Showing posts with label quality. Show all posts
Showing posts with label quality. Show all posts

5.11.10

Standard Of Care Defined

Wireless and Ready

‘Can I tape this conversation?’ I asked.  Dr K was in at 8 am sharp.  He smiled and replied ‘what do you want me to say?’  ‘Well, it’s ok to say what you have to say, it’s just my Wife will kill me and this way she can be part of the meeting as well.’
So I hit the red button on the little recorder.  Our previous experience with my hospital stays included difficulty getting Vanessa in on the conversations with the key players.  It’s Monday morning at 6AM and I am digging the recorder out of my man bag (it’s not a purse) and making it accessible.  The nurse just came in and told me the urologists were running behind because they were entering their own medical orders.  I doubted that Dr. K or his resident would keep me in waiting until some late morning visit.  I just knew they would be in before Van.  Kudo’s to me on packing for this stay. 
‘Want to go home?’ Dr. K asked.  ‘I’m ready’ I replied.  After he left I hit the stop button and set it on the tray, grinning with the self satisfaction that can only come after decades of marriage that I did something really right for Vanessa.  In the quiet I hit the button and started to doze, only to wild click.  ‘This is Bea, may I help you?’  The question came in stereo from both sides of the bed and the hand held device that I could not find but obviously once again butt calling the nurse.  ‘Sorry Bea, wild click'  ‘OK’ she said cheerily. I must have wild clicked ten times a day.  Every time a patient and understanding reply.  I thought about my last few days, which in spite of my difficulty moving went by pretty fast.  Vanessa ever at my side and Jocelyn each day boosting our spirits and providing her Mother the kind of support only a loving Daughter can deliver.  My Surgeon or his Resident or both every morning, a check in from the chief nurse in charge on nursing care, housekeeping twice a day, ten to twenty IV alarms a day and visiting with my Nurse or her helper (PCA which I believe is Patient Care Assistant) plus the wonder of student nurses and frequent walks around the halls a veritable hiccup engine.  I shall always remember walking with Vanessa and the beautiful and graceful K (who was a masseuse and is now only a couple of semesters from becoming a great nurse according to another nurse that always volunteers more information than I really need.  Must be my inviting face is the only thing I can figure).  Students working very hard, strict protocols, nurse assistants and students walking 7 or 8 miles each shift, Nurses often called upon to change beds with workstations all about are hovered over their monitors if not their patients.   
Through it all an epidural in place and a happy button made it easy for me to greet every visitor with a smile and thank every visitor when they left.  Patient responsibilities begin with thankfulness and civility, period. 
I might be sick and helpless, but I have a responsibility to those who are caring for me to make their job as easy as possible.  The standard of care given me throughout my association with IU and Clarian has been nothing less than excellent.  My stay this time was marked by delays as new software was implemented.  No more post it notes or notes buried in charts.  Request for treatment and order for same will be digital.  Like any thing computer, the best way to learn it is to do it, which is like stepping of a cliff for a lot of people. 
With the hiccups throughout my stay except for sleep and brief periods during the day and of course the pain management I got to laugh a lot, they did not hurt but certainly made conversations challenging, and I am a talker.  When they started Dr. K dryly advised that the gas had to come out the other end before I would eat and I just laughed.  Wrong end, but it was a start.  I learned a lot about those who cared for me, their families, our shared interests, their work and life.  I shared freely with them as well.  We were all a smoothly operating team aimed at me firing out the door never to be seen again if the goal is met.  Smiling is an infectious thing and is easier than a frown, I checked it on snopes after Vanessa and I disagreed on the topic, she of course was right, so I tried to start it from wake up to the end of the day, another reason to just say yes to the epidural.  In the beginning Dr. E smiled and said it is part of the process as he explained the steps and order in which they will be taken.  He scrawled it out on a piece of scrap paper and gave it to me with a caring and sad look in his eyes.  The outcome is what it is and so we go on to the next step.  In spite of the long odds I got the chance to try for the cure and my caregivers put concern for me and my quality of life first every step of the way.  And that was how it was on this step in the process.

5.8.10

Spooked and Panicky - Run To The Emergency Room

May 1 2010
4 litres a day
Rex and I meet daily on Skype. We were visiting web sites on the thoracic duct and learned that 4 litres of fluid is moved by this system in the body I know only by name. Astoundingly, it does so without a pump, relying on muscle movement and gravity to get the job done. Clearly in my seating arrangements I will have to redefine elevated, having seen drawings I can finally understand. Clarian gives me pages of explanation, but for me health care is a new language. With each passing week I am learning more and give myself a strong B grade so far.
At present I am too tired to stand on pride when it comes to suffering. Consequently I went along with rushing to the hospital at the first sign of anything. Vance would say this was a huge waste of money and resources (Vance being the fellow who gets teeth filled with no pain killer, 'after all' he says, 'if they hit a nerve the stuff won't work anyway, so why use it?' No such cavalier crap for me at this point.
Suffering a rash and perceived shortness of breath Van drove me to the north hospital. I directed her to the wrong entrance, got out and pressed the talk box button on the wall. As someone answered a nurse who was passing by opened the door. ‘May I help you?’ She asked with a gentle expression, ‘I am patient Michael Courtney, birth date ………. I was instructed by the oncologist on call to report here for possible allergic reaction to antibiotic.’ was my reply. I stopped for the prerequisite pee function and as I came out the attractive nurse smiled holding an inviting wheel chair. To exam room one, an IV set, two nurses attending one manned the workstation and proceeded to find me in the system and the prerequisite questions. Blood was drawn and finally admitting came in. Vanessa of course now has a go kit that includes everything needed. ER got a complete update whish should help on second visits.
I got an x ray and vitals run and blood numbers run and hustled out the door with a scrip for super itch cream. Once again, the standard of care evidenced in another department of this institution. I wonder at how organizations of such size can function at such a high level. I remember as a kid nights in the Pizza King when only the high schoolers were there without adult supervision and under the pressure of heavy traffic we were a well oiled machine that could produce at record amounts, with a smile, keep up with the dining room, sell up to Customers and feel up at the end of the day. Only problem was as kids we could not do this consistently, night after night. After all, we had other interests.
Here from the late teens and early twenties to likely octogenarians and beyond work ‘in the zone’ every day. And that is a hell of a lot more demanding, just in numbers of clients than anything I and probably most people face in their careers.
My first extended hospital stay over and the bill came in at a little over 16 grand paid.