Sunday, October 30, 2011

Headways and Headaches

The good news for today is Derek is finally off of oxygen full-time and is off all antibiotics. 

The antibiotics are the result of the CT scan.  He will be watched clinically and another CT scan taken next week, and if all looks good, he will be cleared of the infections.  Finally

First a question... what is the role of the one-to-one in a patient's room?  To watch the patient.  To make sure that the patient is safe and has his needs met.  Now on to the oxygen....

The oxygen is a wonderful thing, but it was done all wrong and caused my a major migraine.  I hope I passed that migraine on to the ones who committed the negligence! 

A few days ago, we tried to take Derek off of oxygen and he lasted one hour before his sats dropped to the 80's.  During this hour, he wa on the pulsex monitor the entire time and he was closely monitored.  he was also awake.  He was hovering in the mid-90's before he dropped.

This morning, at around 05:30, vitals were taken and the oxygen was in place.  At sometime around 07:00, the oxygen canula was lying beside Derek on the bed.  Nurse brainiac, who has never had him before and did not know his history, instead of looking in the computer where it showed constant oxygen until that point, or instead of asking someone who might know, or I don't know... here's a concept... instead of erring on the side of caution and putting the oxygen canula back on until she could find out... checked his sats, saw they were okay, turned the oxygen off, and left the room.  The order might have said titrate as needed, but without knowing the patient's history, and with the history in the computer being constant oxygen until that point, shouldn't she follow-up and check or at least wait until the patient is awake?  Derek was sound asleep.  I was told by another one-to-one, who I love, that he thinks Derek has sleep apnea.  Makes it worse.

Deep breath.

Let's say what happened a few days ago happened again.  Derek would have desatted without the pulseox (sp?) in place some time around 07:30 or 08:00.  I was told he would have woken up gasping.  Guaranteed?

What was his one-to-one doing when I walked in at 08:00?  Facebook.  Why didn't the one-to-one before see Derek take it off and replace it?  Why didn't the nurse err on the side of caution and put it back on instead of turning it off?  Playing with people's lives.

I was furious.  To say I yelled is an understatement.  It took all day to finally find out what happened and pumpkin butt (she was wearing orange scrubs) brushed it off by saying his sats were fine when she checked them and he was doing fine today off the oxygen.  So not the point. 

Just because it turned out okay does not excuse negligence.

Trial by fire.  Sink or swim.  NOT the safe test that I discussed with Dr. Bograd.  The fact that he was able to do it is a testament to how far he has come.  The fact that he had to do it under these circumstances is a testament to negligence.  And they tell me to trust the staff and go get some rest?  Not.a.Chance.  I only left tonight because I trust this particular night nurse and love his one-to-one.  If it was anyone else, I would be camped out in that chair.

It puts a shadow on the triumph.  I should be celebrating that he is off oxygen, but it happened all wrong and gives me pause about the quality of care from some of the contract nurses.  Is it so hard to err on the side of caution?

But here is to his victories today!  No more full-time oxygen, no more full-time tube feeds (12 hours a day now), and no more antibiotics.  We are closer to the edge of that damn forest!

We are making that climb to glory!  God bless.

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