The Wicked Night, Part 2…

I’d mentioned a few days ago that I’d had a rough time at the local emergency ward. In hindsight another lesson for me in learning how to do better in asking for help.

Let me first say that I’m well aware of the fact that hospitals are understaffed. Many team members have to cut corners in order to get to all the patients. Fewer checks on the patient, hygiene and health safety protocols are compromised, information isn’t passed along or documented appropriately. Charts not reviewed thoroughly (I have serious drug allergies, if I wouldn’t have been somewhat on the ball Wednesday night things could have been even worse!)

Let me also add that it was my decision not to ask Suzanna or a friend to meet me at the hospital in the middle of the night. Many  have offered to come if I need them, my wish to allow the people I care about to get a good night of sleep won over.

I was admitted with severe dehydration, brought on by ongoing renal issues. I know my body well enough by this time to know exactly what I need. Rehydration (by this time I was well beyond doing this orally) and anti-emetics to get the nausea under control. I take some responsibility, my anti-emetics have an uncomfortable side effect and I held off too long with taking them at home hoping that’d I’d rally. A simple equation (and not to get graphic); output of liquids greatly exceeding input equals trouble.

The IV drip had been started by one of the paramedics while still at home, at the hospital a nurse moved the saline bag to a stand well above my head.

I was placed in a room by myself with a heavy door, no monitors, no call button. Too weak to get up in the first place, and not long enough an IV tube to get the door open myself anyway, I resorted to calling out for help when I realized that over the course of a few hours that the level on the saline bag was not dropping at all. I just wasn’t feeling that all too familiar coolness of the saline solution flowing into my vein. On top of that, my blood was flowing up in to the tube.

When a nurse finally arrived, he dismissed my concerns – telling me that because of my cardiac issues they had me on a very slow drip. 

An hour later I again called for help, shouting into the hallways at 3 a.m. as much as my weakened voice would allow, insisting that things were not okay. If I thought that I was dehydrated earlier, I  knew things had potential to become critical. I had missed my dose of cardiac arrhythmia meds on top of it, something I’ve had stern warnings in the past not to mess with. Again, I was told I was being impatient.

It wasn’t until another hour later when a different nurse came by to make a second unsuccessful attempt at gathering a blood sample that she actually looked at the IV tubing and bag. I’d indeed been not getting fluids, or the anti-emetics that would not long after they finally started flowing began to help me feel a bit better.

It was when I had a bit more strength that I had the courage to address what had happened directly with the first nurse.  We ended up having a long conversation about, speaking for myself only, my needs as a palliative patient. I spoke about how the emergency ward was truly the very last place I wanted to be, and that given a lengthy serious illness I had a pretty good idea of what I needed. I needed measures taken to make me feel more comfortable so that I could go home again. What I heard in reply was a plea to speak up on behalf of the nurses, to help their cause. Sorry friend, I really feel for you – but my energy has to be directed towards my own care.

Calls will be going out tomorrow to the team of paramedics who picked me up, and the the doctor who had taken over my care the next morning. Outstanding care, credit where credit is due.

What happened in between was simply awful. I pray that it was my last visit to emergency, when a patient considers that in the future the lessor evil to be possibly dying at home in a great deal of discomfort and mess – there is something really wrong with the system.

I’ve just passed what I’ve come to learn by experience to be the critical seventy-two hours after discharge from the hospital. The time during which if I’ve picked up an infection in the hospital it would have likely shown itself.

If there is a next time, I apologize in advance, but I will be asking someone to come with me. And I’d encourage any of you to do the same instead of trying to not be an inconvenience to a friend or family member. I’ve said it before and I’ll say it again, it’s too risky to go through the system without an advocate.

A special thanks to my wonderful neighbours A and D, who upon learning of my trip to the hospital via my blog wrote me a lovely note, insisting that I need go no further than one door down when I need help. Angels everywhere.