Martha's Rule - are you worried about your child?

Looking after your child while they are in hospital is our priority and listening to you helps us to better understand your child's needs. If you have any worries or concerns, or if you think your child is not improving or getting worse, please tell us.

• If you think something is wrong, speak to one of the nursing team or doctors straight away.
• If you're not sure what the nurses and doctors are doing, ask them and they will explain it to you.
• Asking questions about your child's care is important and helpful. There's no such thing as a silly question.

You can speak to any of the nursing team or doctors you see on the ward, and you can also get support from our LIAISE team. LIAISE provide advice and guidance to families and carers and the team is based in the entrance lobby of Bristol Royal Hospital for Children.

What to do if you are concerned

If your child is on the Paediatric Intensive Care Unit (PICU), the process is different. The PICU nurse in charge will explain what to do.

If you are worried that your child is not improving, or is getting worse, you can talk to the nurse looking after your child, or any nurse available on the ward. They will assess your child and talk through next steps.

To help you describe the changes in your child you are worried about, please read our leaflet: Listening to you - A guide to help you share your concerns about your child

If this doesn't ease your concerns, and you feel your child is still getting worse, ask the nurse in charge to contact the medical team and agree on a time for a review. The doctor will assess your child and work with you to make an action plan, and your child's consultant will be informed.

If at any point you feel your concerns are not being heard, and there is a change in your child, you can contact the Paediatric Critical Care Outreach team by calling 07780 156 043 and leaving a message. You may have heard of this being referred to as Martha's Rule.

When you call, you'll be asked to leave a message. It's important to include:

• Your child's name.
• The ward/department and bed number where your child is.
• A brief description of your worries and concerns.

If you don't feel comfortable calling the team yourself, please ask one of the nurses to do this for you.

Learn more about the escalation process in the video below.

 

Information leaflet and translations:

• English - Listening to you
• Arabic - االستماع إليك
• Polish - Słuchając Państwa
• Romanian - Suntem aici pentru a vă asculta
• Somali - Ku dhegaysanaya
• Urdu - آپ کی بات سن رہے ہیں

 

More about the Paediatric Critical Care Outreach team

The team is a group of highly skilled senior nurses who support the care and assessment of poorly children in lots of areas of the hospital. They are available 24 hours a day, seven days a week, and will start a rapid review if necessary or help to escalate your concerns.

They'll review the information and prioritise the urgency of your call and initiate a rapid review if it is needed. When a rapid review is needed, it alerts a team of doctors and the Critical Care Outreach team to review your child within 15 minutes.

Sometimes the team will be unable to respond to your call immediately, but they will come to see you on the ward as soon as possible.

Paediatric Critical Care Outreach team: 07780 156 043

 

Support for outpatients

As an outpatient at our hospital, whether you're here for a clinic appointment or visiting one of the outpatient areas, you can access a range of healthcare services to meet your needs. Here's who you can reach out to for assistance:

Outpatient nursing staff: The nurse overseeing your outpatient area is available to address immediate questions or concerns.
Clinic doctors: The doctor you're seeing in the clinic can provide advice and guidance during your visit. 
Allied health professionals: Depending on your needs you may also receive support from other teams including physiotherapists, healthcare support workers, dieticians and more.  
Community nurses and midwives: For certain follow-up care our community nurses or midwives may be involved in your treatment plan. 
Family GP or pharmacist: For advice on minor illnesses or questions outside of your visit, they can be a helpful resource.
Consultant's secretary: For questions about ongoing treatment, you can contact your consultant's secretary.
Additional support: If you're unsure who to contact or the level of help you need, call 111 for guidance.
Emergency care: In the event of a serious health emergency please call 999 immediately for urgent assistance.