Thursday, July 9, 2009

Day 2 - Misadventures in Patient Care Coordination

Today was interesting and challenging on many levels. Whereas the Cleveland Clinic is world famous for its surgeons and surgical outcomes, particularly in matters concerning the heart, it sometimes gets knocked for less than stellar palliative care...cases in point:


Barb was whisked away for a chest x-ray and returned to her room, before I arrived this morning. When I arrived at 10 am, she said that she was not allowed to eat because she had to get a CT scan - they took her at about 10:30 and returned to the room at about 11:45. Still, she had not eaten since dinner the night before...at a time when she was absolutely supposed to eat to gain her strength. When we came back to the room, I immediately asked the nurse for some food for her, citing the obvious need. The nurse said "Oh, the lunch tray will be coming any minute now, I'll bring you some applesauce", in a sort of tone that doubted my word about Barb's need for nourishment. Sometime inbetween all of the tests, her catheter was removed and she was "free to go". She just had to get to the bathroom - which means standing and walking. She did!! At this point, since I still had John with me from the night before, and reasonably convinced that Barb would be fed, I took John home.


While I was at home, I got a teary call from Barb at around 3 pm that she just returned from the worst echo-cardiogram session ever. Worse yet, she still had not eaten!! Barb proceeds to describe the echo: The technician, who apparently thought that she looked much younger than she is, made a very strong point of telling Barb that she could not help her up onto the table, or off of the table, nor to maneuver on the table, because of her bad back. "you know, I may not look like I'm nearly 50, but I've been doing this 20 years", she said. According to Barb, she was deluded. Then, t0 make matters worse, this technician kind of "eeewwed" at Barb's various surgical scars (which frankly are not bad at all)...clearly this woman is not cut out to deal with post-operative patients.


At this point, I was boiling mad - vowing to drill all sorts of holes in all sorts of people...etc., but Barb convinced me to calm down (for now). Her lunch tray arrived around 3:30, 1/2 of a turkey sandwich got eaten - all of this really leaving me to wonder who is responsible for coordinating patient care?? Still a question in my mind.


I got back to the hospital around 5 pm, just in time to see the dinner tray arrive - go figure. Beef stew. Naturally, she wasn't hungry yet - so when I went for my dinner around 7, I picked up some soup and her favorite greek strained yogurt with honey for her, from the cafeteria. She ate some of it. Enough to say she ate. Then, she declared that she wanted to take a walk. The nurse checked her blood pressure, gave the OK and suggested that she use the IV pole for additional support.
Barb walking in the hallway!!

She walked about 20 feet in either direction of her room and, exhausted, went back to bed! Her pain is in pretty decent control in the 4-6 (out of 10) range mostly. Wow, what a day! While I don't think Barb will be running a marathon tomorrow, I'm reasonably sure that she'll be able to sustain more strenuous activity. - Gil

2 comments:

Roseann L. said...

grrr...my Italian temper is boiling just reading this latest update, Gil. Now I'll be praying for patience for all of you...until such a time of course, that patience isn't getting the job done and heads may need to roll!!! :)

Julie said...

Barb, Woohoo!! I am so thrilled you are doing so well! Keep it up!

Gil, I would ask who is in charge of patient care for your floor. Then schedule a time to go and sit down and have a heart to heart with them (no pun intended) there is NO reason Barb should be on a testing schedule that does not allow her to eat after surgery, unless they are giving her fluids/nutrition through her IV which it sounds like she isn't.

Hugs to both of you for your patience and I hope that the coming days are better.

Love you!
Julie