Friday, February 6, 2009

The case of the missing blood – A vampire romance??



Have you seen me? I am in a clear container with a blue cap. I was last seen dripping from Elias heel and leaving the room headed to the lab…but where oh where am I?

In case you had not figured out what this is in reference too, they lost a vial of blood for lab testing last evening. It was drawn around  5:30p but we did not hear that it was lost until after midnight. Yet another blunder for this admission. I am starting to think we have a target for idiots on us. All in all though a minor one, but tell that to Elias who had to be stuck three times to get that blood and he just wants to be left alone.

In other events, I have drafted my own letter to the state on behalf of the doctors for an increase in hours. We finally received a copy of the letter sent last week, that got a denial and I understand why. I certainly expected something more profound from medical professionals and case workers. It was  poorly written, lacked substance, and was inaccurate. I feel like it was written in about 10 minutes and rushed. It all goes back to the confirmation of our theory and discharge last week. After talking with the nursing agency trying to get a better feel for what transpired last Friday. She informed me that she was called by the hospital and told that Elias was being discharged on last Friday, that is why she sent the letter in to the state. She also told me that Elias nurses had been contacted and told to report to work beginning Friday night. That was disturbing to hear especially since we were not aware of this until after the fact. It seems that Elias' G/j tube falling out put a wrinkle in the attending that was so fired up about him going home, even if only for three days. When I spoke to the discharge coordinator, which was over the phone and not in person (oddly & convenient maybe) she told a slightly different version. None the less, we discussed the fact that it appeared the doctors conversation seemed to be useless and that the letter did not have enough impact substance. I asked if she was rushed in writing this letter, but she explained that this is the way it always is, last minute. I tried to explain that this was why we were discussing this early in the admission and the inclusion of yourself in the process, but she did not seem to get my point. She informed me that several case managers and physicians read and had input on this letter. Again, as I stated before I expected something much more profound, especially from highly educated professionals. I also need to note to them that while they are being positive because we have "another chance" is to remind them that it was my intervention and my REM case worker’s efforts that gave us the chance for the file to be pending. I think they are forgetting that fact or refuse to acknowledge it, but they nearly jeopardized this entire effort over the push to send him home for a few days. I have started the process to escalate my complaint to the head of Pediatric medicine. If I do not hear something in a reasonable amount of time the next step will be the patient advocate department, and then an attorney. The somber point to all this is it is not like we have other choices for care. This is a university hospital and if we try to go to another hospital they will just send us here. So I have to make sure that our grievances are heard, understood, and managed.

With that said I have taken it upon myself to write a letter for them that I feel portrays our case much stronger, more accurate (in my opinion) and creating a sense of urgency focused on this current situation. I obviously do not know if there are rules to this sort of process in regards to content, length, etc. but I felt obligated for Elias to do this. This is not necessarily what will go out, but it is what I feel the doctors can ethically sign and support. 

Breaking News…. The case of the missing blood was solved today. I found it in his room…here are the crime scene photos:





I was pretty thrown off by this to the point where I wasn’t exactly sure what I should do? After discussing it with Katharine we decided to talk with the attending doctor.  When she came in I told her my issue was about the lost blood work from yesterday. She nodded and apologized, but the I added, “I realize that sometimes things happen, but I don’t think it is common for the father of the child to find the blood 24 hours later.” She was speechless, embarrassed, and visibly upset by this. Not at me , but at the fact it happened. I did not lay into her too bad because she has unfortunately been the one to catch all our other blunder fury, of which she has never been part of the problem, but always a solution. So I was reserved, but displayed my displeasure enough to get the point across. I just can not believe how many mistakes and blunders we have had in this hospital stay, worse yet how many we have caught, not them.

Finally, Elias is still groggy and lethargic. I have only managed to get one smile and he is just not interested in interaction. At one point today he was staring at me across the room after waking up and I walked over to him, but he turned away. So I sat back down and he turned to watch me again…he was just content looking, but wanted nothing more. We understand he just had major surgery, but he usually bounces back quicker than this, plus it is more than 48 hours after the surgery and the anesthesia is still not worn completely out of his system. He is also having difficulty managing his secretion in his mouth, difficulty swallowing them past the Nissen and with the anesthesia effects slowing down his body functions we are finding secretions in his trach after he gets overwhelmed in his mouth. The worry here is aspiration, due to after surgery effects. They are keeping a close eye on him with that, well we are who am I kidding. They have also started his feeds very slowly, he is at 10 ml per hour and they will increase it by 5 ml every 6 hours until he is up to 27 mls. I am having serious doubts for a Monday discharge, but one can still hope.

1 comment:

  1. Good god. And good luck on writing the letter. Remember to use lots of paragraphs. :-) Hope Elias feels better quickly. . .Oh, and I will say that one time Brody had surgery while he had an ear infection, and he was much much much slower to recover. And i think it's adorable that Elias likes looking at you. What a sweetie. . .


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