Wednesday, December 16, 2009

Plans, By Golly


That was approximately the sound of me hitting a wall last night. Jesus. Turns out to have been more of a hedge than a wall, because I made it through. But, man. I was not a treat last night. Or this morning. The whole idea that I have to become a physical therapist (and eventually an occupational therapist, and eventually-er a speech therapist) on top of becoming a respiratory therapist, and an ICN nurse on top of the stuff I already do... well, it sorta felt like a lot to tackle. (That there would be an example of "understatement". Because what it actually felt like was a sledgehammer of responsibility pounding me into the ground.)

Amazingly, it was being back at the hospital that made me feel easier. Is that wrong? I don't care. It helped to see Jane, of course, and it helped to see our awesome nurses, who truly have become part of our family. Tom isn't really kidding when he talks about hiring them away from the hospital and bringing them home with us. And it helped that we had such a good meeting this afternoon.

Ah, the big meeting! Let me try to count heads: Dr. L the attending, the effusive Dr. R who will be the next attending, the clinical resource coordinator, the respiratory therapist from our home medical supply company, our social worker, the transitional long-term care coordinator, the developmental therapist, and three of Jane's primary nurses (one of whom, the Awesome Donna, drove in on her day off to attend! Do you see what I mean about these people? Who does that?). I am almost certainly forgetting someone. Sorry, someone!

Anyway. So Tom took the reins, the way he does, and expressed our gratitude for the team and all they've done for us, and then recapped where things are and our goals for Jane's care: reducing the lobe, avoiding surgery if possible, and getting Jane home. (Seriously. And he does this every time we have one of these meetings. It impresses the hell out of everyone, but it also sort of cracks me up.) We all spent the next hour hashing out what needs to happen, how it needs to happen, what we've been seeing in Jane lately, etc etc etc.

And it went really really well. I mean, really well. Dr. L is pretty old school, and people, we need a little old school. He agreed with everything Tom and I had to say, which was gratifying, but even better than that, far more important than that, was that he said that the plan that he and Dr. R are going to construct (with input from Dr. Boston) is going to be strict. Not in the rigidity of its implementation, which isn't always appropriate (you all know just as well as we do by now how easily things can change, and plans go right out the window), but in who will be responsible for implementing it. That's right! No more willy-nilly issuing of orders by random fellows and residents and therapists. The attending will be in charge, by god, and everyone else WILL fall in line.

I loved that.

They are making sure that everyone who has any involvement in Jane's care is aware of and adhering to the new plan. And, possibly best of all, they are taking the role of our primary nurses very seriously and said, in so many words, that Tom and I can say no to any changes unless or until a primary is around to sign off on it. Praise Jesus! Seriously. I could get religion over a thing like that. Awesome Nurse Angela earned her title by speaking right up and pointing out that there is NO reason for random people who don't know Jane well to be making changes to her care.

It was all just exactly what we needed. We got to air out some minor grievances without presenting them as such, we got some clarity on the approach to Jane's care, and Tom scored some major points with Dr. L. Get this, the doctor actually pulled Tom aside after the meeting and said, "I just want to shake your hand. That took balls to do what you just did." Honest to god! And he also said stuff like, "She's going to get through this. We've got some work to do here, but I think she's going to be okay."

And Dr. R was absolutely adorable about Jane's forays into breastfeeding. Apparently she didn't know about it, and when I mentioned it with regard to the whole rate thing, she about jumped out of her chair. "You mean to tell me that little girl is breastfeeding?" She was beaming. It was lovely.

It was exactly what we needed.

Uh, there is no actual plan yet. But he said they'd have one ironed out within 36 hours AND have everyone on board with it.

And to that, I say BRING IT ON.


Rachel said...

Yay for a good meeting! And the plan can wait. Getting everyone to know not to mess with it sounds huge, though! Yay for everyone!

Anonymous said...

That is so many kinds of awesome! Wunderbar, wunderbar, happy, happy, joy, joy! (And, lest I forget, yay!)

artandsoul said...

Tia - you're amazing. You and Tom are doing SO well with all that you have going on! Hitting walls (or hedges) is probably part of the territory, and I'm grateful that you have each other, good family and good friends to see you through. And you will get through!

You have two adorable daughters and I know that you'll be able to provide whatever care Jane needs... this is what you would be doing even if she weren't hooked up to all those tubes and machines! I feel certain that with all your care, determination and knowledge Jane will come through to the other side - very hopeful stuff that the doctors said!

Peace, I wish you peace for the next few days and prayers continue for healing!


Renee said...

You guys may have changed the way things are done at the hospital for every child that comes after you. They will likely have a "lessons learned" meeting with the hospital staff and the first item will be "Jane's Lesson" -- "No more willy-nilly issuing of orders by random fellows and residents and therapists. The attending will be in charge, by god, and everyone else WILL fall in line."

Jessica said...

FINALLY! Dr. L is the best in ensuring a plan is developed and stuck to. He too gave us the power to say NO to any changes we don't like and made a plan for our little guy. He is the best and I agree with old school is sometimes what we need. We had Nurse Angela and Donna many times on our little guy so they know the ins-n-outs of having a pesky lobe so I am wicked excited that the primaries are being listened to, FINALLY! Good luck and keep the post coming, I DON'T WANT TO FIND YOU IN BOSTON :-)

Anonymous said...

These photos actually make the curtains look pretty!!
Mary Lou