Saturday, July 17, 2010

Blake's Health Update 2010/07/17

I would say that today has been Blake's best day in over a week.

Today he laughed.

Good hearty laughs.

They were usually at MY expense, but whatever.

The kid laughed.

It was good to hear!

There's still some discomfort in his back, but the nausea seems to have settled down. He hasn't had a Gravol or Zofran all day today! Yippee. He did have to take some Tylenol #1's.... which reminds me of something.

When we got to Kingston General last Sunday, after they had called saying a bed was available for him (because he was on the Urgent List), they sent up a doctor to talk to him so they could write up an order on his chart for the meds that he is currently on, as well as the pain meds that he would need during his hospital stay.

The doctor that was on duty for that floor (whose name we didn't get, and I was not in the room when Blake chatted with her) asked Blake about his pain level and what pain meds he normally takes. Blake said that he usually takes morphine when in extreme pain and also takes Tylenol #3's for pain. She looked at him funny and said, "I don't know what you mean by Tylenol 3's.... you mean you take three pills of Tylenol?" Blake told me later, "Mom, I just looked at her, like, 'You've GOT to be kidding me!' and this woman is in charge of my meds???". So this doctor told him that she only knows the meds by dosages and she'd never heard of Tylenol #3's. I personally thought that was EXTREMELY odd.


Anyways, she ended up ordering him Hydromorphone, which works like morphine, as well as some Regular Strength Tylenol. As far as I'm concerned, I could get better pain relief by sucking on my right big toe than taking Regular Strength Tylenol... if of course I could actually physically GET my toe up to my mouth!

Then there was a discrepancy with the way the Hydromorphone was ordered. Nurses always have to be careful as to how they administer the medications depending on how the doctor's orders are written. The doctor on call had written the order for "1 to 2 mg of Hydromorphone every four to six hours". Well, Blake would get an injection of the Hydromorphone, but about two hours later, he'd be in pain again. It didn't matter whether he'd get 1mg or 2mg; it always seemed to wear off in two hours. So the one nurse suggested he get a 1mg injection and then two hours later get a second 1mg injection. That seemed to work great for Blake, spreading it out like that. However, that night, the next nurse would not administer it that way because of the way the order read on Blake's chart.

I explained to the nurse that I understood how it was written up and how they must follow the direct instructions on the chart; however, no matter how much was given by the injection, in a four hour period he still was only receiving 2 mg maximum. The nurse said she understood that, but she must follow the orders on the chart. So I said to Blake, "TAKE THE 2mg! GET WHAT YOU CAN!" hahhaa. I'd make a good drug dealer, eh? hahaha.

When I mentioned it to the nurse the next day, the one who gave us 1mg every two hours, she couldn't understand what the problem was, because she was thinking like me.... he's STILL only receiving a maximum of 2mg in a four hour period.

Then the day we left the hospital, I mentioned this scenario to another nurse and she said, "Oh my goodness... the nurse who gave the 1mg and then another 1mg two hours later could get into a LOT of trouble!!! We MUST follow the orders of the doctor to cover ourselves in case there was ever a problem with a patient down the road and they look back at the chart and realize that meds were not administered by the nurse according to what the doctor wrote!"

Wow! I was surprised! I said to the nurse that it was waaaay more responsibility (or even liability) than I, myself, would want to have if I were a nurse. She just rolled her eyes and said, "Ohhhhh yah!!!"

Now, I COULD have got the nurse to have the doctor re-do the order on the chart and change the meds to make Blake more comfortable; however, he was getting his Remicade dose that day, so we decided to just leave things be, as the pain would disappear soon anyways.... which it did.

I stupidly did not get a prescription order for Tylenol #3's, though. They would've helped with my barometric pressure migraines! Stupid me! I wasn't thinking ahead! haha

So anyways, folks, don't be too hard on the nurses if you're ever in hospital and they are not giving your meds to you like you think you SHOULD be receiving them. Go over it with them, and if it's not suiting you, contact the doctor and review what's on your chart and have it changed. No sense being in the hospital and in pain. That's why they're all stocked up on that Morphine and Demerol and Hydromorphone and even those Tylenol #3's.......

..... although they might not know what you're talking about if you ask for some! hahahhaaaaaa

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