From the hospital - Sunday, November 16, 2009

Please note: I will be frank with the issues surrounding my medical care at St. Barnabas Medical Center (SBMC) and it may seem at times that the negatives outweigh the positives, but they do not. I choose SBMC as my hospital because I get superior care there. I discuss the problems to assist in making this an even better place for patients, and to give other patients an example of actively participating in one's own care. If a patient cannot actively participate by her or himself then I strongly suggest that the patient have a personal patient advocate to assist them in dealing with the issues that arise in the hospitalization of the patient.

It's 2:20 AM and I am sitting on the side of my bed typing on my laptop and waiting for one of my favorite night nurses to show up for her two o'clock rounds to take my vital signs: blood pressure, pulse, temperature, and oxygen level. I have just looked up the side effects of the inhaler drug, albuterol, and entered the information in yesterday's post.

My night nurse came by before 2:30 AM and said I was doing fine, and she had wanted to let me sleep a little longer. They have monitors at the nurses' station that show the heart waves from the monitor attached to my chestthe data transmitted wirelessly. I told her about this website and said I would give her the url after she indicated interest. I had clicked on The Old Man link (on the upper left side of this screen).

After she left I went to make a cup of tea. I had saved a lemon wedge from an earlier meal. The pantry with water, a microwave, a frig, and a drawer full of condiments and teabags is down the hall and patients are allowed to use it.

As I took my hot tea out of the microwave, I noticed blood around my IV access on my right wrist. I finished preparing my tea by squeezing the lemon wedge into it and then went to the nurses' station where I asked for my nurse and showed the nurse at the station the dried blood on my wrist. She checked with my nurse—they have a hi-tech communication system for talking to each other here—and learned she was on her break. There was no reason not to, so I decided to wait until she returns rather than request immediate attention from the nurse on duty ... and came back to my bedside to drink my tea and continue writing this post.

By 4:30 AM I had my IV replaced. Because I don't have good access veins in my right arm, and they can't use my left arm because of the dialysis access, getting any kind of a stick—the insertion of a needle for drawing blood or an IV—can be something of an adventure in minor pain. But this time the nurse who did it was competent and the discomfort was minor. It wasn't my night nurse. My night nurse cleaned me up and then asked for assistance from another nurse.

At the end of the procedure I realized that I should not have had the tea. The cardiologist on duty Sunday had ordered a procedure for Monday that required me to stop eating and drinking at midnight. I'll just have to tell them that I had three-quarters of a cup of tea between 2:30 and 3:30 AM.

I slept until 7:40 AM, then at 8 AM a tech came to draw blood. She had to get my nurse to shut off my Heparin drip. My night nurse came . . . nice! The tech left saying she would be back in a few. They have to let the Heparin clear out before they can draw my complete lab set.

Then at 8:15 AM a respiratory tech came by with an Albuterol treatment. My day nurse, who looks like another great one, met the tech at the door to the room. My nurse asked what the treatment was for. When she found out, she told the tech that I would refuse the treatment. I had told my new day nurse my Albuterol story. The tech was pleasant but she had to hear it from me. I told the tech I fit the patient described in the drug info as who shouldn't have Albuterol, and I could not understand why they were trying to give it to me. I am going to have this conversation with my doctors. The tech told me in an apologetic tone that if the order didn't change she would have to come back at 2 PM and listen to me again. Note: I am going out to the nurses' station and have them put Albuterol on my list of allergies.


At 8:25 AM a different tech came and drew my blood. She checked with my nurse on how long my heparin drip had been off. My nurse cleared me to have my blood drawn.


In full gear at my bedside on the morning of Monday, November 16, 2009.

It's 9:25 AM and my new day nurse is proving to be another good one, as my night nurse told me she would be when I came out on shift change this morning to check on the transition.

9:45 AM: I didn't have breakfast and my nurse doesn't know what is scheduled for me. I certainly don't know. What I do know is that I am not going to have stents put in my heart arteries without a long discussion. This is the first time I have been kept this deeply in the dark.

The lung specialist came by and I told that I was not pleased with having an Albuterol treatment prescribed.

My IV started leaking. I called my nurse and she came in and tightend the connection at the needle, cleaned me up, and said I was good to go.

10:05 AM: My backup nephrologist came by. I told him that I didn't want any lung related treatments until after the tests were complete and analyzed AND the results explained to me, the same as I told the lung specialist.

10:30 AM: My primary cardiologist came and is discharging me with a nitro prescription. He canceled my breathing test and will do it as an outpatient.

Then my nurse came by and gave me my medications to take. There were a couple of pills that I didn't know what they were for. My cardiologist explained one, a different name for Pepcid. I will have to ask my nurse about the other.

Then my backup nephrologist came by and told me that my potassium was high, 5.8. I remarked that I didn't know why that was, I had only been eating hospital food and they have me on a Renal diet. He ordered a medicine (Kayexalate) that pulls the potassium out of my body. He offered to give me a couple hours of dialysis, but I turned that down, opting for the medicine. Note: I have since read the literature on Kayexalate. I should have chosen dialysis. But I have had nothing but positive experiences with the medicine, and it what was always given me when I went to the ER with high potassium levels (5.0 +) before going on dialysis.

Now I just have to wait for the potassium medicine and then go through the final discharge process including taking the IV needle out of my right wrist and the monitor off my chest.


Sitting on the side of my bed midday Monday, waiting to begin the discharge process.

Before 3:00 I took monitor off my chest and laid it on my bed to turn in later.

The order of the medicine to pull the potassium out of my body was placed at 11 AM and it was given to me at 3 PM. My discharge is equally delayed. Note: This is an example of how understaffed hospitals are becoming. IMHO.

I signed my discharge forms at 3:40 PM and 5 minutes later I was sitting in front of the hospital waiting for my ride home.