"Homeland" Extended Health Care

Crazy, busy week. Transcribing orders for new admits, I get to write about two words before the phone rings or a family member appears at the desk or someone phones to say, "'Frieda Last' isn't answering her phone. Can you check if she's all right, and if she can reach the phone?" [For this I went to Nursing School.] Or I need to jump up to do a treatment, i.e. dressing change.

Friday was nuts. Nurses have a superstition about the full moon, and since it's usually crazy to some degree, it would be hard to disprove. Friday was definitely lunacy. I walk in and find the day charge nurse getting ready to send someone out, and help with that; then there's a new admit that came it at two so I end up doing it; and someone comes back from a visit with the infectious disease group with orders seemingly impossible to carry out on a Friday night.

She needs to get started on an IV antibiotic, therefore has an order to put in a PICC line [a central IV-type line which feeds directly into the Superior Vena Cava and needs a specialist to place] and a CAT scan; neither of which can happen at "Homeland." Immediately I decide she needs to go out to the hospital ER, so I start calling ambulance companies. The first one has an ETA of 3-4 hours due to traffic and weather; the second one an hour or two. So I call the son to let him know. Then I think to call the hospital and they're like, "Are you crazy? They don't start a PICC line this time of night, and the ER isn't the best place to have a CAT scan done."

So about that time the Infectious Disease folks contact me and I find out I can have the antibiotic given with an IM injection until a PICC can be placed, and the CAT scan can wait till Monday. I call the son to let him know the change of plans. So now I'm canceling transport about the time the ambulance gets there, and changing the orders. This entire issue has taken me at least two to three hours to deal with. In the meantime the Infectious Disease doctor drew a syringe full of fluid from her wound which he sent back to Homeland with the patient for us to deal with, as if we have a lab on the premises.

I have to send the specimen back out to PacLab. I phone the lab. She answers the phone as she always does: "LabVicky." I explain the situation, that the specimen was collected at the MD office but he sent it to us. She hears the name of the MD's office. "Good grief! That's only 800 yards from us! What a cornball." This is the longest conversation I've had with LabVicky.

I finish the admission paperwork about 9:30 and get to start charting about 10:30 PM. At midnight the DNS phones me back: I had called her cell earlier when I was out of ideas how to get this person's antibiotic into her in a timely manner, but her cell had been off. About 3 AM I'm cuddling up in Eatonville with my dear for the first time in four days, due to not wanting to spend 45 minutes driving home at two in the morning on busy nights . . .