Announcement

Collapse
No announcement yet.

My dad is in ICU with 3 spinal injuries!

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

    #31
    Originally posted by kate
    The most important thing is for someone to be there 24/7 -- and it sounds like your mom ought not be left alone to fend off the doctors.

    Hang in there! We're pulling for you.
    We are all pulling for you! I'm glad that the others chimed in; it is especially important to be firm with the doctors and care staff. While it might seem as if you should just listen to the doctors and support staff, they are not there to advocate for your father. You need to advocate for his rights, and don't let the nurses and doctors bully your mom! Best wishes. You are in our prayers.
    Daniel

    Comment


      #32
      My wife FIRED 3 or 4 nurses, and 1 doctor while fighting for my helth and well being. You have this right! As I suggested before GET AN ATTORNEY! Going to the mediia is also a wonerful suggestion. I even talked to my congressman a couple times. He even gave me his personal cell phone! Help is out there! Go get it. Best of luck! You are in my my prayers! Dave
      Dave E. C6-7 Incomp. Quad 9-06

      "NEVER LOSE SIGHT OF YOUR DREAMS!"
      "THERE IS NOTHING BETTER FOR THE INSIDE OF A MAN / WOMAN THAN THE OUTSIDE OF A HORSE"

      Comment


        #33
        You guys are the best!

        I appreciate your support SO MUCH! I've printed out a bunch of the guidelines from PVA, and I'm going through them with a finetooth comb, esp the pressure ulcer guideline. I'm a nurse (with NO SCI experience), my brother is an attorney, and my uncle (dad's brother) is a hospital administrator, so between the 3 of us, we're setting up a good cop/bad cop situation. I can "work with" the staff to get good care for my dad and if there's any resistance, my brother swoops in (like he did today, and I believe they've dropped the idea of a transfer to Kindred), and if needed my uncle is planning to contact the administrators pretty soon. Contacting politicians and the media is also an interesting idea.... I have my designated notebook with me all the time, and I openly take notes in every conversation.

        My mom is there all the time, and at least one other person comes and joins her every day. She goes in at 4 am so she's gotten to know the night shift too, but they do kick us out for rounds at 7-10 am....

        We were thinking that, even before we get him to Santa Clara, we need to get him away from the Trauma Surgeons. It seems to me that they have done a great job with the trauma part, but he's no longer trauma--it's skin care, rehab, infection, and vent management. As my uncle says, the trauma surgeon needs a nice note and a box of chocolates from us, and we need some new doctors who are more interested in his current needs. Do you have any experience with getting transferred to a different service within the hospital, before we get him transferred out to a rehab facility?

        The eval nurse for Santa Clara came today and talked to me by phone, and she's going to come back tomorrow when I'm there....Do you know any magic words I should use to get them to accept him, complete with decub? When I talked to her today, she said that it's a team decision. She collects all the information about the patient's status, and then the team meets and decides if they can manage the decub as part of their plan of care.....(thanks for your prayers, and please focus them on getting him into Santa Clara!)

        I'm also concerned that he may have MRSA--is that a rehab-no go?

        DorAnne

        Comment


          #34
          A lot depends on the stage of the pressure ulcer. If it is more than a stage II, this could slow you up considerably in rehab. Be frank with the nurse from SCVMC. It is common to have the evaluator just collect data, and for an admission team to make the final decision. Tell her about how you have concerns about your father's safety where he is now.

          You can request that your dad be placed on another service, but it will depend on finding a physician who is willing to take him on, esp. in the ICU setting as I am sure you know not all physicians do ICU level care. You can try a neurosurgeon who is not associated with his current team. Most physiatrists will not do this, but should be consulting already. Is he getting PT and OT?

          MRSA should not be a problem. It is so rampant in ICUs now that we expect all our new injury patients to have it by the time they get to use in rehab, and we often have so many patients with MRSA that we end up cohorting them in rooms together (since we have so few private rooms). Any good rehab center should be able to manage this, and not keep him in his room either. With good hand hygiene and proper use of contact precautions by staff and visitors, he should have the "run" of the center including the gym and patient dining room.

          Keep on plugging like you are now, and ramp it up as needed. This is the time to throw around your weight a bit as a nurse (and attorney for your brother). Take pictures of his pressure ulcers as soon as you can too.

          (KLD)
          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

          Comment


            #35
            Kindred

            I assume they are looking at the Kindred in the Folsom area. Stay away! I have been contacted by their staff looking for SCI materials in the past. They don't really have a grasp on the issue.

            I have worked with many SCI in their 70's. SOme have done well, very well others have nott faired quite as well. I recently helped a T-10 70 yr old get into Sheherd, they were concerned about her age initially. She left walking. While she is the exception, she proved you can be young at 70.
            Every day I wake up is a good one

            Comment


              #36
              Good grief, woman, you're all over this. Well done.

              The only thing I have to suggest is letting them know how involved in his care you all intend to be. There was talk when my husband was having a wretched acute phase of putting him into a nursing home for a month or 2. I was petrified . . . and they told me later that they were willing to go another way partly because they had seen how much support he had. We kept the 24/7 visiting routine going for weeks in rehab, because he really was too much work for a nurse with other patients. It worked out.

              Comment


                #37
                Lungs vs pressure wounds

                I just got to the hospital and they are sitting him up again today. I asked them not to because of his pressure ulcer and they replied again that "lungs are more important than skin" . I agree, but it's the skin that may prevent him from being accepted in rehab. How do I insist without sounding like i'm willing to sacrifice his lungs?
                BTW where is Shepard located? Could he go there if he is not accepted at SCVM? Thanks
                DorAnne

                Comment


                  #38
                  Shepherd Center is in Atlanta, GA

                  Comment


                    #39
                    Yes, his lungs are important, but without rehab, and with the long term scarring and potential for osteomyelitis with a sacral pressure ulcer, they can be setting him up for a very poor quality of life. It is not either or....both can be achieved if they want to. You are going to have to push. Did you dad refuse to sit, and then they actually sat him against his will? If so, then you need to pursue this legally. It is a violation of his rights.

                    (KLD)
                    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                    Comment


                      #40
                      I just got over a large sacral wound and one of the things the doctor had told me when I had it was laying flat on my back put more pressure on it then sitting up. I don't know if that's true, but if you think about it, when you lay flat on your back it's kind of uncomfortable until you put your knees up.
                      C-5/6, 7-9-2000
                      Scottsdale, AZ

                      Make the best out of today because yesterday is gone and tomorrow may never come. Nobody knows that better than those of us that have almost died from spinal cord injury.

                      Comment


                        #41
                        Update on SCVMC

                        I met the SCVMC nurse this evening...had a meeting with her and my mom, the social worker from the hospital, and the discharge planner RN. Bottom line, the wound is too deep for SCVMC to take him yet. However, she definitely wants to work with me to get him to SCVMC ASAP--she explained that if they take him now, he will "use up" his rehab days and then he won't have enough days available later when he's ready for full rehab. Their policy is to avoid ALL pressure on pressure wounds, so he would not be allowed to sit or lie on his back at SCVMC...hence, only minimal rehab for probably a couple of months.

                        She (SCVMC RN) wants him in a sub-acute unit that will focus on clearing up his pressure wound while maintaining his lung health (either wean him or not, she doesn't care). She reviewed the pictures of his sacral wound...the first one was taken 1 week after admission, and it was very dark or black in the center, probably 2" across, with red streaks going out from the wound. SCVMC RN says that this facility is usually extremely good about avoiding pressure wounds, and given the necrosis of the tissue, she believes that the wound probably started from the time my dad laid on his tool belt at the time of injury, and then on the backboard for a few hours. I could believe that, since the nurses were good about turning him at least every 2 hours during that first week, and and the HOB was always flat because of his unstable spine.

                        Anyway, SCVMC RN gave us a recommendation of 2 subacute units (NOT Kindred) where she has visited and has seen good results from their skin teams..... So I'm planning a road trip tomorrow to visit the 2 facililties, unannounced, and see what sense I get from them. She has promised to remain in touch with me throughout the healing time, and is enthusiastic about helping me get my dad to SCVMC as soon as the wound heals.

                        In the mean time, I was able to mention my concerns about skin care to the discharge planner and social worker, in front of the SCVMC RN. I was able to quote the guidelines I've been reading, state the requests that I've made that have been ignored, and then turn to SCVMC RN to ask her what their practice is....and each time, SCVMC RN affirmed that my request was their standard of practice. Bottom line, DC planner and social worker apologized for the problem and promised to take my concerns to the "trauma rounds" team meeting tomorrow morning, and get the problems corrected immediately. HURRAY!

                        An ironic story from today (and proof that my dad is completely "with it" now: He was sitting up in a chair (ugh) with a brace covering his chest and abdomen, and I noticed that his resp rate was consistently 40 breaths per minute, with tidal volume of only about 350 cc (prior to spine surgery his tidal volume was over 800). I was trying to coach him to take slower deeper breaths, and I could tell he was trying, but he could only get up to about 450 cc. Finally, he mouthed "I can't." I asked him why, and he pointed to his chest/abdominal brace (I can't remember the technical term for that thing, and I thought the neurosurgeon said he didn't need it since all of his broken thoracic vertabrae were fused)......The ironic part was that the nurse this morning told me that he had to sit in the chair because his breathing is more important than his skin, but sitting in the chair was actually interfering with his breathing because they had put that silly (and I think probably unneccessary) brace on him..... And no one noticed the resp difficulty--my dad was the smart one who figured it out and communicated the problem! (and to think that "Dr. Death"--my new name for the head trauma surgeon--tried to get us to snuff him the first day!)

                        OK, I could probably go on forever..... Thanks for all your fabulous ideas! If you don't mind, I'll keep posting updates, so you can help me keep him on the right track!

                        DorAnne

                        Comment


                          #42
                          You said it DorAnne: HURRAY!
                          I'm so glad everything is coming together for you and your dad. What a whirlwind. Way to work the RN in your favor, that's what it takes! Good job. All the best today, I hope your surprise inspection is favorable.
                          get busy living or get busy dying

                          Comment


                            #43
                            Make sure the DC planner & the social worker follow through with their promises & action is taken. Its one thing to promise something in a meeting entirely something else to actually see things getting done. I trust you are taking notes at these meetings as to who said what & when. Yeah I'm cynical but I've spent a lot of time around hospitals & goverment, you need to document everything so you have proof when someobdy says "nobody told me that"

                            Comment


                              #44
                              Good for you! I hope you are feeling really empowered and good about being such a great advocate for your dad!

                              Many people with tetraplegia can breathe more easily laying down, or even in trendelenberg than they can sitting. This is because in the seated position the diaphragm is in a position to be adversely affected by gravity, and when laying down it is in a gravity-neutral position. If they are sitting him to try to get him breathing better, that is a mistake. He doesn't have COPD. Also ask about what exercises they are doing for diaphragm strengthening when he is off the vent. He should be using a Pflex and/or abdominal weights for this.

                              Is the area of the pressure ulcer completely bridged with foam or some other way of keeping all pressure off the area?

                              Keep in touch and let us know about your road trip.

                              (KLD)
                              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                              Comment


                                #45
                                Check out Craig Hospital in Denver. MRSA does not matter. Pressure sores don't matter. They are THE BEST! You also should never get kicked out durring rounds. This is your time to ask question to all of the team working with him. If they want you out, They are hiding something. They may ask you to leave durring shift change. But then you know all this being a nurse. Keep up thr fight!
                                Dave E. C6-7 Incomp. Quad 9-06

                                "NEVER LOSE SIGHT OF YOUR DREAMS!"
                                "THERE IS NOTHING BETTER FOR THE INSIDE OF A MAN / WOMAN THAN THE OUTSIDE OF A HORSE"

                                Comment

                                Working...
                                X