Terrible Thursday...Part 3

When I arrived Dr. Karla filled me in. Before giving Heysi her third dose of chemo for this cycle, she became very pale, and was gasping for breath. They debated intubating her but instead gave her some medicine and oxygen. It got worse from there:

1. She now had a 103 degree fever and was vomiting and still pale.
2. We also realized that the oxygen that they gave her was not working...there was nothing flowing through the tube! 
3. I noticed that her IV was supposed to be changed 5+ hours ago and it was red, warm to the touch and blood was infiltrating the tube about 5 inches!
4. Heysi's mother told us that she had not seen the oncologist in 15 days! Somehow in these 15 days, the oncologist decided that Heysi was okay to have chemo.
5. He had not run any urine tests that she could remember despite the fact that Heysi was initially admitted with a kidney infection.
6. Heysi looked the weakest I have yet to see her. She quietly told her mother that she needed to go to the bathroom and her mother got the bedpan from under the bed and moved it under Heysi to urinate. The entire process was very painful for Heysi since her hip/tumor site had to move to have the bedpan under her.
7. There is no toilet paper in the restrooms in the hospital.
8. I asked the residents who were about to pass into the room to wait until after she was done urinating just a moment to give her a little privacy/dignity. They without saying anything turned away from the room and chatted in the hall for a moment. I told them she was done and they could pass into the room, but instead they continued to chat and then LEFT without looking at Heysi or any of the other women in her room.
9. I asked Dr. Karla why they would just leave like that and she said..."Ayla, that is what it is like here. That was the patient's only chance to see a doctor today and they don't care if they skip a room or not."
10. Then, the cleaning lady came to mop the floor of Heysi's room/hall with chemicals that were making even me nauseated. Ammonia and apple. Heysi, like most patients on chemo would, immediately started vomiting again.
11. We tried to tell the nurse of the IV needing to be changed and the oxygen not working and she was in the middle of preparing the medicines for her 60 patients that she didn't care either.
12. We then went to the social work office to tell them of her IV and oxygen and they said it was not their problem and that we needed to speak with the Medical Director of the hospital.
13. There was a long lone outside the Medical Director's office and he was not there. Luckily, Dr. Karla knew one of the Doctor's working there and told him of the situation and he will hopefully look into it.
14. Heysi's mom is tired and crying more and more frequently
15. The family members/friends, if patients are lucky enough to have them, are really the ones that know what is going on with the patients. They are doing the positioning of the patient, feeding, advocating, and doing assessments (not clinical ones...but still asking questions to rate/evaluate how patient is doing.)
16. The doctor's rarely talk to the patient, the patient's family and the nurses...they work pretty independently and do not look at much more than the patient's chart to see how the patient is doing....remember only the nurse and doctor write in the chart, so it doesn't reflect what’s really going on either
17. If a family member is to ask for something or offer information to a doctor such as "my daughter has vomited 10 times in the past hour" the doctor doesn't listen and instead is annoyed. The family member and patient are then labeled as problematic.
18. The longer a patient stays in the hospital the worse the patient's care becomes...Heysi has been in the hospital for 17 days.
19. Dr. Karla told me how "many patient's in the hospital die of dehydration (from not changing IVs) and hospital born infection."
20. There is even less medical care at night and on the weekends.
21. Dr. Karla also told me how "There are also many medication errors, neglect and no accountability."
22. I learned that they do not require teaching medical ethics in the medical schools here.

I wanted to scream/cry/hide/protest/eat an entire chocolate cake/vomit all at the same time. I cannot even explain the rage and helplessness I felt that day. There was so much that could have been done better for Heysi and all of the patients in the hospital. It bothered me that instead of talking about the neglect and awful care of Heysi's case, Dr. Karla explained the situation in general statements that referenced the entire public hospital system. Heysi was not just having a bad day at the hospital. She was experiencing the norm for the public hospital system. We are going to try to get Heysi out of the public system as soon as we can. She could die not because her disease but due to the injustice of the public health care system. I cannot write anymore about this right now, it is making me upset and I am crying again.

Please pray for the many people I have mentioned in the Terrible Thursday posts.

Love,

Ayla Landry

"God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference.” ~The Serenity Prayer