Thursday, October 20, 2011

A Calling?

Ever wonder how and why decisions are made about your care in the hospital?  Do you ever find yourself wondering why something was done or changed and no one coming to talk to you about it?
Communication.  The one thing I have been complaining about is communication.

Yesterday morning, an intern came to see Derek.  He asked if Derek was having any problems, and I told him pain the graft site.  He asked me, "Oh?  Where was the skin graft?"  The nurse was standing beside me and simply grabbed my shoulder and shook her head.  She knew what was coming.  I responded, "Where I would be talking to YOU about it and not another team."  This intern was on a specific team.  Limited.  Specialty.  Common sense should have told him if I mentioned it to him, it would have been in his area of study.  He told me he had not yet had a time to review al the notes.  I told him he would do that BEFORE he did his rounds to see the patients.

How is it possible that the doctor doing the rounds does not know the patient's condition?  What good does that do the patient if the patient needs to discuss a problem?

But further, please think about how you would answer and what you would say if you were awakened from a deep sleep and asked several questions.  "Any problems?"  "Any questions?"  "Any pain?"  The only pain right now is you, buddy, so get the heck away from me!

We were wondering why Derek has gotten such deep circles under his eyes.  I found out tonight.  Between 04:00 and 06:00, several doctors are coming in to examine, turn, question, etc.  No wonder when I would see them later they would say I was telling them something different than Derek told them.  "Well, Ma'am, Derek said he was having no problems."  If you woke me at 04:00 from a deep sleep, I would tell you the same thing to get you to let me go back to sleep!  Plus, who is even thinking when they are just awakened?
Sleep hygiene.  Derek is not getting anough REM sleep because of all of the disruptions.

Guess who will be there tomorrow morning at 04:00?  Hook up the IV drip of caffeine.  I'm going to need it.

The intern who I chased away Tuesday morning showed up at 04:00 and peeked into the room.  When he saw I was not there, he gowned up and came in.  At least that's the version that makes me laugh!  I don't know what was really going on in his head, but Derek's one-to-one for the night said he peeked into the room before coming in and it looked like he was looking for someone.

But I seriously wonder how they are getting accurate information by questioning patients from a deep sleep.  I understand that they have surgery and a lot of patients, but surely there are interns and residents on the service who are not in the OR and can come at a decent hour.  It might even help them develop the novel concept of a BEDSIDE MANNER!

Also, I have nothing again learning, but sending a brand new little doctor into a patient's room when he does not understand what is going on with the patient is just wrong.  A doctor should not have to ask the LPN how the J/G tube works.

I've been told by so many nurses that I need to use my legal background, go to nursing school and get into patient advocacy!  But do I really want to go back to school?  It's possible.  I've gotten really passionate in not only arguing for Derek's sake, but in championing causes for all of the guys.

A minor cause is keeping that darn pantry stocked.  I called every day this week, the charge nurses called, but dietary STILL didn't restock with plasticware, cups, bowls and straws.  The juices and milks were getting low, too, but the other things were out!  We have patients lying on their backs and unable to sit up, like Derek, and they really need simple things like bendy straws.  All it takes is dietary bringing them up.
Yesterday, Derek had his dressing change in the PACU and had difficulty breathing afterward.  The doctors stuck around and made sure he came out of the anesthetic okay, but about a half hour later, his O2 dropped to the low 90's and high 80's.  He had to be monitored closely.  The breathing is getting better, but it is still an issue.  When last night's nurse was told by Derek that he wanted to be suctioned and the nurse said he would call respiratory, I flipped.  Why are we going to wait an hour for respiratory when he needs suctioning now?  I asked the nurse why he couldn't do it, and he said he felt more comfortable with respiratory doing it.  First and last time we had that nurse.  But for the one-to-one Derek had last night, I would have stayed the night.  I like Jon.  He jumped up and said he would do it and gave me a hug, instantly calming me down.

Dr. Howard came around and showed us pictures of the flap.  Cool.  Maybe I do have the stomach to be a nurse.  For some things.  For others, I don't know.

Could this be my real calling in life?  They say everything happens for a reason.  Derek doesn't seem overly bothered by what happened to him.  He is accepting of it and really ready to get moving!  He has been looking for videos of guys getting their shorties and getting up and moving on their prosthetics, and he cannot find any.  He said he wants to videotape all of his progresses on the prosthetics and post them on youtube for guys in the future to be able to watch.

Jessica Allen, God bless her, came and talked to Derek at length today about different prosthetics, different guys who she knows and how they did, what the process will probably be for him, etc.  It helped him SO much.

And I love her daughter's idea for a new toy, with Jessica's caveat to donate all proceeds to the Fisher House.  I won't say what that idea is here, because it is hers, and I am not going to leak it but it's really awesome.

Gen. Dempsey's wife, Deanie, came around for a visit today.  Such a nice lady.  Gen. Dempsey is the Chairman of the Joint Chiefs of Staff.  Good to make contacts.

Derek is a terror in his chair!  He was chasing me down the hall, growling at me!  I had to run into someone's office to avoid him!  And he trapped Krystina in the corner and wouldn't let her out!  He is dangerous!

That's all for today.  Since I have to be back in the hospital in five and a half hours, I best get some rest!  These doctors are killing me.  But some are awesome, and I do love Dr. Perdue, Dr. Bograd and Dr. Howard.

Good night!  God bless!

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