Yesterday, instead of discharging Ambrose, the doctor was going to treat him for a urinary tract infection. His urine sample from Saturday had come back positive with thousands of colonies of bacteria; this was not surprising because on Saturday the ER staff was unable to catheterize Ambrose after two attempts, so they taped a plastic bag around him which contaminated the sample which they then sent off to the lab. So yesterday the doctor wanted a clean sample so he can narrow down which strain of bacteria to treat with IV antibiotics. I watched in horror while the nurses literally "tag-teamed" Ambrose in 7 unsuccessful attempts to start an IV line, and three failed attempts for a catheter, the last of which drew blood.
Well, that was my limit. Momma Bear had to protect her little cub. I told them I was not going to allow them to poke his little veins anymore, they could treat him orally or with an intramuscular antibiotic. I also decided that he was going to pee in a cup the old fashioned way, even if I had to wait all day for it. I just had to wait a few minutes after his next feed and promptly handed the specimen over to the nurse who gave him a one-time dose of the IM antibiotic.
Overall, we have not been satisfied with the care Ambrose has received during this stay. Pediatrics is a world away from Neonatal, it has a very "do-it-yourself" feel to it, and it seems as though the right hand doesn't know what the left hand is doing. I've taught myself how to use their enteral pump, because it doesn't appear the nurses intend to keep his feeding schedule. His plan of care changes as often as the attending staff. We are having to be very vigilant as Ambrose cannot be left alone, because it seems the nursing staff only monitors him electronically from the nurses station. The other day as Ryan re-entered the unit after a quick trip to the lobby he could hear Ambrose screaming and his monitor alarming practically from the elevator. One of Ambrose's nurses happened to be passing by the room and casually pointed out to Ryan, "I think that's your baby crying." He wanted to respond, "When I tell you that I'm leaving the floor, that makes him your baby!"
Happily, I have a wonderful mother-in-law who is keeping the rest of our brood so I can hover over Ambrose 24/7. And he has had lots of visitors from the Nursery ICU, including all of his doting primaries.
We also got the results of the hip ultrasound from Friday, which showed that Ambrose suffers from hip dysplasia on his right side, possibly because he was in a breech position in utero. Treatment for this is simply to wear what is called a Wheaton-Pavlik harness for three weeks, which will hold the legs in a position which should correct the joint. It's super dorky looking but has already provided some comfort. Charlie will be checked out too, because Ambrose doesn't want to wear a goofy looking harness all by himself.
Well, that was my limit. Momma Bear had to protect her little cub. I told them I was not going to allow them to poke his little veins anymore, they could treat him orally or with an intramuscular antibiotic. I also decided that he was going to pee in a cup the old fashioned way, even if I had to wait all day for it. I just had to wait a few minutes after his next feed and promptly handed the specimen over to the nurse who gave him a one-time dose of the IM antibiotic.
Overall, we have not been satisfied with the care Ambrose has received during this stay. Pediatrics is a world away from Neonatal, it has a very "do-it-yourself" feel to it, and it seems as though the right hand doesn't know what the left hand is doing. I've taught myself how to use their enteral pump, because it doesn't appear the nurses intend to keep his feeding schedule. His plan of care changes as often as the attending staff. We are having to be very vigilant as Ambrose cannot be left alone, because it seems the nursing staff only monitors him electronically from the nurses station. The other day as Ryan re-entered the unit after a quick trip to the lobby he could hear Ambrose screaming and his monitor alarming practically from the elevator. One of Ambrose's nurses happened to be passing by the room and casually pointed out to Ryan, "I think that's your baby crying." He wanted to respond, "When I tell you that I'm leaving the floor, that makes him your baby!"
Happily, I have a wonderful mother-in-law who is keeping the rest of our brood so I can hover over Ambrose 24/7. And he has had lots of visitors from the Nursery ICU, including all of his doting primaries.
We also got the results of the hip ultrasound from Friday, which showed that Ambrose suffers from hip dysplasia on his right side, possibly because he was in a breech position in utero. Treatment for this is simply to wear what is called a Wheaton-Pavlik harness for three weeks, which will hold the legs in a position which should correct the joint. It's super dorky looking but has already provided some comfort. Charlie will be checked out too, because Ambrose doesn't want to wear a goofy looking harness all by himself.
UPDATE 4pm
Ambrose has received a second shot of the antibiotic today to cover him for the next 24 hours. In that time the urine culture will complete its 48 hours growth. So far the culture is negative, but if it becomes positive, he will get a renal ultrasound, which is routine for very young people with UTIs. If the ultrasound is normal, he can discharge on oral antibiotics as early as tomorrow night and follow up with his pediatrician. If the culture remains negative until tomorrow night, we will still have no idea why we are here, and he will in effect have been treated for nothing, but he will discharge home anyway on whatever O2 liter flow he requires, right now he's at 1/4l.
I don't know if you know this but.. after a couple of pokes, they can call up to the NYICU and the high risk nurse can come down and start his IV. You can also request that. I have been called down there many many times to draw blood or start IV's. Sorry that you had to go through that. Poor Ambrose, makes me so sad. Keeping him and your family in our prayers. Now my kids are asking every day how he is doing and are checking the blog with me.
ReplyDeleteNurse Terri
I've had a nurse poke me over and over again trying to get an iv in my arm...i know how it felt and i can just imagine poor ambrose going thru it...poor ambrose. good for you for sticking up and telling them to go away! my hubby finally told the nurse to go away and send someone else to put in my iv. she stuck me 10 times in two different spots...the second nurse got it in first try...go figure. i hope he gets to go home soon. keeping you all in my prayers.
ReplyDeletelove, nicole t