General Update #11

At 2:35 p.m. a nurse's aid stopped in to check if Joyce had need of the bathroom. No output (no urination and no bowel movement) from Joyce since she was taken off the catheter. Nurse's aid discovered that Joyce had not even been setup with a diaper. Nurse's aid departed to retrieve a 3-in-1 commode for the in-room bathroom to use. Nurse's aid returned at 2:39 p.m. with the 3-in-1 commode for mom to use. Dusty was excused from the room. Joyce wanted to use the bathroom but nurse's aides convinces Joyce to use the commode as it was closer to her chair and required less walking distance to be covered. Turned out that was for the best. 

Dusty readmitted into room at 2:57 p.m., nurse followed up as well at that time. Urine output occurred, but no bowel movement. Joyce confirmed that she was still nauseated. Pain level currently at 5 out of 10 for Joyce at time of nurse's asking. Nurse informed Joyce that a new pain medication has been ordered with hope that it will not make Joyce sick to her stomach but still provide effective pain relief.

Physical therapists (Mark and Jessie) arrived at 3:24 p.m. to check in with Joyce. She informed them that she is light-headed but would like to sit a while longer. Joyce was invited to do leg and ankle exercises in the chair while she sat. Additionally worked on her breathing and upper body movement range of movement exercises. Joyce tired out quickly. Mark asked if Joyce wanted to return to laying in the bed and she indicated she wanted to remain in the chair for a while longer. The physical therapy team departed then departed around 3:27 p.m., informing Joyce they will return twice tomorrow.

Dana arrived to have Joyce review and sign the Medicare paperwork for her status changing to "in-patient" status at 3:50 p.m. Joyce signed the paperwork. Dana has not heard back from the Aspen Park or Good Samaritan contacts about confirmed vacancies in their facilities or if the 1-day waiver for COVID-19 is still in effect and can be utilized for Joyce's case. If Joyce is able to be transferred to the Aspen Park or Good Samaritan facilities for care, they will require her to be tested for COVID-19 prior to admittance. Dana is going to request that Joyce be tested for COVID-19 so that piece can be out of the way. Dana will follow up with nursing staff so that should occur this evening so the test results would be available tomorrow.  Dusty left his cell phone number on Joyce's patient information board in the room in case he is gone before 5 p.m. today and Dana attempts to get a hold of him with any info she receives.

At 4:09 p.m. the nurse arrived to do a COVID-19 swab test on Joyce. Joyce found the experience incredibly unpleasant. Joyce informed the nurse that she would like to get back into bed. The nurse stated she is rushing the test sample down to be sent up to Spokane (if missed, it won't come back until Monday) but will have nurse's aides come and assist Joyce back into bed.

Nurse's aides arrived at 4:15 p.m. to assist Joyce with getting back into bed from the chair. Joyce was returned to bed with some difficulty.

Room service arrived at 4:19 p.m. to take Joyce's dinner order but departed as efforts to get Joyce settled into bed were still underway. Room service hostess announced they would return later on.

Room service returned at 4:25 p.m. Joyce indicated that she was not hungry at all. Room service hostess suggested that something light could be brought up which she could try eating. Joyce assented to that. Cottage cheese, wheat toast, peaches, and hot tea. Joyce was also talked into a custard for dessert. The hostess, Sandy, said that they make their own custard and it is delightful if one is a fan of custard.  Joyce informed Dusty after room service left that she was still having an upset stomach and didn't feel like she could keep food down.

Nurse's aide arrived to take Joyce's blood sugar reading at 4:42 p.m. Reading was 230.

Nurse's aide noticed that IV bag needed replacement (had been beeping empty since room service left) and notified nurse. 

Nurse arrived and swapped IV bag at 4:45 p.m. and visited with Joyce about her state. Plan is to let the current narcotics wear off before switching Joyce to the new pain medicine. Nurse suspects that the drowsiness and memory lapses are due to the narcotics in Joyce's system. Plan is not to reconnect the catheter to Joyce but wake her up at intervals for bathroom use. Plan is to use the commode stationed next to the bed for this evening and work Joyce up to walking into the bathroom to use the toilet. 

Nurse's aide checked in with Joyce at 5:05 p.m. to ensure she was doing okay.

Joyce's dinner arrived at 5:08 p.m. and Joyce was informed she will be served by a different hostess, Alicia, tomorrow due to scheduling rotation.

Nurse Jill arrived at 5:21 p.m. to provide Joyce with Tylenol in hopes it would take the edge of the pain off without making her feel nauseated or drowsy. Insulin was also administered at this time. Jill informed Joyce that she will be off duty for 5 days starting tomorrow so it will be a different day shift nurse caring for Joyce starting tomorrow morning. Joyce was sad to hear that. Jill will return later to introduce Jess to the night shift nurse and assistants.

Dusty departing Gritman out to pick up medicine for Jess and have meeting with family.

Message(s) from Joyce:

Joyce announced that she is disappointed that she cannot go home today, or potentially for many more weeks given what Dana's options for recovery plans are as they are seemingly recommending Joyce be admitted to Aspen park or Good Samaritan for 3-4 weeks. Joyce is acknowledging that she could have been much worse off from her fall down the stairs.

Joyce used to make her own custard, baking it in the oven. She thinks she would like the first thing done together as a family is to make and have custard together at the farmhouse when she gets to go home. Or maybe just have a custard night. Some kind of celebration when she gets to return to the farm house!

Participant observation:

At 3:58 p.m. Joyce asked Dusty if the doctors had taken X-rays of her back, because it hurts and they should figure out why it is hurting. Dusty reminded Joyce that her vertebrae was fractured and then Joyce confirmed that she knew that, and she figured that was why it was probably hurting. 

Current location:

Gritman Medical Center, Room 226.

Current pain level:
4 out of 10 at 4:55 p.m.

Visiting information:

No change from previous.

Confirmed with nurse's station shift leader at 8:54 a.m. - currently only 1 visitor per day for Joyce, no exceptions. Once current visitor departs Joyce's room, no further visits for the rest of the day. No swapping out visitors (example, Dusty cannot remain on hospital grounds while Craig goes to sit with Joyce for an hour and then Dusty returns to room).