Monday, June 13, 2005

Oh My

The continuing saga of Rose........She actually refused to go in the ambulance on Friday night and avoided the police who were sent by Protective Services by leaving the house and staying with her daughter. The visiting nurses thought she was hospitalized so Rose missed her methadone and other meds all weekend. Damn!

Today I physically brought her to the clinic to see her primary doctor. After multiple telephone consults on the phone between us, Protective Services, and the hospital, we convinced the hospital to allow us to "direct admit" her, bypassing the ER and going straight to a room. I sent her home extracting the promise from her family that she would go to the hospital as soon as the call came that a bed was ready. I crossed every finger and toe.

At 6, the Admitting Dept called me--the bed was ready. A quick call to the daughter and Rose was on her way to the hospital, at least for a 24-48 hour tune-up while we buy time to figure out what to do next.

At 7:30, her daughter calls me on my cell while I'm at a meeting in my hometown for one of my volunteer gigs (she has Caller ID and has my cell # now)---Rose snuck out of the hospital fifteen minutes after her daughter dropped her off and was on their front step like a puppy dog within forty minutes! I pleaded and cajoled them to return, which they eventually did. Just now (10pm), I called the nurses' station on the floor where she is staying and suggested they give her some Ativan and post security at her door to keep her from leaving in the middle of the night and putting herself at risk on the dark streets. She has AIDS dementia, after all. The friendly nurse on the other end of the line agreed to bring this up with the attending physician stat. That was my 11th phone call about Rose today, and I interacted in person or on the phone with at least six other patients and/or providers in the course of the day---plus the ubiquitous paperwork which such interventions necessarily generate.

Now it's 10:30 and I ruminate. Could I have handled it better? Was my game-plan on Friday a mistake? Most likely. Will Rose get through the night at the hospital? I hope so. Will I sleep tonight? That would be nice. Does the week stretch before me like a gaping maw of unmet need and unknown crisis? Most definitely. Do I still love my work and maybe enjoy the adrenaline and drama? Is the Pope Catholic?

Well, The Daily Show with Jon Stewart is on soon. Must take a shower and settle in for some laughs. Maybe it's me who needs that Ativan......
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