Tobias Rent update. I awoke at 230 and saw Toby looking at me, his hands rising into the air as far as his restraints would let them. His eyes acknowledged me and I went to hold his hand. The nurse came in and turned on more lights and said she wanted to bathe him. As I removed the compression devices from his legs, he felt super hot and upon taking his temp it was 101.6. I mentioned it to her when she returned, but she has not had him before and felt that bathing him would lower it. Apparently protocols call for actions of blood cultures and CXR after 102.3. Main complaint is the chest tube insertion site and secondary is his breathing tube.... After giving him some Ativan for agitation, She proceeded with his bath and I took the opportunity to get clean clothes out of the car. The hospitalist who has been here the week was in the hallway and I asked him about the fever, emphasizing that the pulmonologist had mentioned if Toby spiked a temp that they would do blood cultures as he had been concerned about the central line which remains in place. He said he would look at the trends and let me know. The nurses finished up his bath, repositioned him and dealt with hanging a new bag of sedation. RT came in and suctioned him and just now the nurse came back and lo and behold,she has tylenol and is going to draw2 sets of blood cultures... fantastic! Lots of praise to the nurses and staff for their hard work in dealing with a complicated patient and helicopter mother. :-) vital signs (v/s) are better, heart rate down, O2 level is 98%, he continues on 40% per vent, 14 resp, 500 volume. daily labs being drawn as well and soon his daily chest xray. Patients in the hospital need an advocate, they need someone who knows them to let the staff know when something is different. The best situation is to have continuity in care with the same nurses each day, each night. For whatever reason, that doesnt happen. Ive seen nurses from the previous day/night shifts in the hallways and upon questioning, they are quick to support their current shift assignments (always good to toe the company line.) You know your family member. The nursing staff has only seen a snapshot of that shift, of that day, of that week... you know what has happened since admission. I knew that Toby hadnt had a fever that high since 10/3. While the staff could certainly have gone and looked it up, they are busy with other patients. There is a mouthcare system the nurses use. Very thorough, the kits are to be used every two hours on ventilated patients... EVERY TWO HOURS??? who has time for that? in theory it is great, in reality, not so much. These nurses are busy, 2 or 3 patients who are complicated, multiple meds, multiple procedures, I am thrilled if they can give mouth care every shift. This isnt a tv show, it is real life and they have a lot of responsibility. OK, Marie M Mulling just texted, she was a rover at a youth rally at the church and just got home, so Im going to get on the phone and chat with her..... sweet dreams everyone.
Posted on: Sat, 11 Oct 2014 08:58:22 +0000