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2007 - June 20th - Wednesday

POSTOPERATIVE DAY ONE

JH’s obs(ervations) were taken by a ‘live’ Nurse 4hrly, ie, over and above the continuous monitoring of pulse, blood pressure, pO2 via – was it one or two leads attached to a digit recording digitally!?  Of course JH was not disturbed by the necessity of getting out of bed to PU as her urinary catheter precluded this!


 

JH felt very woozy but determinedly raised the head of the bed so that she could reach her breakfast:  At first a load of wind was retched up, but a slice of toast spread with ?butter and jam was eaten with enjoyment, and a cup of tea drunk.  At about 9.00am {but JH’s clock had stopped as usual} the usual interruptions were visited on the patient {who was of course pleased to be interrupted}!  The large black Charge Nurse looking after Kathy came and asked JH for the telephone number of her console – to give to Kathy so that K could phone JH.  On JH pointing out that she had not paid for the use of the Patientline console, she was told that its use was free – presumably between patients.  However, the Charge Nurse managed to phone JH but Kathy failed to phone JH – presumably the Charge Nurse had not been phoning from Kathy’s console.  In any event, JH had already mentioned that there was a fault on her console: in due course the Patientline ‘Engineer’ appeared and confirmed that JH’s console was not responding at all, and that inter-console phone calls could not be made - JH sent a message back to Kathy via the ‘Liaison’ Nurse to this effect.  [JH did NOT mention that she was too mean to pay for the use of Patientline in any case!] 

The lady and gentleman Registrars called by – with continuing suggestions about bowel management such as senakot, and lactulose, and suppositories the following morning.  A Consultant called by {as to whether he was Mr Chawdhery or a Renal Consultant JH did not record/remember}: JH was feeling so emotional that she said that she was not often lost for words but she was now.  JH was given reports regularly about Kathy by passing persons.  It was decided (again) that JH should be out of bed in a chair; mention was made of stopping the opiate PCA and replacing it with tramadol (JH had already received an oral dose of paracetamol).  JH received her meal of shepherd’s pie, swede, and peas – as ordered – and ate it with a certain amount of relish, and also with a certain amount of apprehension.

Discussion took place: it was decided that JH’s urinary catheter should be removed by Amelie, JH’s Named Nurse; however, as Amelie was still a Student – albeit in her third year of training – she was required to be supervised by the Staff Nurse whilst carrying out this procedure so, as all the Staff were required to attend a Meeting at some point in the middle of the day, the procedure was postponed until about 3.30pm (in fact the catheter virtually ‘dropped out’ after the retaining balloon - or whatever - was deflated).  Later in the evening JH used a commode, as she had failed to PU into a bedpan – without being able to dangle her legs over the edge of the bed: JH does of course recollect having trouble PU ing into a bedpan, after she had had her angiogram performed; also JH now had the added problem of losing the proper stimulation to her bladder in order to micturate – after having had an indwelling catheter in place for the last 24 hours or so!

Mary Andrews, the definitive helpful and sympathetic visitor (but not overwhelmingly so, and she did accuse JH of being drunk and disorderly on morphia) arrived at 4.00pm-ish with a basket of fruit, and with get-well cards from both herself and Mary Haddock.  And Mary arrived just as Mr Chawdhery and Co arrived on their Round - so JH introduced Mary to Mr Chawdhery who courteously acknowledged the introduction with no impression of haste in his manner.  Mary then helped the patient have a wash: this procedure was hampered because JH could not take off her hospital gown due to JH’s arm being ‘trapped’ in the gown by the PCA line (at some point the saline drip had been discontinued); Amelie was ‘not permitted’ to touch this line or apparatus; subsequently Staff Nurse endorsed the embargo on trammelling with the PCA line – and so JH stayed in her vomit-stained hospital gown.  JH did admit to Amelie that she was tempted to cut the gown off as she thought it was disposable!  Mary was then introduced to Ralph and Lorraine who had both arrived: Mary was taken round to see Kathy – with the message that JH had enjoyed the marshmallows, JH not having puked-up the lot, and herewith (the message) was the empty packet!  Ralph and Lorraine brought along a couple of get-well cards one from Lorraine, and the other from the Bill Hipseys: over the ensuing week of admission, more cards arrived (by hand or by post) from various friends known to JH, and from members of the family; furthermore, a few arrived after JH’s discharge and these were kindly forwarded to St Budeaux by the Ward Clerk.  JH compiled a list of all the cards she received which is on file {at April 2009} in her ‘Peri - and Postoperative Records’ File; the cards are in a box-file.    

Apparently the Pentecostal Pastor came to call on the Lady with the Tourette’s Syndrome (LwTS) but she was not to be found (possibly being in Devonshire Ward having dialysis): so the Pastor then walked round the Ward and gave everyone in the near vicinity an item of fruit; JH was given a banana because – as the ‘escorting’ Nurse explained – renal patients are not permitted to eat bananas because of their high potassium content, whereas JH has not got renal failure, but only one kidney now which was working perfectly, still!  JH was pleased to note that later in the evening the LwTS had understanding visitors who calmed this unfortunate patient with further kindliness.

Mary left to stay at Frances’s (Mary Haddock’s daughter) at about 6.30pm.  Subsequently, JH did not get her beef sandwich as ordered, because the Supper Lady had run out of sandwiches: never mind!  JH had a vegetarian meal of rice, swede, and peas, followed by a yoghurt.  Hussein, a busy Night Charge Nurse from Palestine ‘got the message’ about JH trying to use bedpans with no success, so he fetched a commode; after which (ie, after JH used it appropriately) he wheeled JH on the commode (ie using it as a mobile seat) to the four-bedded room to see Kathy – JH having been detached from her monitor, and the integrity of her PCA line being somehow protected by dragging along a drip stand (or was their one attached to the commode?).  Kathy was fine – commensurate with being encircled with all the paraphernalia required for her succour in this Critical Care Area; but JH felt distinctly woozy, and changed colour (KS): it was just SO HOT in Kathy’s four-bedded bay!  Hussein was anxiously summoned by Kathy, and the former rapidly returned JH to her bed by the veranda windows.  Later, JH sent a message via one of the Night Nurses, that JH was OK.  A friendly lady patient, whom Ralph had recognised as being a frequent occupant of the Ward, and who had informed JH that she spoke Bengali, Hindi, and English well, came to give JH words of thanks for being a kidney donor, and words of ongoing encouragement – which JH could hardly understand because these words were expressed with such a broad accent: however, the friendly message was clear, and much-needed, and appreciated.  Then another Bedlam Night began: screaming was heard through the open windows above the entrance to the A&E Department, to which was added the importuning of every Nurse by Grace, the ‘starved’ lady {‘starved’ being a less unkind epithet than ‘rampant’ which JH had written in her Diary before learning Grace’s name, and after JH had eaten Grace’s omelette} from an adjacent bed:- ‘Who is screaming?’ and again ‘Who is screaming?’ and on and on – to which there was no answer - and so both very distressed ladies were locked in almost macabre dialogue unbeknown to each other.


 



 
 
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