and because it's better for your recovery) so while there may be some chat and camaraderie, especially if people are there in traction and not seriously ill, generally people are tired and sick and sleep a lot. A few weeks is a long time for a pneumonia stay in an elderly but otherwise healthy person, but he might have a relapse or be slow to get his oxygen stats up, or have trouble getting rid of the infection and keep having a fever.

[b37d45]

Thank you for your reply. That's loads of great information.

I hadn't even considered that he'd have to be sat upright, that's a detail I would have missed? Would he still be propped up at nighttime to sleep as well?

That info on physio is interesting too. I knew he'd have some but I wasn't sure exactly what it would be. He's the kind of person who is very stubborn so he's likely to want to get up and about as soon as he can as well, which at least might make it a bit less of a challenge for the nurses.

I know there wouldn't be muscle wastage but I was unsure about exactly what would constitute "weakness". Am I right in understanding then that he would be able to drink and stuff on his own effort would knacker him?

I think the JR in Oxford does have a chest ward but as far as I could tell it's for long term lung conditions like COPD and cystic fibrosis so I guess he could still be on a regular ward. It will be more interesting if there are a variety of ailments and people there and 4-6 is manageable.

So it's likely that if some people on the ward are nearing the end of their stay or don't feel massively ill, they may strike up a bit of a friendship.

Ohh that is useful info, I was wondering how to get him to be there a little longer, a cycling fever would be good.

Thank you again for your comments, they've been really helpful.

[lilacsigil]

They'll assess how much to prop him up, but yes, he will be at least slightly elevated when asleep. And yes, he should be able to eat and drink by himself, but then have to have a sleep and be incredibly exhausted.

[b37d45]

Thank you. I guess inferring from that, that he is unlikely to stay awake for the whole visiting time as well then.

Edited to add a question if someone sees it.

If he was to have a fever that kept coming back how would that present itself? Would it be a case of he's pretty much the same but the monitors and readings are showing a raised temperature? Or would he be lethargic and confused and such? What I'm getting at I suppose is will they just know he has a temperature from the monitoring equipment, or will he present with symptoms that will cause them to look and find out?

Thanks.

[lilacsigil]

He will be on "obs" (observations by a nurse) every X number of hours. In ICU it would have been very frequent, less so on a general ward. Every 4-6 hours (including in the middle of the night) is common. They will observe his behaviour, take his blood pressure, oxygen saturation and temperature, give any oral medication and note any changes in his status. Whether temperature shows up on the monitors depends what he's hooked up to - some hospitals have constant temperature monitoring, some take it during obs. Either way is common. Of course, if he calls for help or if someone notices he's having symptoms and tells a nurse, they will check much sooner.

[b37d45]

Okay. Thank you. It sounds like it will be reasonable for another patient to realise he's in distress in the night and call for help, or his family to notice while visiting him that something isn't right then.

[sollersuk]

Being propped up to some extent is, literally, vital. Uncomfortable thought from the past in England (not sure about the other countries): in the days before pensions etc, pneumonia used to be called "the old man's friend" because it killed quickly. If the patient took too long to die, the person caring for him would "draw the pillow", take the pillow away so that he lay flat. Death usually followed very soon.

[b37d45]

Well that's grim. Interesting though.

[marycatelli]

Walking around also has the advantage that it's something to do. It was very boring in the hospital.

[b37d45]

That's why I wondered about him talking to people. I figured that someone in sound mind would get bored very quickly.