I won't get into all of the details right now because I'm trying to unwind before going to bed, but I will say that things are looking up. We still did not get to see an attending this afternoon, nor did we get the test results that we needed, but I did get to the root of the problem. Of course, that was around 9 on the Friday night of a holiday weekend so the attending had gone home (and only comes in for morning rounds and emergencies), but I do feel better knowing that the problem concerned residents not following (or knowing?) protocol and multiple breakdowns in the lines of communication.
Today, we did not have access to our daughter's attending physician, and while I understand we are in a teaching hospital and I appreciate that structure, it is NOT okay for a parent not to have access to an attending. I mean, I don't expect them to come right away or to take my call at home on the weekend or anything, but when, during the work day, parents have a list of 15 questions that the residents are unable to answer and outside nurses are coming to train you on home care post-surgery, you really ought to be able to talk to your doctor. Even better if the residents are there and can learn something and/or give their input, but, please, let me talk to the expert. They are why we are here. I'm happy to use the interns and residents as our first line, but if they can't answer the questions, they need to get the answers for me. And if they don't have access to the test results, they need to track down the attending and have them read them. (Seriously, the results have been sitting in the computer since 2 this afternoon, but only an attending (not even a fellow) can access them. And these results may chart the course for the next few days. C'mon.)
But - it turns out that we DO have access to our attending if the residents in question do contact them the proper way, which, despite my, um, persistent insistence, they did not (in fact, they told us they weren't allowed to contact him at one point!). So, I feel better knowing that the process is as it should be (though multi-layered - back to the teaching hospital thing), but today the process broke down, and that's not okay. But I make mistakes, too (who, me?), so I'm going to try not to hold a grudge, though I am planning on calling patient affairs in the morning just to make sure that things are handled better in the future - for us and for all the other families with whom these winsome and well-meaning residents will work.
(But if it happens again tomorrow, I'm busting open a can of whoop-ass.)
Ugh. We had a resident once who was assigned to our little guy after possibly laying eyes on him for 2 minutes. Wouldn't have been an issue but it was a weekend and after hours and our attending was gone but the chip on the resident's shoulder was not, and I was, in fact, just a stupid mom. So despite my constant complaints about how agitated the increasing doses of morphine were causing Dax to be, as anyone who laid eyes on him could tell you, she instead told me that "morphine is a sedative" and "could not possibly ever cause agitation." After I kept complaining she finally told me that she wasn't going to change the sedation regimine because she'd have to call the attending to do that and she didn't want to have to do it. A fellow finally wandered over and changed the type of sedative, I think to just shut me up, but in the end it was what Dax needed to rest so I could care less why they did it.
ReplyDeleteThere just needs to be a little more experience and knowledge under the belt before these guys are left in charge of anything other than the minor stuff!
And again, sorry for the way today turned out, but I swear on everything good you're going to love the button! Give it a month to have all the kinks worked out and it will be your best friend! (You know, other then Jesus :P)
I am so sorry to hear that the wonders of Vandy have caught up with you. I worked as a RN on Vandy's peds surgical unit and some of peds hem/onc. too, back in the day. Loved what I did. Hated Vandy. Which is why I quit. I am actually sadly shocked you've had a 2 year relationship with them and it's taken that long for something like this to happen. I hate that is has happened to you and Becca. I hope it all gets better, and you get your answers. (And truthfully, new residents just started. And all of them are afraid to call their attendings, but they all can- 24/7. So can nurses.) Hang in there!
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