Saturday, March 28, 2009

Cast of Characters

I want to capture some sort of "snapshot" of all the various players that we've dealt with as we've gone through this surgery and recovery process. There have been a few heroes, some angels, and more than just a few who have behaved in ways that were simply unprofessional or uncaring or both. So, here, for the record is the cast of characters in our little drama:

Dr. George Kerlakian is the surgeon. He is awfully good. He inspires confidence. He's been very willing to talk to us all and make sure that we were fully informed of the realities and choices that we've faced all the way along. He's got a whole team assembled that all work to support the success of their bariatric surgery practice. In general, the staff in Kerlakian's office have been helpful and responsive. We have been very impressed with them as a group.

Kerlakian has a couple of partners who seem to be competent enough although neither of them inspire the same confidence as he does. One of our issues at present is that Dr. Kerlakian left yesterday to travel to Memphis for his daughter's soccer tournament. Although I understand that doctors need to have lives too, I am nonetheless frustrated that Kerlakian's life had to happen just now. We really need him here!

Kerlakian gets followed around by a whole gaggle of medical students and surgical residents on rotation. Most of them are as bland and dull as white bread. Perhaps they haven't arrived at the point in their medical educations where they are taught to exhibit personality -- where they learn to relate to human beings as part of their practice. Blech! The one oddball fellow in the group is a young medical student who we've come to call 5AM Nick. He is the first one on the floor every morning, and comes bounding into the room promptly at 5AM with a thousand questions. In the beginning, we found Nick to be awkward and moderately annoying, but he is so gosh darned earnest that it is hard to not like him.

We had excellent nursing care during the first part of our stay here at Good Samaritan Hospital. The nurses and Personal Care Assistants that attended to Master and T after their surgeries were very good. Megan and Meghan, Tracey, and even Jodie (who sometimes seemed very brusque) were all very good, each in their own way. The PCA team was helpful and friendly and supportive. Carol, a great, tall, warrior woman, was cheerful and efficient, and she cheered for every accomplishment. We all got very fond of her. Sarah and Amanda, likewise made so many things about our early days here much easier.

During those first days we met and became very fond of the Nurse Manager, Sherri Joyce. She was quite intrigued by our family and by the "couple" surgical adventure that we were embarking on. We spent a lot of time talking with Sherri, and she was clearly very proud of the team of nurses that she had working under her supervision.

When Master and I came back here in the very early hours of Friday morning, we first came into the Emergency Room. There is major construction happening around the outside of the hospital, and the entrance to the emergency room is far from obvious. I drove us around and around, until finally, in desperation, I pulled into the space that was marked for ambulances only, and ran in to see if I could get someone to help us. A very kind, gentle voiced nurse, actually came outside and walked around the side of the building, guiding me to the place where I needed to go. Once inside the place, we found that the gentle voiced fellow would be Master's emergency room nurse. His name was Michael. Michael's kindness and compassion was simply remarkable to watch. He made what was a very stressful time just a little more bearable.

Then, we came back up to the same surgical floor where we were earlier in the week. Except that, these last few days the level of care and attentiveness has been much less even. The nurse who was on duty when we first came up seemed alright at first, but when the first IV faltered, she told us that she couldn't start an IV -- didn't know how. Really? A nurse who cannot start an IV? As it turns out, it was a sign of things to come. We had an older nurse during the night last night, when things were so terribly difficult. I believe that she was well meaning, but she seemed very old fashioned and unwilling to act as our mediary with the doctors. She just kept feeding us the same useless pablum until we finally got frustrated and made it clear that something needed to be done or there was going to be real trouble. Today, throughout the day, we've dealt with "nurse" Angela. Angela got herself into a snit very early on, as Master opted out of taking a number of His usual medications. He is choosing to wait to resume many of those during this time when His newly remodeled stomach is being so sensitive. Angela clearly disapproved of His choices, and made her feelings very clear. For the rest of the day, she was largely absent, only coming in when she couldn't avoid it, and then providing only the most perfunctory level of care. Randi, the PCA was just frankly not interested, and seemed to spend most of her shift sitting and chatting at the nurses station. Tonight, finally, we seem to have a pretty good team again. Tracey is back. She's wonderful! The PCA is a delightful young woman named Kimmie, and just having her around seems to lighten Master's mood.

I am hoping that tonight will be better than last night. Soon, within the next few days, we'll be heading home. The days here in the hospital will blur into memory. I wanted to have a record of the cast in this part of the saga.



Amber said...

Checking in, how's it going? Hope things are well.

Anonymous said...

Is he doing better than last night then? I kept all my parts crossed for luck.


LynLass said...

I was so sad to hear about what Tom's been going through. I just got back and up to date on the news. Vancomycin is really potent. You probably did see a measurable decrease in redness that fast. I trust it will continue to do it's thing well in the days to come. Once he gets past the really tough part, it might be able to get him home and finish his IVs at home with a home health agency. Just an idea.

It's really sad but some nurses are just less compassionate and/or less skilled. Some have not adjusted to the new age when we are practitioners in our own right, not just people who "carry out the doctor's orders". The problem that you just came up against is that the "weekend" starts either with Friday evening shift or Friday night, call-offs are higher and so you're more likely to get an as needed person or an agency nurse. The really good nurses earn the Monday thru Friday slots. They are also more likely to be understaffed, partly for the above reasons but also because of the nursing shortage. PCAs are a lot more likely to call off on the weekend; most of the time they can easily get a job somewhere else even if they've been fired!

By the way, lots of nurses can't start IVs. I've been working psych, chemical dependency or administration for so long, I can only do the very easiest sticks--that does not include someone who is overweight and dehydrated!

So all the more reason to support serious health care reform. That should include some funding to increase nursing education.

You're all in my thoughts and prayers.