Sunday, February 08, 2009

Argg! UMMS sucks!

I'm posting about this now because I've been too angry to post it sooner. I know this is a teaching hospital and I'm all for on the job experience, but it peeves me to no end when yesterday a resident intern doctor who has never met the boys, never even came to check them over told the nurse on duty to just push the NG tube in to make it into a NJ tube. Thankfully our nurse was smart and refused to do it because only PICU and NICU nurses are allowed to do this. When she told me this is what he's said I verified that those were his instructions again and asked her to please have him come see me personally to discuss his instructions. I just knew there would be something wrong with all of this.

Having already had one baby go through this torture I know exactly how the procedure is done, what type of equipment they should use and who is authorized to do it. Later on in the day he barged into the room while the guys were sleeping, said in a loud voice "Can I turn some lights on?" and left the door wide open. (Most of the doctors do this kind of thing and it really pisses me off to no end. Do you know how hard it can be to get two sick babies to go to sleep??)

In a not nice tone I told him to keep the lights off because the babies are sleeping. He began to introduce himself and explain the process of an NJ tube insertion, still telling me we'd use the same NG tube already in there and push it down a couple of inches, the whole while gesturing towards Evan who's already got this kind of NJ tube. I told him that can't be because it's a different type of tube that's used. He then got a confused and worried look on his face and then recanted that yes indeed it would be a different tube with a special wire in it and that we would indeed need to pull out the existing NG tube to place the NJ tube. Then they did the procedure to have the NJ tube for Cameron almost immediately after this conversation with a very well trained PICU nurse teaching our wet-behind-the-ears resident intern doctor, and our on duty nurse helping.

But all of this pissed me off because A) a resident better not come to me and tell me how a procedure is done incorrectly and not even check to make sure he's looking at the right baby, and B) it just proved yet again that poor Evan was made to starve and suffer unnecessarily yet again for more than 12 hours. The PICU nurse was shocked that Evan had been made to go so long without food just for an NJ tube insert.

***Guest author says: and don't forget this morning's dazzling display of incompetence! Nurse A comes in, introduces herself and tells us she'll be Evan's nurse today. Excellent. Later, nurse B comes in and introduces herself indicating *she'd* be Evan's nurse today. Huh? Daddy, being very astute and suspicious, asks if she's working with another nurse because Evan's nurse already checked in with us. She assured me, nope, she's his sole nurse today. So she gives him some of his meds. Fast forward a short while and nurse A returns with those same meds! Thank goodness we were here AND micromanaging these clowns or who knows what would happen to our boys.

Also, last night both boys managed to throw up while on their NJ tubes. We've set their rates of formula distribution on their feeding pumps to slightly slower rates but if they throw up in the NJ tubes between now and when they have the GJ tube then we will try to get MRI's done while they're still sedated for the GJ tubes. This is scary because we've had so many system failures here that coordinating two different proceedures done at the same time while the boys are under longer sedation which has greater risks in and of itself.

I have made attempts to contact the patient advocate office but they don't seem to have anyone in their office on the weekends.


Maria said...

I've been following your blog for awhile now as I also have twins (Evan and Colton) and my Evan had some mild reflux the first two months of his life but nowhere near what you are going through. This post outraged me with the stupidity of both residents and nurses. We went through something similar when Evan had hernia surgery at 6 weeks. I just wanted to say I think you are outstanding parents and thank god you were there for the nurse mishap. I hope and pray your boys are healed soon and you can begin to really enjoy your twins. God bless you!

Annie and Jason said...

You keep up this GREAT micromanaging work!! are some nurses/doctors thinking?!

SO I was pretty upset yesterday seeing Jax still heave and puke with the GJ tube....but he's turned a major corner overnight. My fingers are crossed so tight! The GJ tube seems to be giving him some relief. The GI docs who came by promised me again that he WILL grow out of this since every single test tells us reflux. So I wanted to pass this along to you as some HOPE.
God knows these babies could use some relief until this stupid reflux passes.

I guess that once a child is doing well on the GJ tube for awhile, they switch back to the G. If they don't do well, they go back, but if they do okay, this is the process to get off completely some day!
We'll be here at least another night to monitor everything and I'll let you know how it goes. He's currently at 26ml's/hr and I think only 30 caolories. We're going to increase the calories today to his full 27.
Good luck girl - you keep up the good work!!

Blue Moon Mama said...

We are anxious to do something, anything, for you guys. We can bring you food from the restaurant of your choice, a box of good books, a pile of movies. Ask and you shall receive. We'd give even if you don't ask, but we don't want good intentions to burden you with stuff you may not be able to eat or use.

We want to help so much. Please please ask if there is anything at all we can do to make this easier for you.

Anonymous said...

sounds like you are very comfortable speaking up against the 'medical powers that be" but don't forget that if you are unhappy with a doctor...tell him to leave and send someone else. It's your right as patients to demand competency. Dr. and nurses are trained to apologize in a way that not only sounds sincere, but that also places no blame. Do not accept failure and don't be cautious about demanding a more experienced caregiver. It's your insurance paying them after all.

Preemie Parenting said...

I seriously wonder how people even survive the hospital. One of Olivia's nurses tried to start weaning her off oxygen when we had to stay overnight. I had to force her to read the chart before she believed me that she was on O2 all the time.

Thank goodness you guys are there and are on top of everything. The boys are lucky to have you.

Kim said...

Oh man, they need to get their crap TOGETHER, and FAST. I hate that you even HAVE to micromanage, that shouldn't even be needed, let alone your job. I'm really glad that you plan to say something. Definitely make sure you bring up the nurse issue also, what if your boys doubled-up on meds and something HAPPENED? That's a lawsuit waiting to happen. Not to mention SCARY!

I wish that there was something we could do from here :O(.

n. said...

i would be sure to share the bit about two nurses trying to give medication when you do get in touch with patient advocates. that is pretty scary stuff! keep up the good work.