About thirty hours ago, my mom called me. Only hours after telling me to tell my dad that we should stay home and stay out of the (very) rainy weather, she was calling me. At the first phone call, my mom sounded confident (almost happy–for her) and was sure that she was going to spend the day sleeping. By the time she made the second call, she was having a panic attack. She was crying and worried that Willow wasn’t getting enough attention while she was at the hospital. She tried, at first, to conceal the crying. It didn’t take long, though, for her to break down. I could tell, by the shift, that she was depressed. She sounded extremely depressed. Extremely depressed doesn’t go well with my mom. She told me that she wasn’t getting her pain medicine. (She was still getting morphine instead of Talwin NX.) She also said she was getting half of her psychiatric medicines. (I found out when I got there that she wasn’t even getting some of it.)
When she started crying, I knew one thing above anything else. I knew that I had to get there. I knew that if my mother was sitting there depressed and no one was checking on her or giving her the proper care that she was going to get worse. I was afraid that if we waited too long to get there that she would harm herself. I thought about trying to see if any of my friends who work in the medical district (or at the hospital) could get a few minutes to stay with her so she wouldn’t be waiting alone for the half hour or so that it would take us to get there.
I didn’t ask. I knew we could get there quickly. I hoped that she would be okay. All I had was hope for her and anger at the hospital. When we finally got there, though, my mom was about ready to break down more. She then told me that her nurse was also being rude to her. The nurse told her that she couldn’t help her get up and get around. She also told her that she needed to give them at least 30-45 minutes notice of anytime that she needed to go to the bathroom. This was the day after they had had my mom on a catheter, so she wasn’t fully aware that she needed to go until she went. (This is normal, according to the nurse that took last night’s shift.) She had been hostile towards my mother and was not concerned about helping her get her doctor to order the proper medicine.
When the nurse (Tabatha) finally came in, she was half-assing around the room. When she looked at the bottles of pills that we brought in to show that my mother was definitely prescribed certain pills, she just said, “Oh, I gave her that.” She didn’t pay attention to the doses, and (for some) she said that my mom had been given pills that were never ordered. She was quite snippy prior to my saying anything. I could tell that the only way to get her attention was to get loud and assertive.
I never really yell at people. My yelling is generally ineffective, but there have been instances where it has worked. I called on the temper that used to get me some level of respect and awe from my social work program days. I started by telling her that my mother was depressed and that she was not being given the proper medicine and that which was being given was not at an adequate level. Tabatha denied it, getting a bit more hostile with my increased temper. I asked her if there was a way that she could possibly contact the pain clinic or the Mental Health Center to get proper orders for her pain and psychiatric medicine. She refused. She said that the only doctor who could consult was my mom’s family doctor. That is bullshit. She also said, in a snippy manner, that she had 6 other patients who were on pain medicine so she really couldn’t keep up with the medication. This is also bullshit.
If you’ve read this blog anytime since November of 2008, then you might know that my mom has been in the hospital a few times. I understand the hospital system from that. I’ve previously dealt with this hospital system when my grandfathers were patients. There is no time when a doctor who isn’t the primary care giver is considered irrelevant to a person’s case. The family doctors don’t always know what is going on at other clinics. They don’t always understand the specialties. (When I finally talked to someone from the UAB Clinic, they said that they had never heard of Talwin before my mom’s case.) The whole reason that specialties exist is to make sure that people get proper care for their specific issues.
Apparently, Tabatha was not aware of this. I tried to change her perspective. When it didn’t work, I asked to speak to her supervisor. (If you can’t get the proper treatment from one level, you go up the chain of command until you do.) She (eventually) brought her in. The charge nurse was nice, and she tried to defend her nurse. (I understand why she did this.) I expressed, quietly and calmly, the concerns that we had over my mom’s care. Tabatha, when she started giving her opinion, got very defensive and was being quite offensive. The bad thing (for her) was that she was still being rude with her boss standing right there.
After explaining what was wrong, what we needed to be done, and what behavior I thought was inappropriate, I brought up that Tabatha said that she couldn’t keep up with the pain medicine for more than six patients at a time. This brought out the fire in Tabatha’s personality. All of a sudden, she was saying, “I never said that. I wouldn’t say that. I’ve been a nurse for a long time and I can be a good one.” She did say it, though. I repeated, verbatim, her excuse. I then requested that the charge nurse take my mom off of her caseload, so that my mom could get proper care and so that Tabatha could better devote herself to the other six patients. The charge nurse agreed and, for the next few hours, my mom was cared for by not one registered nurse but three. She also had her (very sweet and thoughtful) tech Mea helping her out whenever she needed it.
Later, the charge nurse came in and told me that my mom couldn’t be given her Effexor at the full 300 milligrams because her doctor said it was too high for her kidneys to handle. I didn’t dispute this, even though my mom’s nephrologist had told her before that Effexor is mainly broken down in the liver and doesn’t really hurt the kidneys much. (Some people do get kidney damage from it, though.) She did, finally, get her on the proper pain medicine.
After my mom’s pain medicine was fixed, my mom’s blood pressure went from 174/80 (yesterday afternoon) to 153/82 (last night) to 135/66 (this morning). The whole time she was on the morphine, her blood pressure was sky high. She also was having more trouble sleeping prior to getting the Talwin. Afterward, she finally relaxed.
She also relaxed after my little outburst with the nurse. She wasn’t feeling up to taking them on, and she was afraid of reprisals. I knew that reprisals were still possible, even with a different set of nurses. I also wasn’t feeling very trusting towards the staff at this point and I was still worried that she might get extremely depressed/self-destructive if left alone, so I asked my mom if it would be okay with her if I stayed overnight. She was okay with it. I also okayed it with my father. He let me go grab some food from the cafeteria before he left, because we didn’t want to leave her alone. I brought the food up and ate my meal while she was having hers. I didn’t leave her at any time until the morning, when I went down and got my breakfast from the cafeteria. I also brought that meal up and ate while she was eating.
While I was there, we brought up the Effexor thing with the UAB doctors. They said that that was ridiculous. Apparently, her Effexor dose had never been changed. They had no intent to change it.
My mom got discharged today. Of course, before she was discharged, she had to talk to an actual Madison County DHR social worker before they’d send her home. (My dad also had to talk to the social worker.) The social worker had my dad and I leave the room, and she asked my mom (in various ways) how many times my dad had hit her or beaten her or what forms of physical abuse or torture did she go through on a regular basis. I could hear what was being said through the door, so it wasn’t a 100% confidential environment. (By my ability to hear discussed, the social worker was breaking certain rules set up by the NASW.) She spent around an hour trying to get my mom to say that she was assaulted. She also told my mom that the bruises that occurred from the fall and from being on the floor were different ages, which was not true. My mom kept telling her it wasn’t true. She didn’t take into account that my mom had been having bleeding/clotting issues the whole time, including a blood test that had to be redone because it separated between it being taken and it getting to the lab. (It did this within minutes.)
The social worker then took my dad down the hall and interrogated him. She tried to get him to say that he had physically assaulted my mother. She also, apparently, used a very accusatory tone toward him in many ways. She told him that in her fifteen years as a social worker she had never seen something like this, which has got to be crap. In social work classes, we got to hear about much worse cases of familial neglect and abuse. So, if she hasn’t seen people who’ve gone through worse, then she clearly hasn’t been dealing with many cases.
At about 3:30, my mom was finally discharged. Then, of course, they had to find a wheelchair to take her downstairs in, which took a little while. But now my mom is definitely home. And we will definitely take care of her, even if the hospital and DHR thinks that my dad is a major domestic violence case and that I’m not competent (or too afraid) enough to stand up to anyone who is wrong. (After the nurse thing, I don’t understand how they thought this, but whatever.)
