Thursday, May 27, 2010

Vigilance And Spirometers

After spending a few days at the hospital with my dad, who is recovering from total knee replacement, I have witnessed a few indiscretions that reinforce in my mind the need to be vigilant when it comes to making sure loved ones are properly cared for when recovering from illness or surgery. To begin, though, let me say that this is not meant to be critical at all of health care providers. After observing how hard they work (and under adverse conditions of long hours and short staffing), I recognize that their place in providing care should only be part of the puzzle. Because my mom and I practically lived at the hospital for four days, the level of care received by my dad far exceeded that of, say, my dad's roommate, whom I will call "Mr. B."

Mr. B is a very elderly man who had just received surgery on his broken hip. He is sweet and frail, although once in a while he did give the nurses a few harsh words. In particular, he did not appreciate being woken up throughout the night to have his vitals taken. In any case, Mr. B hardly knows what day it is. When asked at one point by the nurse if he had had surgery, he replied, "Not lately." (FYI...He had had a pin put into his hip just the day before.) The showing by his family was fair at best, with a couple of hour-long visits by his daughter and granddaughter. The remainder of the time, around twenty-three hours a day, he was given what he needed to be comfortable, but that was about it.

My dad, on the other hand, was attended to, kept comfortable, and consistently encouraged to drink plenty of fluids, move his legs around, and eat and rest properly. In addition, under our watchful eyes, little errors were corrected without incident, and questions about treatment, medicines, and further care were answered in a timely manner. Since it is difficult for a person to even keep his or her eyes open after a dose of, say, Percocet, it is evident to me that to keep things moving in the proper direction, having other trusted individuals present for support is necessary, if not critical.

Take the lungs, for example. In my opinion, anyone who enters the hospital for convalescence should be presented with a spirometer. While this plastic contraption looks a bit like a Fisher-Price toy, I think there are few hospital accouterments that are more important. Since pneumonia is so prevalent in situations where the infirmed are lying on their backs for extended periods (with the lower air passages becoming breeding grounds for harmful microbes in the absence of air due to shallow breathing), the spriometer encourages patients to inhale deeply with the incentive of a little ball that needs to be kept in place by the controlled breath.

Around five minutes after my dad was released to his room, I requested a spirometer. His lungs stayed free and clear. Mr. B? Well, not so much. After two days of hearing him become more and more congested, I was relieved to hear one of the nurses tell him that would need to practice deeper breathing and, at long last, give him a spirometer. After spending about two minutes instructing him, Mr. B's method sounded somewhat like puffing on a cigarette. Although the curtain was always drawn closed, it was difficult not to hear all that went on and I couldn't help but take note that ne'er did I hear that spirometer in use again. While we left the hospital before Mr. B did, I pray that since he was able to spend some time sitting up, that he never experienced the symptoms of pneumonia. Yet I can't help but wonder why there wasn't a more proactive approach taken with Mr. B to ensure his speedy recovery.

Lesson reinforced...Ignorance is foolish, vigilance is bliss. The best care for individuals recovering from illness or injury combines quality treatment of trained professionals with the tender loving care of family members who make their loved ones' needs a top priority.

Oh, and a spirometer...



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