Monday, August 16, 2010

Can I get a witness...

Can I get a witness,
can I get a witness?
--Sam Brown, "Can I Get a Witness"

The song title is kind of random for the subject of this post, which is the nurses here at CHOP. The title comes from me walking through the CICU and hearing one of them ask, "Can I get a witness?" What that means is that they need another nurse to come in and check behind them to be sure everything is done correctly. They are required to get a witness for certain tasks, including adding a new drug, a dosage change, and a triple check when he gets any blood products. Since Jay got a boatload of blood products (friendly reminder to give blood if you're able!!), and is getting dosage tweaks & new drugs pretty routinely, we hear a fair amount of "Can I get a witness?" They are vigilant about checking/double checking everything, which is very comforting given the sheer amount of "things" that get done to him.

He has one on one nursing care everyday, and each nurse is on for a 12 hour shift. He also has an ECMO specialist assigned to just him. So there are two people focused just on his care 24 hours a day. It seems like overkill to have 2 people in the room all the time, but he is currently getting 13 different IV infusions at a time (not counting the ECMO) so there is almost always something to do.

One of the little things they are very concerned about is making sure he has a good mattress. They switched him to a "Rik" mattress, which is kinda like a giant cloud to sleep on. (Let me add for the record that while they are very concerned about the sleeping comfort of their patients, they aren't nearly so worried about the squishy-ness of the parent beds. One night, my pillow was so flat I seriously thought they had forgotten to put the pillow into the pillowcase. Not complaining, mind you. Just sayin'.) But Jay's mattress is so awesome that it adjusts to his position so that he doesn't get irritation or put too much pressure on his little hiney, head or heels. While a new mattress may sound like no big deal, it took an army of people to get him on it. One person to hold the cannulas for ECMO (definitely don't want those to come out!), one for his breathing tube, one for his top half, another for his bottom half, and another to put the mattress in while the other 4 lifted in unison. They definitely waited on his arrhythmia to improve before attempting this, but with all of them and 15 minutes of planning, it went off without a hitch.

There are lots of other little things that are just good nursing care, but make a big difference in his comfort. He gets a wipe down bath once to twice a day, which again is a bit of an ordeal to roll him onto his side so they can clean his back. He has a little gown on--it probably doesn't matter a bit to him, but we certainly feel that he looks better that way. Also in the way of clothing, he now has some Buzz Lightyear boots (not really, but they do some what resemble space boots) that help keep him from getting "dropped foot." That way when they let him walk again, he'll be able to.

Hand washing and infection control are huge. CHOP was recently named the top hospital for nursing care, but didn't have the top spot for patient safety. Now they are gunning for that too by putting a huge focus on preventing infections through urinary catheters, IV catheters, ventilators, etc. Every visitor gets grilled about coughing and runny noses and is instructed in proper hand washing.

All that is great, but more than anything they treat Jay like a person, not just a case. Before doing anything, they explain what they are doing and ask him to help (open your mouth so we can clean your chompers!). Several have stopped by to check on him when they were assigned to a new patient on their next shift. They want to know what he likes, and when they found he likes tools, they did this:

It may be hard to tell, but the tool box at the bottom is an actual tool box, so the window art is 3D! I'm not sure if this means he is a favorite, or that we are going to be here a while--either way it brightens my day when I walk in, and will certainly make him happy when he wakes up.

Last, the nurses are quite concerned about us. On Wednesday night after Jay arrested, a nurse from one of the other patients spent the entire time with us. She constantly went back to check on how things were going and made sure we knew what was going on. She was super-supportive and still drops by to check on us each day. We've gotten to know several of his nurses and ECMO specialists quite well, and it always reassuring to see a familiar face at shift change.

As for actual Jay news, he had a good night last night hanging out with the guys--he had a male nurse and male ECMO specialist. We joked that they would put some pizza and beer in a blender and put it in his nasogastric tube. Hopefully today will be a quiet day today with more rest and recovery.


Anonymous said...

Send me that pancake of a pillow and I'll send you one of our too big and fluffy ones. You know I don't mind! ;) When I got home, last night, I put on my "saw" silly band that Jay had given me. Tyler has the pliers. Here's to another good day...


jeannette said...

Love the Bob The Builder poster and so will Jay!! I loved that you gave a "High Five" to the nurses, ECMO people and all the others that truly are the ones that make these hospitals run so smoothly - nothing against the wonderful docs but these folks are usually the "unsung heroes" among us!! Here's to another good and more steps in the right direction!! LYTB - AJ

Rebecca said...

Good morning! So glad Jay another good night. And so thankful for the wonderful group of people working with him and you all. Special people all around.
I have had the song "Beat It" in my mind ever since I read your post yesterday. It is now my constant reminder to pray specifically for the beating of Jay's heart. Who knew Michael Jackson would play such an integral part of my prayer life?!?

Emily Erin said...

So delighted to see that things are going well! I am so glad that CHOP works to make the hospital personal and child friendly-- it makes such a difference! Still sending up lots of prayers, but many are prayers of thanksgiving!

Anonymous said...

Jen - I am a friend of Jane's and just wanted to let you know we are praying also. Our family had a similar experience only at the Cleveland Clinic and you will find your nursing staff to be the angels on earth to help you! They are wonderful for information, support, sounding boards and just sometimes can "get the ear" of the doctor when you are unable. May He sustain your days (and nights). Praying for the next test and encouraging reports. Rhonda

anna claire said...

Prayers are with you, my daughter spent 8 days on ECMO and I know how rough it can be! She also had rhythm issues and now has a pacemaker. Praying for a smooth recovery!

Beth said...

Thank you, thank you, thank you for the shout-out to the hard-working nurses taking care of this precious little boy. Give them an extra thank you from me.

Gabby, RN

Becky said...

Wow, that hospital sounds great! I've been to many hospitals where some of those preventative measures get forgotten. The nurses can really make or break your sanity.

Anonymous said...

The nurses sound wonderful! They obviously care a great deal about all of you. As the sister of an MD who works in a hospital, I know this: Although the doctors don't spend as much time with the patients as the nurses and are often rushed when they do, they spend a lot of time thinking about their patients, trying to figure out what's going on, and yes, praying for them. I'll bet Jay has a whole team of doctors doing that -- including some you've never met!

We look forward to seeing all of you back at FBC when Jay is well! So many people at church are praying for your family.

Lynn Marshbanks