Care Team meeting at the hospital today. I have a LONG list of issues/concerns/complaints. I asked the charge nurse last night, “Who is coordinating her care?” Crickets. “Is there someone coordinating her care?” Silence. “I’ll take that as a no.” She says, “The nursing staff.” Really? When it’s constantly changing and she had yet another new nurse yesterday who couldn’t even tell me when she last had Zofran? When I asked for a copy of her current medication list, I got a hand-written list 3 1/2 hours later, with no notes as to when she last got the medication. And some of it was STILL wrong after nearly three weeks. Which is why I asked for it. I asked our local ALSA chapter social worker to attend, because she will be more diplomatic than I can be at this point.
Mary’s been in the hospital 5 out of the last 7 weeks, all of it in the SAME room. I asked for a patient advocate, and was told, “oh, quality management. We’ll have them arrange the meeting.” My first question will be, “When did this hospital veer away from patient-centered care? A patient advocate and a quality management representative are NOT the same thing. A quality management representative is trying to avoid lawsuits, not make sure the patient is getting their care needs met.”
Post-meeting update:
Everyone was there except the Quality Management representative. I muttered under my breath, “They might wish they had been here.” I hope now at least everyone is on the same page. We are coming up with a “care plan” for her daily care – a schedule the nursing staff can follow. One nurse approached me a little later and said “When I come back (from my days off), I’m going to request I be on Mary every shift”. We love him! They kept saying how they are acute care and not used to long term care. I told them that I don’t want this to turn back into acute care, and that’s why these issues are important. They’ve got at least 3-4 more weeks to find a way to figure it out. I told them communication is the biggest issue – they aren’t using the communication boards with Mary or showing the nurses how to use them, they aren’t communicating between departments or sharing crucial information with new nurses taking her care, and they definitely aren’t communicating with me. I said “I’m here every day. I’d rather not be (because I am exhausted), but I feel like I have to be to make sure she is getting care.”
After the meeting, Mary was exhausted, then started saying she couldn’t breathe and was having sharp chest pains. Goodie. RT said nothing wrong with vent or her lungs. Had the charge nurse page the hospitalist, who ordered a stat ekg, which came back normal (sinus tachycardia at about 117 bbm) as I suspected. That relaxed her anxiety a little and they gave her some ativan. I finally got to work at 2pm.