As a medical nurse who is still actively involved in my profession, I
thought it might help list members to understand the 'other side' of the
dilemmas Bob experienced with his wife's hospitalization and perhaps offer
some suggestions as to how they can be avoided.
Bob Anibal wrote:
One year ago Aug 7 Cecily had a stroke while in the hospital for
>pneumonia. The neuro ( not our neuro) called in, immediately decided she
>needed more sinemet. She said that every neuro had different ideas about
>dosage of PD medicines. Being in a state of shock I didn't realize what
she
>was saying. After it sunk in I eventuall got our MD to change it back. I
>also told him that under no circumstances was that person to be allowed
>near any of my family - get a witch doctor first.
In teaching hospitals (where interns and residents follow patients) such
situations commonly occur. To avoid this kind of encounter, request that
your physician stipulate that you be 'non-teaching' - thus preventing
interns and residents from over-seeing your care. The down-side to such a
stipulation is that in emergency situations, attention to your problem might
not be as immediate as possible. Your physician must be called for any
orders in regard to your case. If he's indisposed (at a wedding, funeral,
on the golf-course or out of town) getting timely medical care might present
some difficulty.
If you decide that you wish to remain a 'teaching patient', then *clearly*
express that under no circumstances may your PD meds be changed without
direct consultation with your neurologist (this was Bob's solutionin his
wife's case).
As a nurse I recommend the latter.
>In Feb she was in the hospital again and altho I had given the nurse a
>writtten program of her medications, I caught them giving her a wrong
dosage
>at a wrong time. Asking around I found that they had a different regimen
>than the one I had given. When as and if she is ever in the hospital - any
>hospital - again you can bet your bottom dollar I will see that they do
>what they are supposed to - not what THEY think they should.
Hospital medication schedules are often very different from the regimen
patients have established for themselves. Although we would love to
accomodate patients, it is often difficult to administer medications on
'patient time' as opposed to 'hospital time.'. To give Annie meds at
6-10-2-6 and Jim meds at 8-12-4-8 and Tom meds at 9-1-5-9 would dictate that
the only function a nurse could carry out would be to pass meds to patient
to the exclusion of other medical care.
Therefore, if you have a medication schedule that must remain constant,
request that your physician write orders that specify that you may keep
your meds at the bedside so that you can take them whenever you need them.
If you are a care-giver whose charge is not of sound mind and thus cannot be
trusted to take their meds on their own ask that your doctor write specific
times when meds *must* be administered.
Hospitals are very busy places. On my clinical division where cardiac and
respiratory problems are the major focus, emergencies occur every day.
Frequently medication schedules are thrown off because of those crises. We
try very hard to insure that our patients be managed in an optimally
therapeutic environment, but sometimes our best efforts fail. It is
important that all contingencies in regard to medication administration be
anticipated by staff and patients so that rapid recovery can occur and the
patient can be discharged back to their normal environment. We need your
help for that to be accomplished.
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Regards
Mary Ann
