Monday, February 28, 2011

The Procedure: Part 1

Last Tuesday Ellie went in for an upper GI scope and biopsy and a colonoscopy. Due to some very last minute changes in childcare, I headed to the hospital with Ellie by myself. My 5 year old has been put under twice at Sutter Davis Hospital and I was impressed both times with their professionalism and ability to work with children. This time we headed to Sutter Memorial, and a different experience.

I had some difficulty finding the pediatric check in station because it was a regular nurses station in the middle of the hospital floor. The check in staff and nurses that got us situated were very nice and accommodating. As we checked in, Elianna coughed her nasty cough, and so began a round of questioning about whether or not she was sick. I reassured her that she was not ill with a bacterial or viral infection, but that she had respiratory issues as well as allergies I needed to discuss with the anesthesiologist. I was told that she would let our nurse know, and so began the multiple 'blow offs' I would receive.

We waited in a regular hospital room that we shared with another toddler who was having a procedure done by our same, favorite GI. We would be going out of the room, around the corner to the next room for the procedure, and then Ellie would be wheeled back into the spot where she was at for recovery.

From the moment I met our nurse I began requesting a consult with the anesthesiologist, and was reassured that I would get one because that was routine and everyone got one. He listened to my concerns, and listened to Elianna's chest to tell me that the lower portion of her lungs was restricted and concerning, and that he would have the anesthesiologist listen to that as well.

The child life specialist came in and expressed sympathy that I was by myself and provided a bunch of stuff to entertain Ellie. She was a great resource to have. We were off to a good start....for about 45 minutes. The clock ticked, and no one came for us or the little girl next door. She was supposed to be first, and we were supposed to be second. Then they moved her out into the hall, and wheeled a teenage girl into her spot. And the time for Ellie to go into her procedure passed. At least we weren't waiting in the hall. I finally asked the nurse about the delay, and he said that we had been bumped due to an unexpected procedure brought from elsewhere in the hospital. That was fine, but they could have let us know. Especially since Elianna had not eaten for 4 hours at this point when she is used to eating about every hour.

In the meantime I continued to ask for the anesthesiologist, and our nurse said he had spoken with her directly and that she said she was coming to discuss the medication as well as listen to the respiratory issues.

Finally the nurse came in and put Lidocain on the backs of her hands to prepare for the IV. They gave me instructions saying that I would be sitting on the gurney with her, holding her while they put the IV in, and then I would ride with her in my arms into the procedure room and stay with her until she was asleep. Multiple nurses spoke with me about how she would suddenly go limp in my arms and how her eyes would roll back. It was traumatic for some moms but not to worry, it was normal. I tried to brace myself for it.

And I asked for the anesthesiologist again.

The time to put in the IV arrived. We climbed up onto the gurney and the process began. We started with two nurses and myself. Soon they were yelling for someone next door to come and help, and then asked the child life specialist to come and assist. Ellie is a fighter, and this showed through. Nurses dropped things and didn't have things, and it got more and more chaotic. There was blood on her hand and blood on the sheets, and blood on me. And she screamed. Another nurse came in to help. I realized that I was the one holding her body and felt an incredible sense of responsibility. This was not my job! I began to get angry that four of them could not hold one arm, and I began to cry. The child life specialist stroked my shoulder and I tried to go back to that place of 'it is what it is'. They finally got it in and let go to find more tape, but left the flush attached which Elianna promptly began to swing all over the place and grab in an attempt to pull the IV out. Once more it was left up to me to make sure she didn't yank on it, and the child life specialist trying to get the attention of the nurses between clenched teeth. It took them all to find tape? Ten minutes later the IV was in and her arm was taped like a cast. They wanted to make sure that she couldn't pull it out and they would have to start over. So much for limited exposure to adhesives.

I tired to calm her while the child life specialist tried to wipe up the blood. Ellie was no longer mad; she was afraid. And it hurt my heart.

I asked for the anesthesiologist one more time, but was pretty worn down. This time our nurse blew me off, and was clearly uncomfortable. She would talk to me IN the procedure room he said. In retrospect I believe it was because they were behind schedule, but they were no longer winning awards with me for bedside manner or quality of care.

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