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A blog about our busy family with two amazing kids, one of whom happens to have Down syndrome!

Saturday, March 17, 2012

Surgery is rescheduled

I haven't updated since the "fiasco".

We have had lots of nursing students. I was obviously okay with that, seeing how I just was one not long ago! Until Thursday.

The nursing student assigned to Lauren seemed extremely nervous, which I would've been fine with except for the fact that I only saw the RN once that day. She never double checked the assessment or anything. Lauren had a small red spot on her foot that the student said she'd tell the nurse about. Well, she forgot. It ended up that Lauren's whole left ankle became red, puffy and hot. Lauren was obviously in pain. It wasn't even looked at by a doctor until around 15 hours after it was originally noticed, when the new nurse at shift change saw that it was getting worse (she marked it with her pen at the beginning of her shift).

The student also recorded a fever of 39.6, which is almost 104. She didn't tell anyone and recorded it in the chart. The RN she was following didn't double check the student's charting so it was missed. Nobody noticed that a fever of 104 was recorded until over 4 hours later. If you get a fever of 104 on a 4 week old baby scheduled for surgery in 3 days, you tell somebody immediately.

All of this resulted in Lauren having to get a lumbar puncture (spinal tap) done at 4am. She was so worked up and in pain from her ankle and blood draws and the lumbar puncture that she literally screamed from about 10pm to 5:30am.

I basically flipped out and yelled at everyone who would listen because honestly, all of those things combined are totally unacceptable. There is no excuse. So we no longer have nursing students assigned to Lauren. I feel really bad about it but maybe this group of students should be assigned to less critical patients.

They've been checking her blood for cultures to see what exactly the bacteria is so they can treat it effectively. For now she's on Vancomycin which is super strong and pretty much kills everything. She's had one negative culture since it was started, so that's great!

The problem is that Vanco eats up IV's like nobody's business. So Lauren has had a new IV every day. She is tiny. Her veins are tiny. There are no more spots for IV's. They want to put in a PICC line (a central catheter that goes much further into her vein and is a much better long term solution that repeated needlesticks for IVs that don't last) but the doctors want to wait until her infection is cleared up.

All of this means that surgery cannot happen on Monday! I'm actually a little bummed because I just want it over with. I spoke with the surgeon again (I met with him while I was pregnant) and he really put me at ease about her surgery.

Surgery is tentatively scheduled for Thursday March 22nd, pending blood cultures. She's a lot more comfortable and her ankle looks way better. Happy baby equals happy mommy, so we're all good for now.

I'll update again when we for sure know her surgery date.

3 comments:

  1. That is completely uncalled for. I'm so sorry. I remember Morgans first lumbar puncture, they tried 3 times and couldn't get it. They wouldn't let me stay in the room but I could hear her screaming and I just KNEW they would be calling a code because I was sure she couldn't possibly continue to breathe through the screams. The last 2 times M has needed blood work, she has been poked 3-6 times and never got it. It really sucks when it's hard enough they have to go through this anyway but why can't SOME aspect of it just be easy for them.

    I'm glad the first blood culture was negative, lord knows I've lost count of how many blood cultures we've had to do. I think usually if the first is clear you are probably OK especially for really bad things.

    We've never had the vancomycin but we normally get IM injections of rocephin which is a fairly painful shot, especially for a little one.

    I'm sorry the surgery was rescheduled and hope she is feeling better soon.

    And good job to you for advocating for Lauren, you did the right thing. A temp of 104 in a child that young is considered a medical emergency. Sheesh, did anyone even ask her why she failed to mention it? Or act like it was no big deal. She really should be punished in some way.

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  2. A PICC line sounds like a good option for Lauren. My little girl had one for about a month and I have had one for about 3 months during my pregnancy. Hopefully her infection will clear up and her care can be continued so she can come home soon!

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  3. Good for you for speaking up that is so important....the doctors, nurses and staff become so preoccupied with the routine. You are the best advocate for your little one...
    Kudos!

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