Monday, September 03, 2012

Changing of the Guard

I now know why you don't want to spend more than a week in the hospital.  Today started a new week and a new team consisting of a new intensivist and a new resident.  This morning, we were the last stop on rounds and by the time they got to Jack's room at 10:30am, I was more than a little stir crazy.

The resident starts giving her report on Jack and states that he is a 13 year old with muscular dystrophy, who is ventilator dependent and who presented with increased secretions

What? Did she really just say my child was admitted to the PICU because he had increased secretions?   After everything Jack has been through the last week in this unit and that's what this team thinks he's in here for?  The intensivist then proceeds to ask why is Jack on regularly scheduled iv pain meds and why is he on the hospital vent instead of his own.  Legitimate questions for a kid with increased secretions, but my kid isn't here for increased secretions!  Apparently, the team that just finished the week in the unit does not give report to the team coming on board. I lost all interest in participating in the discussion because they were so off base and I didn't get the sense that my input was desired at this point.  After they left, all I could think was if they proceed to undo all that the team spent last week doing to make sure Jack is comfortable, I was going to lose it.  Clearly, it is going to be my job to educate the team on where we started, where we are now and what the plan is based on all that transpired last week.  I should just tell them to read my blog entries for the week, it would be a lot easier.

In any event, I had to go into the office today, so Mark stayed with Jack.  I called Mark as I was driving to the office and asked him to please ask to speak with the resident and make sure she gets the accurate story of what is going on with Jack.  He called me later and told me he talked with her, but I'm not convinced we are on the same page yet.  They proceeded to put Jack back on his home vent and switch him from iv to oral pain meds.  It's as if they are preparing for discharge, however, that was not the plan when the team signed off on Sunday.  Furthermore, since they are busy changing everything up, I wish they'd go ahead and stop the continuous feeds as well because I do not want Jack going home on those.  

I think tomorrow will bring more clarity once our urologist is back in the picture. We should know when Jack can get on IRs schedule and, based on that, when surgery will be scheduled.  And, I will be more prepared to actively participate in rounds tomorrow morning, keeping in mind that

is a two way street. 



Susan said...

OMG that cracked me up so I hope that was what you were trying for. Increased secretions. Sometimes I really just can't believe the things that come out of a doctor's mouth. Residents anyway. I think when they review the chart and see they'll be dealing with a trach mom they must start shaking in their boots. But yes, kindness. Two ways. Do some deep breathing Ann. Hang in there!

Eric said...

Since we share the same experiences I just want to say, you're on top of things (keep them on their toes)and thank you so much for keeping updates live. However painful it is to see someone mirror my own experiences in hospital and with my son, we have to be strong advocates for our kids.

Amanda said...

This is laughable. Sad, but laughable. When I took Jacob to the ER last week, the immediate thought from everyone was pneumonia. They became so focused on dx'ing him pneumonia that everything I told them about him was thrown out and ignored. Of course he didn't have pneumonia, but it took 2 more doctors and refusing to give him powerful ABs to be heard. ((HUGS)) Ann. Sometimes you just have to laugh it off, ridiculous as it may be. I hope this week brings a clearer plan and open schedules. Much love.

Sarah said...

Sadly all too true and frustrating. I hate change of guard. I love the TouchStones! I also believe they should have a dual purpose and at times need to be chucked at someone's head to really get the message across. We could rename those skipping stones...for parents...therapeutic release??

Anonymous said...

I would have asked her to leave and come back when she knows what's going on with the patient. Angie

ssouth said...

"I should just tell them to read my blog entries for the week, it would be a lot easier." Lol. Do it! Gotta hate the changing of the guard and that look on a new resident's face that clearly says, "Ah! A challenge! I will be the one to figure this kid out." Stay tuned for my daily dose of love and prayers heading your