Tuesday, May 03, 2016

Retirement Home Goat-Rope

     The nameless technician whose work product gave us Major Edward A. Murphy Jr. (formulator)* and Colonel John P. Stapp M.D., Ph.D.'s (popularizer) "Murphy's Law" could not have created a greater screw-up.  Then again, he was just wiring up four-wire strain gauges; yesterday's mess involved several levels of administrators, nurses and aides.

     Late yesterday afternoon, in an appointment made last week, Mom needed to go from the retirment home's hospital-lite† to a surgical oblast of the hospital, specializing in oculofacial work.  It had been arranged she would travel on a gurney, via ambulance.  So I showed at the appointed hour and lo, a bus driver appeared rather than an ambulance.  He was a bit skeptical of getting her in a wheelchair, what with the neck collar and all, so he asked for help moving her to it, which is where Mom's aide (from, let us note, an outside agency, not retirement center staff) and I realized the metaphorical wheels had done come off.  I corralled one of the administrative types from our conference last week and received somewhat snippy assurances that "doctors don's make that decision, we do," and "It's a perfectly safe way for her to travel."  Him not being an M.D or a Nurse-Practitioner, I asked him to confirm with her chart and the top nurse on duty.  Oddly enough, he returned shortly (still snippy) to say the ambulance was delayed but would be there in "about fifteen minutes."  H'mm, so much for "perfectly safe way...to travel," ey? Fricking stonewalled by a shitheel?  Sonny, I have to take that at work; from you, not so much.

     There was way more confusion and back-and-forth than I have time to describe, none of it in any way demonstrating concern for the patient, let alone effectiveness or organization.  Eventually, Mom's aide recognized the 'bolance livery though an outside door, went to check with them, and discovered they'd been waiting for several minutes at least.

    Have I mentioned Tam took time off from her writing and online work to drive me, as I'd been up since the previous evening for work?  Mom, aide and a pair'a paramendices took Mom to the doc in the big ambulance while Tam drove me. Tam waited in the car, so it was only Mom-plus-four waiting and waiting in the doctor's office (overscheduled as usual and you can't really blame the M.D.s: anymore, they just work there, same as the janitor).  Once the doctor got around to us, he was great, and Mom won't need additional surgery for the other (small) broken bone.  He even took out the complex stitches the ER had used on her forehead.

     We got Mom back a bit after dinner-time, some three hours or more after everyone (except the transport!) had showed up to move her.  Mom was feeling pretty good.  I was barely coherent.  After a short chat, I went home and slept, forgetting to reset my alarms and sleeping right through them until my normal waking time. 

     This would have been kind of difficult but not that bad had it gone as planned.  As it was, there were several occasions when I was pondering planting myself in the center of the nurses's station/office area and commencing to scream as a mildest-possible response.

     I'm not impressed with this place -- and I know from grim experience that as such places go, it's above-average. 

     The New Deal promised Mom's generation certain things and I feel obligated to help deliver.  My generation?  Let's just say my expectations are lower and I have planned accordingly.
* "Murphy was said by his son to have regarded the many jocular versions of the law as 'ridiculous, trivial and erroneous.' His attempts to have the law taken more seriously were unsuccessful."  --Wikipedia.  Maj. Murphy was a proponent of "defensive design," which examines worst-case scenarios and their probability, then redesigns around them as needed.
†  Hospital very light, if you ask me, and not all of it their own fault.  Turns out bed rails are all but illegal now, partially because of their use as a restraint device, partially because they're not a very good restraint -- high-side a bed rail and your injuries are worse than they would have been had you only fallen from the bed -- and partially because patients were getting tangled up in them and being injured or killed.  Much of that could be solved by, ahem, defensive design (and the rest at least addressed by regulations), but we're woefully short on Edward Murphys these days.


Anonymous said...

The "above average" nursing homes are scary. Imagine how bad the bad ones are. And it helps that relatives are very much involved in the process. Trying to negotiate it on your own would be impossible.

A friend, looking at a long stay, as he deteriorated from stage 4 cancer, found the exit via a .45 caliber round (self-administered). I didn't really understand at the time, but I do now.

Maybe it is time to learn to ride motorcycles or something.

Roberta X, remotely said...

One of the reason I learned to ride was I asked myself, "If not now, when?" Didn't have a good answer. And I had wanted a motor scooter for years.

David aka True Blue Sam said...

A patient in a hospital or a nursing home needs a family advocate there to look out for them, or the bureaucracy will kill.