Wednesday, September 25, 2013

Grateful for Great Care

Some people review restaurants, movies, cruises or even shopping experiences.

Me, I think I could make a career out of reviewing hospitals.
Robert on the mend in the MICU
Robert has been hospitalized three times over the last year and a half – all at the UC Davis Medical Center.  (He has also been to the emergency room of another hospital for a couple of falls when he lived at New Home but those were not overnight stays.)

I have come to expect great care from the UC Davis Med Center and I couldn’t be more grateful. 

When I changed Robert’s primary care physician from the New Home “doctor” (yes, I used quotes) to a UCD Health System physician, I didn’t know what to expect.  I was concerned because Robert is not a private pay patient – he is on MediCal and Medicare so I wondered what type of care he would get. (A stereotype I had in my head that I am not proud of.)

When we first visited this doctor, though, I thought I had hit the jackpot. She was kind; she listened to me about Robert and even wrote down the name of an online shoe store that she loves.

Now that’s my kind of doctor.

When she went on leave and Robert had to see other physicians, I never expected to get that same level of care. Again – wrong! Robert has seen two other doctors and both have been thorough and caring (although no one else has given me tips on where to get great shoes).

One of them even explained that she had read Robert’s records before our appointment but wanted to read them in more detail after meeting with us and politely asked if we could wait.

Um, you read his records and you want to read more?  Oh yes, we’ll wait. We will be happy to wait.

As a comparison, for years I felt like I was meeting my own physician for the first time each time I had an appointment. (My doctor is through a different medical group.)

There are many reasons I am grateful to the UC Davis Medical Center and I want to share what they are doing right!

Robert’s first bout of pneumonia and sepsis landed him in the UCDMC for a week.  He was in a regular room and the nurses were all terrific. My husband or I stayed with Robert during the day and through the shift changes to be sure there was a smooth transfer of care but it always went seamlessly. 

Round two of pneumonia and sepsis happened last April and, while I was still grateful for the good care he received, there were hiccups. An ER nurse didn’t even look at me while I talked to him (much less listened to me) and actually gave Robert a duplicate of a seizure medication I had already given him at home an hour before. (He was a better listener after that incident but I was/am still bitter about it.) 

During that stay, once Robert was out of the MICU, he was moved from room to room on a daily basis until he was discharged.  I never could connect with his doctor until I had the nurse call the doctor and I talked with her on the phone.  Even she didn’t listen to my concerns! Note to medical professionals:  LISTEN TO THE CAREGIVER!  (Phew – just had to get that out.)

Robert’s most recent hospitalization was a dream come true (well, except for that whole pneumonia and sepsis business). 

The personnel in the emergency room (nurses, doctors, x-ray tech) were fantastic. They asked questions. They were concerned and caring. They were respectful of Robert and me and my husband.

They listened.

They actually made me feel as if I was a member of the team caring for Robert. Which is awesome because I am

The decision was made to transfer Robert to a regular room which seemed reasonable to me based on his vitals.  The nurse caring for him on the regular floor kept a close eye on him and very quickly realized he was going downhill.  She notified the right people and we had a rapid response doctor looking at Robert and then calling the MICU team for evaluation.

It was obvious the systems in place for quality patient care were working properly. There are protocols in place which were followed to the letter as far as I could tell.

Robert was transferred to the MICU in short order where the great care continued.  The team of doctors who visited Robert actually talked with me each day and asked questions as well as explained what was going on.  (By contrast, the team in April discussed each patient outside the patient room and I had to try to eavesdrop to get any real information.)

Robert was moved back to a regular room once he was stable enough. He stayed in the same room for several more days which I think is a very important part of his recovery.  He had fantastic care from the nurses and I was able to talk to the doctors who had been involved in his care from the beginning when he was admitted to the emergency room. 

One of the most important aspects of Robert’s care at the hospital, and one for which I am extremely grateful, was the willingness to adhere to his medication schedule.  I get it – it’s not easy since Robert has seven times throughout the day he is getting medication.  One of the first things I do when Robert is hospitalized is hand out a copy of a one page contact and medication schedule – to the ER personnel, to the nurses once he is in the MICU then again to the nurses once he is in a regular room. Everything you need to know about Robert is listed on this sheet of paper (except the fact that he loves Family Feud and Jeopardy). 

When he was hospitalized in April, Robert was not kept on his regular medication schedule no matter how many people I gave the med list to or how often I went through it with then nurses. The nurses actually told me they weren’t able to adhere to his regular schedule. I wondered how we could evaluate his progress if his medication schedule was not kept the same (I don’t even think they gave him all of the medications he was supposed to have). If he doesn’t get better or develops a new problem how can we determine if it’s the bacteria or a new problem or because his medications were changed?

I was concerned the same thing would happen this time so asked one nurse if she needed me to go over his medication schedule. While I was offering to give her the medication list and schedule, she produced a copy of it and asked if it was what I was about to give her. The nurse who had been with Robert before her had given her a copy.

She acted like it was the most natural thing in the world to listen to the caregiver.

Oh my god. I almost hugged her. (Instead, I thanked her profusely.)

Robert eventually improved and was discharged after the doctor and I talked at length. I was also contacted by the discharge coordinator and told Robert qualified to get physical therapy at home. In the three times he was hospitalized, this was the first I had heard of this and was thrilled when she told me it might take a few days to set up but that he could have it at home. Fantastic! Sign us up.

Robert has beat pneumonia and sepsis not once, not twice but three times.  I am well aware this is nothing short of a miracle considering sepsis is the leading cause of deaths in US hospitals. 

Robert may have been given a miracle (or three) but I know that much of that miracle is due to the outstanding care he received at the UC Davis Medical Center, especially during this most recent visit. 

To the doctors, nurses, physical, speech and respiratory therapists and staff as well as administrators (for developing and implementing those helpful protocols):

Thank you from the bottom of my heart. 

And, to share Robert’s words (words he repeated to every single doctor, nurse, technician, therapist and custodian who came into contact with him whenever they left the room):

“Goodbye and God Bless You.”  

No comments: