"Hospital discharges" often eat up a lot of time; though we are told the patient has a set discharge appointment, when we arrive there still remain the unplugging (catheters, IVs) and the paperwork. When these tasks have been accomplished, we usually must wait to enlist help from the staff to transfer the patient from the hospital bed to the stretcher and to gather his personal items. (I always double-check the closets.) The
patient's belongings are stuffed into drawstring-equipped plastic bags which are hung from the stretcher handles, and/or crammed into the empty space under the "head" (the "head" of the stretcher can be elevated separately, just like a hospital bed).
Stretcher w/Head down
Stretcher w/Head elevated
Sometimes the hospital staff flat-out lies. My radio screen will indicate, for example, a 3pm pickup time. When I arrive at 3pm, the staff says "we were told the pickup time is between 3:30 & 4:30". Waiting for the patient idles my van, meaning that it cannot be used for other clients - and costs me money, as I am paid by commission. Some of the hospitals are notorious for this. When dispatched to those hospitals I ALWAYS call the client's Charge Nurse in advance to learn when the patient will
actually be ready to leave. If there is a major time adjustment, I then call our dispatcher so the van and I can be used elsewhere.
The case below was different.
Was dispatched to pick up an elderly woman. I was to transport her 8 miles by stretcher from a hospital to a hospice. My radio screen indicated that she needed oxygen (2 liters) so I first stopped by our office to pick up an oxygen bottle. The screen also indicated "DNR" (do not resuscitate).
Upon arrival at the hospital I unloaded the stretcher and O2 bottle from the van and rode an elevator up to the woman's floor. Couldn't help but notice the staff giving me strange looks as they pointed me to her room. Everything was ready to go! Paperwork, personal items packed, unplugging, etc., and the staff jumped to help me transfer the patient from the bed to the stretcher. They couldn't get us out of there fast enough. Two elderly ladies were shooed out of the room to allow the nurses and I space to transfer the woman from her hospital bed to the stretcher. The women were obviously in shock and were saying their final goodbyes. They had the look of not-quite-accepting the inevitable. The patient's eyes were closed, and she lay there, mouth agape and gasping for breath. A nurse asked her if the most recent dose of pain medication had kicked in. No response. I was asked how much O2 was to be used. I said "2 liters" and was immediately corrected - 5 liters!
The nurses and I grabbed the sides of the sheet on which the woman was lying and slithered her over to the stretcher. During this process I noted the woman's stomach was abnormally distended. Her eyes were closed, skin was gray and she was 100% unresponsive. The only indication she was alive was the rise and fall of her chest and the gasping for air.
When I was outside loading her into the van I could better see her skin color. Gray. No pink. Not good. Her breathing hadn't changed.
As I sat down in the driver's seat, I was thankful I had already done the paperwork and needed only to send an email to the dispatcher stating the van was loaded. I then had two choices. I could take a direct route to the hospice over bumpy city streets, or take a longer route via the freeway to give the woman a smoother ride. I took the direct route, avoiding potholes the best I could, reasoning that my passenger had recently been dosed with pain medication AND that I didn't want her to expire in the van.
About 15 minutes later, we arrived at the hospice. As I unloaded the stretcher I saw there was no longer any rise and fall of her chest and that she wasn't gasping for breath.
I wheeled her into the hospice as quickly as possible and encountered two nurses in the hallway. They looked at my patient and then at me. "Is she still alive?" I responded "I don't think so" and one immediately checked the patient's carotid artery while the other hurriedly placed a stethoscope on her chest.
At this point, my eyes began to leak and one of the nurses asked if I was OK. NO! She rounded the stretcher and gave me big hugs.
Though my client was now face-to-face with her Maker, procedure didn't change: I pushed the stretcher to her room and the nurse and I placed her body onto her reserved bed. I told the nurse that we no longer had to worry about causing her pain during the stretcher-to-bed transfer. The nurse agreed: "She's in a better place."
Our patient had been suffering from an aortic aneurysm, and she was not a "good candidate" for surgery, according to the nurse. (Her tummy was pooched out because her body cavity was filling with blood.)
Why is this post titled "Afternoon Delight"?
Because everything happened in the afternoon, and...
As I was loading the empty stretcher into the van a gorgeous blonde pulled up and stepped out of her car. She said she was the Social Worker and asked if I had delivered our patient. I told her yes, but that the poor woman was no longer with us, and that she had expired in the van. The blonde then asked me the same question as the nurse: "Are you OK?"
Hmmmmmm...."NO!"
Huggy huggy huggy. Not a bad deal.
