Losing it with the SNF staff
All my life I've had problems with being assertive; it's very hard for me to express to someone when I'm not happy about something, and I'm one of those people who tends to let things build up without saying anything, until I can't take it any more and then there's an explosion. This is not my best trait, and I've worked hard to get better about learning how to have a confrontation without it being fatal. Something else that Larry's stroke has taught me is that I have to learn how to handle situations where Larry's not getting what he needs, because this happens a lot in the SNF.
When I saw Larry this morning he let me know at about 11:30 that his bladder was hurting and that he needed the in/out catheter. He's been "going" on his own for the last couple of days, but it was clear that's what he was asking. I got the nurse and she did the in/out cath and drained 500 cc's She told me that there was more in there, but that 500 cc's is the maximum that's safe to drain at one time, because the bladder can spasm if you take out too much at once. Interesting, since other nurses have taken out as much as 900 cc's at a time, but I didn't argue. She said she would check him again in 4 hours, which is the protocol - "right before she went home". I left at around noon and took care of some chores.
When I got back to the SNF at 5PM, Larry was pointing to his abdomen and indicating the he was in pain and needed the catheter. I was hot at that point!! I demanded to see his chart and sure enough - nothing to indicate that he'd had the cath at 3:30. I demanded a meeting right then with the charge nurse and told her that I was fed up with the treatment that Larry was getting, and that this was not acceptable, and that I was going to file a formal, written complaint, because this was the LAST STRAW. She gave me the usual apology and said she would write a note in his chart - this does no good, because nobody ever seems to read it - and then she went with me back to the room and did the cath herself. As I stood fuming over her, she put in the catheter and....nothing came out! Not a drop. I was pretty mortified. I have no idea now what happened - did the nurse do the cath at 3:30 and not write it down? After 6 hours, something should have been there. I don't know what to think. Larry has a low-grade bladder infection right now, for which he's on an antibiotic, but that still doesn't explain how he could be dry after all that time.
So, I don't know what happened. I feel bad about losing my temper, but on the other hand I feel like if I don't make a big stink nothing ever gets done. I am just not very good at this yet!
One good thing happened. Larry was trying to tell me at some point today that he wanted something, and we went through the usual round of 20 questions - "is it the fan? is it the curtain? do you want the door shut? are you too hot?" - finally I hit on the right thing, and he looked at me and said "BINGO!" It was so funny; I really was not expecting it. Of course he wouldn't say it again when I asked him to, but I'm always so thrilled when he says a word! I wish I could understand him better. The aphasia not only robs him of language, it also makes it so that he's confused about how to point to objects. He may want the fan off, but instead of pointing at the fan he'll point at his eyes (because the fan makes his eyes dry), or at the ceiling (because the breeze goes up there). It's so frustrating for us both. I told him again today that I am trying my best to help him in any way I can and asked him not to get angry with me when I can't understand. Not sure what else to do with it, just keep hoping he improves.
-Janine
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