Caden went to the PICU after surgery yesterday. This was mostly precautionary. Sherry and I did not know going into this scoliosis VEPTR Rod process would require an ICU stay every time Caden has an adjustment. Come to find out this is the norm for this particular surgeon even when the surgery is less invasive. A precautionary ICU stay might not be too bad, but most people we run into at MUSC who don’t know Caden are scared of him. The last time we were in the PICU the doctors in the unit would hardly lift a finger without consulting cardiology. Cardiology was not concerned about Caden’s heart because it has been “repaired”. So we end up in the triangle of finger pointing between the PICU staff, cardiology, and the surgeon who put Caden in the PICU. One is scared to do anything, the other is not concerned, and the last is just doing what he thinks is best for the patient. That translated into four nurses in five hours yesterday and caused Caden some unnecessary pain through the night…that was NOT best for the patient.
The lead resident for orthopedics came around this morning and asked how the night went. I told him that Caden seemed to be in pain, but the nurse kept telling me that he only needed morphine on the surgery day and was getting it as often as he could get it per the doctor’s orders. The resident told me that Caden should have been getting Tylenol with Codeine as his primary pain medicine and Morphine as the breakthrough medicine. He suspected that the orders got lost in the shuffle last night. The nurses in the PICU had a shift change at 7pm right after the surgeon came by and then Caden got transferred. Then the nurses on the floor changed at midnight. I didn’t notice pain issues with Caden until we got to the fourth nurse and she only knew what had been pasted down to her. Now it is almost 8AM and we are going through another shift change. We have not met his new nurse what came on at 7AM, but I raised enough of a stink to get the Tylenol with Codeine and Morphine brought in by another nurse. I feel like I am in the middle of an episode of the Three Stooges.
It seems like we have had some kind a communication issue with the majority of our recent inpatient visits at MUSC. This place does pretty good as long as you get in one unit and stay settled with the same care team for a few days. Stay through a weekend and/or move between units and you are in for a ride. Especially with a complex kid like Caden and a paranoid staff.