Yesterday morning was pretty rough. Mother was in a lot of pain. She was highly agitated and squirming around in her bed. She kept pulling her IV out. The first shot of Demerol the nurses gave her barely put a dent in it. I ran into the doctor out in the hall and told him that the situation was intolerable and that she needed stronger intervention.
He said he would take care of it. He also explained that Mother is a tough case because she cannot really communicate due to her dementia. Secondly, they try to find that balance between pain management and over-medicating which is always an issue with the elderly. ( By the way, this surgeon used to live in Jackson. He is close friends with one of my little lawyer friends there whose name I invoked without ceasing. Small world, huh?)
Anyway, eventually, the nurses showed up armed with Ativan and another shot of Demerol at twice the strength of the first one. This did the trick. Eventually Mother settled into a deep sleep. John showed up around two and Bob and I left. John called around 10pm to say that she had gotten another whopping shot at 8 and that she was asleep.
I have no yardstick in my head by which to measure all of this. Bob, being a nurse, is able to view this situation with some clinical detachment despite being emotionally involved. Me, I'm a lawyer. I just want to fix stuff.
Bob says they are doing a good job. Mom is a tough case. If they can't keep an IV in her then they will have to insert a central line which will mean more trauma. If they don't get the pain under control she may have a coronary. If they can't get her upright, pneumonia comes into play. You can't hardly give an elderly person aspirin. If you give 'em to much Demerol, well.....
This situation can't be fixed. It can only be managed. I know understand why they use that term so much in nursing now,
I do not see how she possibly be discharged tomorrow. But we shall see.
I'm off to Conway. Give my regards to the Outside World.