General Update #20

2:21 p.m. - Nurse's aides returned with toast, encouraged Joyce to attempt to eat. Joyce confirmed that she was still nauseated. Nurse's aides confirmed that the nurse had increased Joyce's oxygen flow to 2.5 litres from 2 litres, then departed. Joyce kept falling asleep.

2:31 p.m. - Nurse returned with magnesium citrate (laxative) and the lidocaine patch, informing Joyce that they want her to have a bowel movement. Nurse adjusted oxygen flow (back down to 2 litres?). Dusty let nurse know that Joyce has been falling asleep while eating. Nurse suggested that was most likely due to the pain medication and directed Joyce to drink the magnesium citrate. Joyce gave up trying to eat her toast, spitting out what she had been trying to chew since nurse's aides brought it and tried to drink the magnesium citrate for the nurse. Nurse thought that Joyce had finished mouthful of toast, Dusty pointed out that Joyce had spit out the mouthful of toast she had been working on into the napkin. Nurse directed Joyce to eat food. Dusty pointed out that Joyce has continuously been interrupted and hasn't had a chance to eat her food since it was delivered. Nurse's aides just brought in toast Nurse was unaware Joyce had vomited after being moved out of the bathroom earlier. Nurse confirming that pain medicine on an empty stomach would make Joyce drowsy and constipation would make her lose her desire to eat. Dusty countered with the fact that Joyce had been interrupted at least twice so far since lunch had been delivered. Nurse departed after telling Dusty to have someone send for her when Joyce finishes eating and the nurse will apply the patch to Joyce's side at that time.

2:41 p.m. - Joyce continuing to have trouble staying conscious or focusing on eating. Dusty would wake Joyce and ask her to eat the toast (she would take a bite but she would fall asleep chewing it, took to 2:51 p.m. to get Joyce to swallow one mouthful). 

Nurse's aide stopped in at 2:51 p.m. to check if Joyce needs to go to the bathroom, stated that it appeared Joyce had been eating. Dusty clarified that she has not actually been eating much yet, toast may look depleted but some of it was spat out into napkin when nurse came in and pushed the magnesium citrate. Nurse's aide departed.

Nurse's aide (junior) returned with with nurse's aide (senior) at 2:54 p.m. Joyce was asked about her stomach and if Joyce wanted to go to the bathroom. Notified Joyce that the nurse really wanted them to encourage her to try to poop. Joyce acknowledged this and then vomited at 2:55 p.m. Nurse's aide managed to deploy vomit bag in time. Nurse's aide informed Dusty that the vomiting and drowsiness is most likely due to the medication and constipation. As Joyce has not had a bowel movement, and is most likely backed up, things are backing up. Nurse's aide noted that Joyce was not nauseated when she got her upright in the morning or moved her about for breakfast. One nurse's aide (junior) took vital signs on Joyce at 3 p.m. while the other (senior) went to go update the nurse about Joyce's nausea and vomiting. Before leaving, senior nurse's aide informed Dusty that Good Samaritan would not accept Joyce today if she had not had a bowel movement by 3:30 p.m. as it is their deadline for transfer. If Joyce does not have a bowel movement before then she will remain at Gritman overnight again (and hopefully have a bowel movement during that time). If Joyce has a bowel movement after 3:30 p.m., she will most likely be transferred to Good Samaritan at some point tomorrow, pending a new timeline via Dana/Dr. Brown, etc..


Message(s) from Joyce:
"The lump on the left side of [her] head puts [her] to sleep. The lump does... The lump does..."

Current location:
Gritman Medical Center, Room 226.

Current pain level:
Unknown.

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).

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