So far there hasn't been any new injury to Linda, but the problems continue. One of the nurses left the roller clamp on Linda's antibiotic open, and while no one was watching the entire contents of the bag ran out onto the floor of the room. When I came back from lunch yesterday there was a huge puddle on the floor right at the bottom of the IV pole, and that's when everyone noticed something was amiss. They were able to get another bag right away, but it's just one more example of the carelessness with which they are treating her.
This afternoon, Linda's feeding tube began to clog up every ten minutes. The nurse would flush the tube with a product called "clog buster" but the tube would clog again ten minutes later. This repeated itself six times in a row. Apparently the new renal formula of feeding they switched her to has a particle size too big for Linda's tube/ I pointed out to the nurse that the doctors and nutrition people were about to leave for the weekend, and that I found them going off with the situation unattended to was not satisfactory. The doctor came in at 4:15 p.m. and went to talk to the nutritionist about the situation. Obviously, since the tube can't be changed for another seven weeks, they are going to have to find another feeding product.
The nurse told me at 7 pm as his shift ended that the doctor had ordered a different feeding, but said it had not come from the manufacturer, and it’s now 10:15 and there's no feeding for Linda at all this shift. Unacceptable. I spoke to the charge nurse, who told me the feeding order has been changed two times since the last shift ended because the feeding the doctors ordered is out of stock. Shouldn't they check on that before ordering it? I don't understand how a hospital can leave a patient, whose sole source of nutrition is tube feeding, without anything by way of nutrition for a weekend, while the doctor and the nutritionist leave the premises until Monday without making sure the problem is solved.
Now two nurses are in here with a product they "think" will work. The way to find out is to hang it and see if it clogs Linda's feeding tube. When did patients become guinea pigs for running tube feeding experiments? There is no information available anywhere in the hospital about the comparative physical and chemical characteristics of these two products by which anyone could judge whether or not it is likely the new stuff will solve the clogging problem.
Seven hours with nothing to eat while the doctors are at the steak house on date night chowing down on their porterhouse and baked potato.
I don't know what else I could have possibly done for Linda beyond pointing out that if everyone went home at shift end without addressing this situation Linda would starve all weekend - and I did point out exactly that - and yet it happened anyway. Callous does not begin to describe the treatment Linda is getting - or more significantly, not getting. How can a doctor write an order for something on a Friday, when he knows there aren't any nutrition deliveries on the weekend, without checking to see if the product is actually in stock, rather than just being listed in the formulary?? It's as if I were to go to court without my trousers on.
As I write this an assistant administrator arrives in Linda's room with two bags of the prescribed product she cadged from cupboards in nutrition rooms on other units. What has become of the computerized inventory control that she needed to go from unit to unit peeking in cabinets to find the stuff? If I were in charge at Clarian Health I would be on the phone with the nutrition product distributors Clarian spends millions and millions of dollars with every year, getting the supplier to put a trunkload of the stuff in a car and start driving to Indianapolis right this minute. The new product is called Nutren 1.5 and comes from a Nestle factory, apparently in Minneapolis. No customs to clear. By FedEx there could be a case here tomorrow morning before 10:30 AM. The two bags in the room now would last Linda until then. Why do I have to be the one telling Clarian how to solve what should be a minor logistical problem? I'm not even getting a Porterhouse and baked potato. There was a fire in the Bistro last night, and there's nothing here for me but cafeteria food and MacDonald's at the children's hospital down the block.
People, beware! This is the state of health care in the medical school teaching hospital in the capital city of one of our midwestern states, BEFORE the federal government takes over health care in the name of cost cutting. It's an absolute shame. I'm copying the Joint Commission on this letter.
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