ICU ... Again

Dear Colleen,
I have been with Lana for the past seven days day and nights. Some of the RNs are competent and caring, others are only in nursing to follow all the rules and for the money. I caught both doctors and nurses making life and death mistakes this week.

Lana had been bleeding from her nose for two days and I asked for platelets. The answer was that she had 45 and did not warrant them. The next day a nursing assistant looked in her mouth with his flashlight and her entire mouth cavity was filled with bloody mucus which had the consistency of tar. She failed the swallowing test and also was unable to speak. They ordered a CT scan of her head which showed nothing. Not even her doctor or any of her RNs thought to look in her mouth.

They sent her to the intensive care unit and the RN there put her blood pressure cuff on incorrectly and was getting readings above 190/--. The cuff was timed to inflate every 15 minutes. The next time the cuff inflated I noticed that even full of air it wasn't touching her skin so of course she always got the highest reading it was pumped to. I brought it to her attention and she redid it. The next cycle read 158/-- and the following was 136/67. I informed the RN that these were her usual numbers. She threw me out of the ICU but while I was leaving I ordered her to correct the erroneous readings in her chart. I doubt that she did.

Lana is not able to speak and sleeps most of the time. She still has no white blood cells. The reading is 0.0. Her hope for recovery lies in her body's ability to begin making white blood cells. She has no fever but still has pneumonia.

One of her doctors resents my being there. His comment to me the other morning was, "You're here again!" He was not the doctor in charge who cares very much for my input.

Yesterday Lana was visited by the head doctor and eight assistants who were RN and MD interns. I had equal say with all of them and they made certain that my concerns were immediately acted on. They now clean her mouth out at least twice a day with a special suction device. It is easy if the blood is still less than a day old otherwise it becomes very thick and hard to remove.

I am still hopeful that what I am seeing is just "chemobrain" and not permanent mental impairment. It always takes two people to handle her and turn her and keep her clean. On several occasions she did lie wet for several hours. She has severe rashes on her back and genital area. You can see the value of my staying there 24 hours a day. They all know that they are being watched. Had I only gone twice a week for an hour or so I truly believe she would have died.
Joe