Monday, 9 March 2009
Does He Really Need To Go Tonight?
It's been an eventful weekend. It started with a large vomit at 6.30 am on Fri. I had a feeling in me waters that, for Rory, this was going get worse before it got better. Me waters are rarely wrong. As the day progressed, the bug took hold. Phone calls back and forth to Temple St. ironed out a plan. The plan then changed hourly. Initially, I had some success giving saline fluids down his NG tube. But, as the afternoon rolled on, he was tolerating less and less and I was playing catch up with his fluid balance. If action wasn't taken quickly, we were looking at dehydration, which is never a good idea with a transplanted kidney.
We assessed the situation, weighed up the time it would take in Friday evening traffic to get to Temple St., versus the time it would take for Rory to get into difficulty. I/V fluids were required fast. With the team in Temple St., we made the decision to go to Galway hospital to get an i/v line started before transfer to Dublin.
The Paeds unit in Galway has been an invaluable support to us. The nursing staff there are second to none. They provide that wonderful combination of professionalism and humanity.So, I made all the arrangements, left Jess with her granny and auntie, then made a run for it.We were met at the door, they had liaised with our consultant in Dublin and a bed was waiting.So we checked in, and watched helplessly as this group of highly trained professionals had to wait for registrars to arrive from various other wards in the hospital to put a cannula into Rory's arm. It was not a pleasant wait.
Now, I feel that the 5 years I've just put in, allows me to speak with some authority on how to get blood from children. There is no nice way to do it. The kindest thing you can do for a child is be swift. Lessen the stress by having all you need prepared in advance, and don't let the child see the paraphernalia until you are ready to stick the needle in, draw the blood, and then get the hell out of the room. Putting a tourniquet on their arm and then realising you're missing a vital piece of kit is not an option. We didn't manage to get i/v access to Rory as the Registrar had to cover many other wards in the hospital and Rory was not an easy case. The consultant in Dublin called a halt and asked for Rory to be transferred immediately without delay by ambulance to Temple St.
So acting on consultant's orders, the highly trained wonderful nursing staff phoned ambulance control in Castlebar at 10.00pm. The call was greeted with annoyance, as the controller impatiently asked 'Does the child have to go tonight?' OK, now here's where I loose the plot. Where exactly, did that ambulance control phone operator do their training in paediatric nephrology? When did their job of delivering ambulances requested by consultants, morph into a second guessing of those same consultants? The Paeds nurse, fair play to her, remained calm in the face of such insanity and politely answered yes, he did indeed need to go tonight. It was 10pm on a Fri night - what did they think, I was on my way to some designer shoe sale? Piqued by the answer, our friend the consultant nephrologist ambulance controller, then inquired if the patient had private health insurance!
That's when I put a stop to the conversation, I was in no mood to be insulted any further by another HSE Muppet. We called a taxi and, with a pump very kindly on loan from those wonderful nurses, I managed to continue to pump i/v fluids into my son's NG tube arriving in Temple st at 1.30am.
It's not enough that I have to worry about my son's health, but I also now have to defend his use of the health service. I am no longer shocked when I see that patient respect is non existent, I've been desensitized so much over the last 5 years. However, I was shocked to see the complete erosion of respect for the professionalism of health care workers. Paediatric nurses are highly trained busy professionals, they are overworked and often abused by the public. They now have to take abuse from Muppets at the end of a phone who are abusing their power.
I don't know about you, but I've just about had enough.