General Update #14

Nurse checked in with Joyce at 9:49 a.m. to see how the pain medication was working. Joyce indicated that it only helped "a tiny, tiny bit."

Keri (sp?) the social worker at Good Samaritan contacted Dusty at 9:51 a.m. via phone call, having been relayed through Dana. Keri informed Dusty of their current visiting policies: 

• No visitors at this time, they do have digital connection options such as use of the FaceTime application, phone calls are highly encouraged, and visiting through the window using phone calls. Keri is currently not certain on when let-up would occur, not June 13. Plan is being developed for "normalcy." 

Keri stated that the current plan is to have Joyce moved to Good Samaritan today (timeline yet to be determined) after speaking with Dana. If done during business hours, Good Samaritan will handle the transfer of Joyce to their facility, coordinating with Gritman. Good Samaritan nursing staff will be sure to plan to accommodate Joyce's fractured ribs and vertebrae as they transport and care for her. 

Joyce will be placed in isolation in a private room in the 600 wing of the facility for at least 14 days to ensure no COVID-19 symptoms. After that time Joyce will probably be moved from the 600 wing into a shared room with a roommate. Roommate assignment is dependent upon space and what is available. Keri indicated that they might be able to place Joyce near sister-in-law Jeanette's room, depending on openings in space availability for rooms in that wing and floor. Potential for Joyce and Jeanette to be roommates could also be explored if desired. Good Samaritan attempts to pair roommates to be compatible but does reorganize roommates if initial pairings are not good fits.

Family should plan to bring Joyce clothes, entertainment (books, bible), insurance cards (actual or photo copies/pictures of front and back sides), and any advanced directives/will/living will copies at time of (or just ahead of) check into their care. Family can drop off package for Joyce at front entrance at anytime to be taken back to her room. Joyce's personal walker okay to bring in from home for her to use while at Good Samaritan. It was determined that Joyce should be competent enough to sign her own admissions paperwork at time of arrival to Good Samaritan. 

Keri can be reached at 208-883-2914 (Monday through Friday from 8 a.m. to 4 p.m.) or via kgrosecl@good-sam.com with any questions the family might have. The weekend social worker, Cassandra, can be reached at 208-883-2916. 

At 10:12 a.m. a nurse's aide checked on Joyce and she indicated that now she felt like laying down in the bed to rest. The nurse's aide departed to obtain assistance from nurse's assistants for moving Joyce to the bed. 

Dusty informed Joyce at 10:18 a.m of plan to move her to Good Samaritan later today and she seemed to think that was acceptable, though she expressed concerns over having a roommate. 

Nurses' aides arrived to take Joyce to the bathroom at 10:20 a.m. They talked Joyce out of laying down in the bed as lunch time was fast approaching. They got Joyce to agree to remaining in the chair but will recline it to make her more comfortable. They asked if Joyce wears oxygen at home all the time, Joyce admitted that she does not wear it all the time. When asked that the pain level was at, Joyce indicated it was 7 out of 10 at 10:25 a.m. and so nurse's aides said they would let the nurse know. Joyce was returned to her recliner at 10:39 a.m. and made comfortable. No bowel movement. Nurse's aides checked on Joyce's comfort and areas of body pain. Commode placed over toilet to provide more assistance to Joyce in getting up and down from toilet for next trip.

Dr. Brown arrived at 10:41 a.m. to visit with Joyce. Joyce stated that she is in pain, with one spot being "painful all the time." Dr. Brown investigated, Joyce indicated mid-back area. Dr. Brown assuming it is most likely the vertebral area that is troublesome to Joyce. Dr. Brown confirmed that the plan is to get Joyce moved over to the skilled nursing facility (Good Samaritan) later today, timeline for that transfer is still being developed. Dr. Brown still attempting to make connection with Joyce's oncologist for insight and plan for Joyce's (potential) spine cancer treatment. Oncologist will determine what to do, then coordinate with the skilled nursing facility if a plan for radiation treatment needs to be implemented and transport for Joyce arranged. More information to come once Dr. Brown learns more. 

Dana arrived 10:45 a.m. to notify that she is waiting for doc brown to write orders before any kind of transfer processing of Joyce can begin. Once approved by Good Samaritan, then Joyce will be scheduled for transfer to their facility and things will start aligning for a timeline. Dana will verify if Gritman has copies of Joyce's will/living will/advanced directives on file and if so those will be sent along with Joyce's therapy treatment plan notes, doctor notes, care notes, and all other gathered materials which will be sent along with Joyce to Good Samaritan so they have it. Dana is anticipating any kind of transfer of Joyce would occur post-lunch time, maybe even late afternoon as there is a seriss of back and forth things that have to occur on their side of things before transfer will actually happen. 

When Dana next returns to the room, she estimated that she will have the timeline for Joyce's transfer.

Joyce's vitals were taken by nurse's aides at 10:52 a.m.

Blood pressure 114/74, pulse 76, temperature 98.5 degrees. Oxygen at 93.

Dana notified Dusty at 10:57 a.m. that she has a copy of Joyce's living will and healthcare of attorney (dated 2016) as well as copies of Joyce's insurance cards on file and will plan to send those over to Good Samaritan if those are still current. If the living will and healthcare power of attorney has been updated since 2016 they will need new copies for check in at Good Samaritan.

Occupational therapist arrived at 10:59 a.m. to work with Joyce. Inquired about Joyce's pain levels and Joyce indicated that she was in quite a bit of pain. Finger, wrist, and arm exercises performed. Confirmed that she heard Joyce was going to Good Sam later today and she thought that it was a good idea. Joyce stated that she didn't know that she was to be transferred to Good Samaritan. Therapist informed Dusty that she would write up and send arm therapy directions for Good Sam therapists to accompany Joyce. Good Sam team will develop a back therapy plan for Joyce once the inflammation goes down from her injuries. Therapist reiterated that Joyce should try to continue to sit upright as much as she can in the chair if possible as that would be good for her breathing and lungs. 

Nurse's aides arrived to inform Joyce at 11:06 a.m. that Joyce will be moved back to bed after physical therapy concludes to be administered a suppository (for constipation).

PT interrupted at 11:09 a.m. as nurse arrived to administer pain reliever and suppository. Nurse was not told that PT was occurring. Room service arrived to take lunch order from Joyce simultaneously, told to return later by nurse. Joyce experienced pain as she was moved back to bed. Nurse happy with Joyce's mobility.

Message(s) from Joyce:

None.

Participant observation:

Joyce fluctuated several times between knowing and not knowing she was being transferred to Good Samaritan. 

Current location:

Gritman Medical Center, Room 226.

Current pain level:
6 out of 10.

Visiting information:

No change from previous post.

Confirmed with nurse's station shift leader at 9:30 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).