From the archives …
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It all started on a Friday night. Our primary care physician told us to go to our local hospital after Dave’s complaints of coughing up blood. We got settled into his room around 7 pm that night. I stayed for awhile then eventually went home to get some sleep before his endoscopy first thing the next morning. I waited for his endoscopy to be over and was looking forward to us going home after he recovered. Instead, after the procedure the doctor came to talk to me. He told me Dave is having a major upper and lower gastrointestinal bleed. He stopped the upper bleeding but lower bleeding was still a possibility. He also informed me Dave’s liver was shot and he would need a transplant or die. Dave needed to be admitted to the ICU and would need blood transfusions and medicines to stop the bleeding.
I was familiar with this hospital’s ICU. I had transferred many patients their after recovering them from open heart surgery at the facility next door. But I was not eve close to being prepared for our experience there. I spent the day and evening with him sitting quietly next to him as he tried to sleep. The nurse was busy giving several blood products and medications. By afternoon things seem to quiet down, maybe Dave could finally get some well needed rest. Unfortunately, the IV’s they inserted were in his wrists. Every time Dave would doze off the IV pumps would start alarming. The nurse at the nursing station would yell across the desk to Dave “straighten your wrists!!!!” Dave would plunge awake and straighten his wrists. This went for what seemed like hours. Being an ICU nurse, I knew of an easy answer. I asked Dave’s nurse for support boards that are used to keep a persons wrists straight. But shecurtly informed me that they don’t use those. Where I worked we couldn’t function without them. But I didn’t say much – I had to go home and leave him there with them. I didn’t want to make waves, I just wanted them to take good care of him.
It was awful having to leave him there – he was still in danger of bleeding but thankfully we lived 5 minutes from the hospital. As I was leaving I said good night to his nurse and told her to call for if anything happened. She said to me “Your husband just doesn’t get it. He’s very sick and could die if he bleeds more”. I couldn’t believe she said that – she knew nothing about my husband. I left quickly before I started bawling in front of her. Looking back on our experience that was the worst thing someone said to me and the worst night in an ICU.
The next morning I was back at the hospital, Dave hadn’t slept hardly at all. He said the nurses were noisy and they kept the lights on all night. The rest of the day was the same. By night fall he developed ICU psychosis. I had seen it many times before – patients become confused and disoriented from lack of sleep. He had another bad night in the ICU but thankfully the next day he was transferred to the transplant referral center . compared to where we were I felt like we just checked into a four star hotel.
The point of this entry is two fold. Never feel like you have to be quiet so the nurse takes good care of your loved one. Having worked in an ICU for 20 years my patients got the same good care regardless what the families said. Also, it is true the noisy wheel gets the grease – so if you think something is not write speak up. Get to know the hospitals in your area and what your options are. I realize in rural areas you don’t have much of a choice. But you need to be honest in discussing any concerns with your loved one’s primary care physician.
Here’s a good way to describe for yourself, and professional care givers as well the “value” you should as a family member expect in any intensive care setting:
V – Value Family Statements
A – Acknowledge Family Emotions
L – Listen to the Family
U – Understand the patient as being a Person
E – Elicit Family Questions