Tuesday, December 23, 2008

Avoiding a glitch

I've had a bit of an unsettled feeling about Steve leaving on Christmas Eve. The processes are so slow here, and it's Christmas week, and there have been enough glitches already that we have faultering confidence in the system (and how all the little systems work together).

About 1:30 p.m. today a case manager stopped by the room to get the home health process started.

Started? Really? We've known since Friday that he would require help at home receiving IV antibiotics.

The case manager didn't exude confidence that everything would be in place by tomorrow. She also said she was leaving early today. Around 3ish.

My unsettled feeling heightened.

About an hour later I stopped by her desk to inquire about progress. She seemed less certain that Steve would have home health in place on Christmas Eve. It's been difficult to get staffing this week, as many home health nurses are on vacation.

My impassioned speech in reply was something like this:
"I can't think of anything more important than getting him home in time for Christmas. He was hospitalized last year on Christmas, in the middle of his cancer diagnosis. We have a 3-year-old and 7-year-old at home who desperately want to see their daddy. Steve's morale will be devastated if he has to stay in the hospital because there isn't enough staffing to administer IV drugs."

(I didn't tell her that last night, as Cooper was falling asleep, he asked me to pray aloud that Daddy be home for Christmas. And that he's been assuring Margie the dog that Daddy would be home for Christmas. And that Katie tells me every day that she's sad that Daddy is in the hospital.)

Then we started working on other solutions. Perhaps the nursing staff here could teach me how to administer the drugs. (As a bonus, there are no needles required!)

I returned to the room and then today's RN arrived. She's going to let me give him the next dose of antibiotic in the room, under her supervision. I'm going to ask to do it every time so that I'm comfortable (and Steve, too!) with the process.

I'm supposed to follow the SASH method: saline, antibiotic, saline, heparin. (Today's process will be a little different than tomorrow -- today he has a short IV line, tomorrow he'll have the PICC line.)

We're starting to feel a little better about a Christmas Eve solution. The nurse is going to start inquiring about the necessary equipment and pharmacy's role. I'll continue to be assertive until we're certain.

Steve looks good today. Yesterday he started walking around the third floor. Today he made two laps and even ventured into the gift shop. He's wobbly, but his left knee isn't locking as it has in the past. He's eating really well, thanks to many welcome deliveries of meals and treats. He's still running a huge sleep deficit, but we'll take care of that when he gets home.

He continues to show no sign of active infection. His temperature is back to his "normal" 97. His cough and wheezing are completely resolved.

As always, we're gaining strength from your prayers and ours, your faith and ours, your love and ours.

We're also enormously thankful for help in the past 24 hours, during this especially busy season:
Jim and Betty: meals, caring for Cooper and Katie, arrangements and rearrangements for Christmas celebrations
Uncle Jim: caring for Cooper and Katie, handling the ensuing chaos (fun chaos, but still) and helping around the house
Mel and Greg: caring for Cooper and Katie
Mary MT: meals and Christmas treats
Sharon: afternoon Starbucks and snacks
Andy and Julie: gift hiding, heroic package delivery and problem solving
Liz and Holly: gift wrapping
Allison: grocery shopping, card addressing
Pastor Andy: visit
Geneva: dinner and gift delivery
Meghan: caring for Margie and the house


Anonymous said...

You can handle the meds for Steve. I had to take care of Jamie's port when she was sick and after a while, it was second nature to handle it. I sure hope that you all can get out of that darn hospital tomorrow. I will pray extra hard for that! We love you and give Steve a big kiss from me!

Anonymous said...

Tyra- You are amazing! I'd be happy to help to help, if you'd like...

Anonymous said...

Even if you have home health care, they're just there to train you how to administer the meds. Usually, they come once & show up maybe once or twice a week thereafter -- the rest is up to you. But, its OK, with a PICC line, the administration is usually pretty easy. If you need help, I'd be more than happy to stop by (but I'm sure you'll get the hang of it in no time!).

Take care & I'm praying right along with Cooper that Steve is home for Christmas!

God Bless,
Jennifer W.

Anonymous said...

Saying extra prayers that you are ALL at home on Christmas Eve!

with love,

Cyndi said...

Please don't hesitate to call if you need any help. I am pretty good with PICC lines! We are praying that all goes smoothly for Steve to go home today.


Joanne said...

I'm sure you have a thousand more qualified people than me to help with the PICC issue, but my daughter has had one twice now and you will get the hang of it in no time!! You can do it! You sound like a pro already! Hopefully his meds won't be every 6 hours because that means a lot of interrupted sleep. Thinking of you all from here in cold and rainy Indiana.

Anonymous said...

I don't have any experience with home health, but it look like lots of the posters here have.

Before I read the part about what SASH stood for, I instantly thought it was some shorthand for "Soon As Steve's Home." Or maybe it could be "Schedule Accelerating Steve Homeward."

We'll give a prayer that they'll all do their part to get Steve outta there today! Including prayers for all the caregivers (home and hospital), and strength and comfort prayers for you, Cooper & Katie. Much love!
--Mary & Kevin

Gregory said...

Call me if you need me to come to the hospital for a little "Good Cop, Bad Cop". I'll be the bad cop, of course! No joke. Your sister, Mel.