when the left hand doesn't know ...

what the right hand is doing ......

My mother is STILL in the hospital.

For the last couple weeks we've been playing a game of "hurry up and wait" that alternates between her coming home the following day, and her coming home sometime in 2010. Firstly, it took her about 2 weeks to convince the doctors to go ahead and order that her trache be taken out. Finally, they got on board with that idea, and a new trache (a smaller one) was ordered. The plan was, to change to the smaller one so that they could plug it and see if she could "breathe around it". Well, some genius, ordered it to be shipped by regular mail, rather than overnight, so that was another full week of waiting around (not that any one was upfront about that - it was always, "it should be here tomorrow".

It finally arrived last Friday morning, and we were told it would be changed that day. Initially, the story was that it had to be plugged for 48 hrs. before they would take it out and send her home (with a piece of gauze over the gaping hole in her neck). Then, 24 hrs. became sufficient. By the time it was eventually changed (at 5.30pm on Tuesday) the story was that they would plug it at 7.30 that evening, and if she did alright, they would take it out at noon the following day and send her home. She called us later that evening (fortunately for everyone, her voice came back as soon as they changed the trache) to let us know that it had not been plugged.

According to the respiratory therapy techs, there was nothing on my mom's chart about plugging anything, so they did nothing. The following morning she asked again, still everyone seemed oblivious. Plug? What plug? Why would we plug it? Eventually, someone took 5 minutes to rifle through her chart and found that it had been written down, but that it was written in the "progress notes", and not actually written as an order. Until it was written as an order, they said they refused to do anything. About an hour later, they changed their mind and decided that it was ok for her to try the plug (despite the fact that no one had gotten a hold of a doctor). So, she wore the plug for about 4 hours yesterday.

Then, one of the RT's came in to do a treatment and told her they thought the plan was for her to be changed from the size 8 that she had previously, to a size 6, which she has now, and then go down to a 4, and then just pull it out - no plugging involved. What? Where did that come from? And how LONG is that going to take? UGH!

Meanwhile, Medicare was only ever going to cover a stay of up to 20 days in the TCC (Transitional-Care-something-or-other: a fancy name for the Nursing Home wing of St Jude's), my mom is far beyond that at this point. She's been in the hospital since March 16th, but I think her stint in TCC started about a month or a month and a half ago. So, as she was being taken downstairs for an ultrasound yesterday, she spotted a note stuck on the outside of her chart. it was written by the hospital Social Worker, addressed to any/all of my mother's doctors. Saying that, "there was no longer a medical reason for her to stay in the hospital", that "someone needed to tell her to go home", and that she was obviously "avoiding going home".

Excuse me?

That annoyed my mother to no end, so when her doctor came in later that day, it was the first thing she mentioned to him. He laughed, and said not to worry, nobody would listen to that note anyway (considering the source), everyone knows it's just that the coverage has ended, so they want to shove my mom out the door ASAP. Then he said, "What I'd like to know is, how are they going to justify an entire week's worth of a hospital stay just because they were too cheap to spring for overnight delivery?" That made her feel a bit better, but she still hates the Social Worker.

The bottom line is - my mom can't come home until they either successfully pull her trache, or until we are trained in how to clean/care for it - which is something they've never bothered to do, mostly, I think, because hardly anyone there ever bothers to clean it. It's supposed to be suctioned ever 4 hours or so, and the inner cannula is supposed to be completely changed every 24 hrs. They suction her about every 12 hrs., and the inner cannula has sometimes been left in place for 3 or 4 days. The RT's say that the nurses are supposed to be doing it, the nurses say only the RT's can do it (which a blatant lie - my mother was a nurse for over 20 years, and suctioning trache's is part of what the nurses can do). And basically, nobody wants to do anything.

BTW, I hate people!

So, anyway, that's the situation with my mom - basically, I'm coasting along in limbo, not having any real idea of when she'll be home. Could be next week, could be they will call in the next minute (as they have done on other occasions) and announce the ambulance is going to bring her home - she'll be here in an hour. One of my mom's friend once rented a condo to a couple who had been living together for years, but never married. The man was relatively ill, and in the hospital frequently. One day (no doubt, his insurance ran out), they decided it was time for him to go home, so they loaded him up in the ambulance and drove him home, without even so much as calling first. The man's companion/girlfriend/common law wife/whatever label you're happiest with, refused to answer the door, at first. She wasn't ready for him to come home yet - none of the medical equipment he needed had arrived yet, or something like that. But they kept banging, and banging on the door. Finally, she did the only thing she could think of - she went outside and said, "Get out of here, I'm no relation to this man. You need to track down his son, leave me alone." Then she went back in the house and the ambulance took him back to the hospital. And don't even get me started on the fact that hospitals up in LA take seriously ill, often non-ambulatory patients, whose insurance (if they ever had any) has run out, and dump them off (via taxi or ambulance) on Skid Row to fend for themselves.

But enough moaning about the American medical system (for now, anyway - I'll have more later, I'm sure). Yesterday was my dad's birthday, at 55 he's now officially entitled to that all important 'Senior Discount'. He's been getting it anyway for the last several years (on the merit of his Kris Kringle beard, no doubt). I teased him that for his b-day dinner we had to go to Denny's and get the Early Bird Special. But we didn't, thankfully! We went over to see my mom, as usual, and then stopped off at the store on the way home to buy him a birthday cake and the ingredients for the dinner of his dreams (at least at that moment), thick juicy steaks, mashed potatoes, and cauliflower with melted cheese on it.

1 comment:

CyberCelt said...

Sorry about your mom. I hope everything turns out okay.

Just a reminder about the Carnival of Blogging Chicks at Texas RV Travel blog

The topic is: What are your plans for summer?

You can share vacation ideas, great ideas for keeping the children busy during summer, plans for home improvements projects, you name it. Email to cybercelt at cooladz dot com.

Deadline is noon Sunday, but I am flexible.

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