Thursday, June 17, 2010

What a Month

Earlier this month my doctor decided the time had arrived to put me on a much stronger IV antibiotic then he has been using to treat a stubborn infection. On Friday June 4, 2010 he admitted me to a local hospital; see my blog Note to Self. That just seemed to place the month on a busy footing.

This past Tuesday I had a doctor appointment and the doctor decided to keep me on the IV antibiotic for 14 more days. So then there were phone calls to the nursing organization and pharmacy that is supplying the IV antibiotic. This change necessitated additional blood work ½ hour before starting the IV and ½ hour after the IV finished. In the state I live in the law is that when an in home patient has a PICC only a Registered Nurse, patient or patient family can administer the IV or do blood draws using the PICC.

Yesterday morning, the Home Nursing Agency’s RN called and told me that she was on her way because my doctor had ordered a stat blood draw for the morning to insure that he receive the results while he was still in the his office. Once the RN arrived she insisted that I was to receive my IV antibiotic after she did the blood draw. I mentioned to her that when I had asked the doctor about moving my IV time from 4:30 – 5:00 PM to 8:30 – 9:00 AM, he told me that in order to safely do that he would have to order a couple of half doses. I questioned the nurse about the safety of repeating a full dose so soon after my last full dose, especially after my doctor told me different. The nurse told me this was what the new orders they had received from my doctor said to do and brushed my concerns aside, drew the before blood draw and started the IV.

Late yesterday afternoon, I received a phone call from the Home Nursing Agency nursing supervisor telling me that the first blood draw’s results were normal. The nurse also told me that they had not understood what my doctor was actually ordering and that my IV should still be at the 4:30 – 5:00 PM time. I do not know what the results of changing my IV time will be; I hope this doesn’t increase the treatment time.

This morning I received a phone call from the Home Nursing agency nursing supervisor telling me that the second blood draw, testing for Peak level of the antibiotic in my system was rather high. I told the nurse “Of course it is. The RN gave me a full dose of the antibiotic 15 hours after my last full dose.” I then called the pharmacy to alert them to what had happened. I wanted them to know that there was a reason for the huge increase in the IV levels in my system. Now I am worried that when my doctor receives the test results, he will want to once again lower the dose. I would call his office except today is his day off and I don’t want bother him. Hopefully if he questions the results someone will explain to him what happened. If he wants to lower the IV dose, I am going to have to call his office making certain that he has the complete story.

I believe the time has come to replace this Home Nursing Agency. I no longer feel safe in their care. I never had that concern with the first nurse Chuck. However, with this new LPN home nurse and with the new visiting RN, I no longer have any confidence in them.


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