I won’t call these updates “surgery” anymore because we are way past that. My sister-in-law’s condition continues to be troubling. She HAS developed pneumonia and is now dealing with this new problem. She is still septic in her abdomen and is not responding well to the antibiotics she is on. She is on blood thinners, we have been assured, since the risk of a blood clot is a reality.
Today when I visited she had just been fully reviewed by the attending physician, who has ordered another CT for tomorrow morning. The nursing staff had washed her hair and given her a sponge bath and consequently she looked better than she had in days. They had also changed all her tubing and replaced all her lines. She remains swollen from the fluids. The level of mechanical support has been increased for both sedation and respiration. Despite this, her son, who was there (as always) was a bit more optimistic than he has been in recent days. The stress is definitely wearing on him but today he seemed to be cautiously optimistic, exhausted but hopeful. It could be that he felt an affinity with the Charge Nurse on today – Pam, her name is Pam, and she was impressive in her approach, kindness and outlook. We’ve met quite a few of the nurses throughout this ordeal, and they all leave an impression.
One stark reality of today’s healthcare is that most of the staff are part timers – that way the hospital doesn’t have to pay them benefits, it’s a cost savings. It speaks to the potential for lack of continuity in care since the only history the incoming nurse is going to look at is likely the last 24 to 48 hours. For my sister-in-law if we had our way we’d have a dedicated cadre of four nurses looking after her (night/day/weekend); developing a relationship with the family and with her – personalizing this experience. I know some will not agree with this but it’s how I feel. I believe that in some areas of the hospital it should be mandatory that the hospital staff areas with full time members to ensure knowledge transfer, awareness and consistency in approach to care – the ICU is one of these. Use your part time staff in Emergency – where the patients come and go within 24 hours, or even on the Wards; for palliative care, again, use full time staff – it provides a familiar face as well as stability and continuity for patients facing an uncertain and, in some instances, a short future.