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It's gonna be a long day.....
Aug. 28th, 2014 01:43 pmAs noted earlier, it was a perfectly horrid night. What I didn't note then, was that the 1:15 AM call was just one factor in the night's lousiness.
I was about to head for home, planning a nice salad for dinner for the two of us, when the call came from the ER. There was an elder who had had an apparent TIA (a stroke that passed without permanent damage) who was in the ER and the ER doc was not successful in talking the family into taking the man home for outpatient follow-up. Instead of heading home at 6:45 I was headed home post admission a few minutes after 9pm. Rather than stop at Safeway for overpriced produce, since my roadside green grocer closed at 7:30, I opted for re-heating two slices of the gluten (GF) pizza I brought home Monday, with 2 slices of the regular for my husband. I walked into the sitting room with a tray at a quarter past 10, only to have him take a bite or three, then beg off claiming a sour stomach. He gave the remainder to the dog, who I swear gave him a high five the moment his plate was set down on the floor. (Yes, the wolf-dog adores both pizza and Chinese, the more garlic the better.) It was later in the night when I found out just how sour his stomach was, when at 3 am I was again awakened by noises from the bathroom, as what little he did eat came back up. Sadly, this happened to him a couple of more times before the night was over.
The ER called at 11 stating a women had come to the ER and was too weak to return home, and I would just have to treat her UTI in the hospital. I reminded the ER Doc she had come not from home but a SNF, one that perfectly capable of administering her antibiotics and waiting on her hand and foot until she regained her strength from both PT and her medications. This did not stop the SNF from calling me at 4 am, to ask if they could change her oral solution antibiotic which they did not have on hand to the oral tablet of the same med which they did have on hand. Now, since the next dose of meds were not due until the morning, I have no idea why they had to call at 4, but it did give the RN in that facility the opportunity to talk with me about another patient to get an antibiotic order for a UTI. Why they didn't call in the evening is beyond me, but so be it. Don't all lab results that arrive during the prior evening have to be dealt with at 4 am? (No this was not the same facility that called me at 1:15.)
The bedroom had become too ungodly warm sometime between 3 and 4 am. There is a woodstove in the room and my husband has the unfortunate habit of over filling the blasted thing. (No sweetheart, sauna is not the Finish word for bedroom!) Even though I proceeded to open the window wide, there was not getting back to sleep as I was already drenched in sweat as were the sheets beneath me. Had I been allowed to sleep, that might not have awakened me, but lying on sweaty, damp sheets is quite uncomfortable for me and there was just no going back to sleep with the room that hot. Worse, the room cooled off, but the sheets did not dry out. Cold wet sheets are even more annoying a sensation to me that hot ones. I would have had a few choice words for my husband for once again trying to bake me out of our bedroom, but he was already feeling horrid, and I already felt bad enough that the multiple phone calls had disturbed his sleep as much as mine. I did finally drift back off to sleep, only to have one of my husband's elderly clients call at 10 minutes to 6. I handed him the phone, sans comment.
I did speak with the Director of Nursing at the SNF from the 1 am call, just to vent about the inappropriateness of the late night call. It hit me as I drove in, if she had been riled by the RN from the swing shift that this tube feeding had to be dealt with, then a) why had swing shift not called to deal with it, or b) if it was communicated at change of shift at 11 pm, than why was there no call by 11:30, right after sign out? If it was so crucial that they felt it had to be dealt with right away rather than waiting for the morning (rather questionable judgement in my book), then why did it take over 2 hours after change of shift to do so. The more I thought about it the angrier I got. The DON had already gotten warned by the RN in question, that she would likely get a call.
We'll see how long I last tonight. Of course, it's Thursday which is my late night in the office. At least I'm not the person on call tonight.
I was about to head for home, planning a nice salad for dinner for the two of us, when the call came from the ER. There was an elder who had had an apparent TIA (a stroke that passed without permanent damage) who was in the ER and the ER doc was not successful in talking the family into taking the man home for outpatient follow-up. Instead of heading home at 6:45 I was headed home post admission a few minutes after 9pm. Rather than stop at Safeway for overpriced produce, since my roadside green grocer closed at 7:30, I opted for re-heating two slices of the gluten (GF) pizza I brought home Monday, with 2 slices of the regular for my husband. I walked into the sitting room with a tray at a quarter past 10, only to have him take a bite or three, then beg off claiming a sour stomach. He gave the remainder to the dog, who I swear gave him a high five the moment his plate was set down on the floor. (Yes, the wolf-dog adores both pizza and Chinese, the more garlic the better.) It was later in the night when I found out just how sour his stomach was, when at 3 am I was again awakened by noises from the bathroom, as what little he did eat came back up. Sadly, this happened to him a couple of more times before the night was over.
The ER called at 11 stating a women had come to the ER and was too weak to return home, and I would just have to treat her UTI in the hospital. I reminded the ER Doc she had come not from home but a SNF, one that perfectly capable of administering her antibiotics and waiting on her hand and foot until she regained her strength from both PT and her medications. This did not stop the SNF from calling me at 4 am, to ask if they could change her oral solution antibiotic which they did not have on hand to the oral tablet of the same med which they did have on hand. Now, since the next dose of meds were not due until the morning, I have no idea why they had to call at 4, but it did give the RN in that facility the opportunity to talk with me about another patient to get an antibiotic order for a UTI. Why they didn't call in the evening is beyond me, but so be it. Don't all lab results that arrive during the prior evening have to be dealt with at 4 am? (No this was not the same facility that called me at 1:15.)
The bedroom had become too ungodly warm sometime between 3 and 4 am. There is a woodstove in the room and my husband has the unfortunate habit of over filling the blasted thing. (No sweetheart, sauna is not the Finish word for bedroom!) Even though I proceeded to open the window wide, there was not getting back to sleep as I was already drenched in sweat as were the sheets beneath me. Had I been allowed to sleep, that might not have awakened me, but lying on sweaty, damp sheets is quite uncomfortable for me and there was just no going back to sleep with the room that hot. Worse, the room cooled off, but the sheets did not dry out. Cold wet sheets are even more annoying a sensation to me that hot ones. I would have had a few choice words for my husband for once again trying to bake me out of our bedroom, but he was already feeling horrid, and I already felt bad enough that the multiple phone calls had disturbed his sleep as much as mine. I did finally drift back off to sleep, only to have one of my husband's elderly clients call at 10 minutes to 6. I handed him the phone, sans comment.
I did speak with the Director of Nursing at the SNF from the 1 am call, just to vent about the inappropriateness of the late night call. It hit me as I drove in, if she had been riled by the RN from the swing shift that this tube feeding had to be dealt with, then a) why had swing shift not called to deal with it, or b) if it was communicated at change of shift at 11 pm, than why was there no call by 11:30, right after sign out? If it was so crucial that they felt it had to be dealt with right away rather than waiting for the morning (rather questionable judgement in my book), then why did it take over 2 hours after change of shift to do so. The more I thought about it the angrier I got. The DON had already gotten warned by the RN in question, that she would likely get a call.
We'll see how long I last tonight. Of course, it's Thursday which is my late night in the office. At least I'm not the person on call tonight.
