At The Hospital
Roughly 3pm I arrived at the ED. I had never walked in the front doors of the emergency department, so this was a new experience. I had done a clinical rotation in the ED here before so had a good understanding of where I thought everything was, but lord has that changed since school. I was told to sit in the waiting area until they called me back, that was agonizing, I felt like I needed to be back there talking to the staff helping EMS give report. I tried to relax and knew Kristen would handle it. As I sit there, I start looking around the entire lobby just judging everything and trying to understand why it was in the shape it was. There was one other person in the lobby with an active cough and looked miserable. Then a woman walked in and loudly said she had been exposed to COVID and wanted to be tested, seven kinds of hell crawled all over me. I wanted to give her a lecture about she was an idiot there were tons of other resources out there she was one of the reasons the ED got bogged down. Instead, I gave her the idiot stare. Kristen came out to the lobby and got me. Walked through the maze of hallways to her room. Was a slew of nurses in there and the doctor outside looking in. He was pleasant and greeted me. Asked for a back story, I gave him the spill how I found her but was nervous because I did not want to forget anything, so he had a full detailed history. I am shaking at this point because I was scared, I had forgotten something. So, she is in bed mad as hell because she hates stuff like this and is just ALWAYS a horrible patient. She is breathing 30-40 times a minute just looks miserable. The doctor was a little displeased EMS had brought her in on Bipap because he felt they were spreading COVID. They had her on high flow oxygen briefly and her oxygen saturation plummeted again, and she was turning blue. So I know what that means, and I am just at their mercy to fix it. Doc decided to put her on their Bipap. Shortly after being on their high flow oxygen her saturation came up, but she was still breathing so fast. Doctor felt like he needed to intubate her but decided not to since she improved her saturation on the Bipap. I have a little anxiety regularly but when I heard him say this, automatically tore up. I personally have never had anyone in my family hospitalized with COVID and had only heard horror stories and the news hasn’t helped at all. All I could think was if she’s gets put on a vent that’s her death sentence. Moma has always been adamant not to have her on a vent. She agreed if it was for a short period of time but never to be put in a nursing home with a tracheostomy. So we never truly get settled in the ED room but there we are sitting beside each other staring at each other and her breathing 40 times a minute. I am like something has got to give. Coaching her to calm down her breathing wasn’t doing anything but pissing her off more. So I just hold her hand and stare at the monitor hoping it will change. Due to having some connections we were able to have the ICU provider take over care roughly 4 hours into her time in the ED. The bad news was there was no bed in ICU, so she was under ICU attending care but no ICU, no ICU nurse, no ICU staffing ratio, no ICU monitoring. This is where it got stressful. My sister came and I could see it in her eyes when she laid eyes on out mother that this isn’t good. She wasn’t really alert and oriented and just struggling to breathe. A little while longer passes then blood draw after blood draw and blood gas after blood gas not much improvement. I went home to take a shower and change while my sister was there. When I came back, she was breathing even faster and uncomfortable. I put my hand on her and told her I was back she automatically started to relax some. Obviously, I’m the favorite child. While I was gone the Intensivist had a conversation with my sister about what was going on and what was next. The Doc wanted to intubate her because she felt it was better to do it now to maintain an airway than to code her and struggle getting in an airway. My sister said the nursing care had been subpar while I was gone with minimal observation. My mom’s room was down the hall from the nursing station, and they kept the door closed sometimes and the curtained pulled. Perfect scenario for poor direct observation. The Intensivist swung back by the room and noticed Moma was breathing a little better and wasn’t as tense. She also made a comment that she could tell a difference with my presence in the room. At that point she decided to leave her on Bipap and recheck her blood gas shortly later. Several times when someone come in to do something I or my sister would step in to help but we never played the I’m in healthcare card because who honestly cares? They would be like ok you’re in healthcare what do you do, and I would try to brush it off for some reason. They came and got her to go for a CT of the head and chest. Before they rolled her out, they put her on high flow oxygen instead of the Bipap. As they rolled her out, I told her not to die, morbid but just how I am with her usually, she said OK. They brought her back and said no pulmonary embolism and head scan looked good which was relieving. My sister noticed she wasn’t getting worse, so she decided to go home to take care of the kids to get them ready for school. So here I am just me and Moma and her breathing like hell. The Intensivist come back around 11pm and said her blood gas had improved some so this made me feel better. The Intensivist saw that she was squirming and when she moved or slumped down in a poor position her saturation would drop. She looked me dead in the eyes and said “You are going to stay the night, aren’t you? You need to stay and keep eyes on her, her life depends on it.” At first, I was like what the hell that’s a big job to put on a kid’s shoulders and then I was like ok yes ma’am. I didn’t realize what she had said honestly, I did not know she meant me being in my mom’s room being her advocate and helping take care of her was going to make that much of an impact on her healthcare. Later that night I began to realize what she meant. My mother was under intensive care, unstable under the care of an emergency room nurse that had 5-6 patients mixed complexity and was still expected to help others in emergency situations. I also didn’t realize how the rooms had the bare minimum or how the equipment in the rooms was not but for short stays. Continuously Moma would try to reposition herself because the bed was so uncomfortable. Every time she would do this, she would stress herself out more increasing the pulse and respirations and decreasing her oxygen saturation. Moma had to use the bathroom often and the staff wouldn’t let her use the bedside commode they wanted her to use a bedpan. She absolutely was not going to have that and was not happy about it. She would have an accident and they would take a while to come change her. By the second time I just started helping because there was no point in putting pressure on Moma because they didn’t have enough staff. Yea I saw her butt and that’s ok, not the first one and not the last. The nurses were shocked I was willing to help do anything like that. She wanted to get up in a chair. We asked for a chair. Two hours later we got a chair. Now I get they were busy, but… In the meantime I had put her in the chair I was sitting in. When you can’t breathe good sitting leaning forward is like the body’s natural go to for comfort. She was only able to do that in a chair. I moved her back to the bed because she was getting uncomfortable in the lobby style straight back chair. We did this switch between the lobby chair and the recliner style chair they finally bought and the bed several times. I was down to do what ever she wanted to get her comfortable to hopeful it would help improve her respiratory rate which was still 30-40 times a minute. Honestly never seen someone breath that fast for so long and not knock over. That was a long night. I tried to work on some work stuff through the night to keep busy to stay awake. I’m not built for night shift anymore. Consistently through the night she would pop off the Bipap or unplug something as she tried to put herself in a position of comfort. Just consistently breathing 30-40 times a minute and miserable the entire time. During the night I decided to put my business on the Facebook and inform people and ask for prayers. I was overwhelmed with the response. There were so many people that have reached out and been so kind during this time. Morning come and my mom started asking for a catheter. She wanted a catheter because she felt she wouldn’t bother the staff. Each time she asked for a catheter they would give her a lecture about how she didn’t need it. At this point I’m exhausted and just not understanding a whole lot. I asked if they understood she wasn’t an ER patient anymore that she was under ICU care that they get took care of a little different. Fortunately the nurse was a straight shooter and took that well Roughly around noon no catheter still, but I decided I needed to go home and take a nap I wasn’t worth much. My sister was going to keep tabs on her while I was home. I went home what felt like for just a minute.
Comments
Post a Comment