General Update #24

4:22 p.m. - Room service arrived to take Joyce's dinner order. Joyce informed them that she did not feel like eating. Hostess offered soup or broth as an option as a "light" meal. Joyce declined. Hostess departed after letting Joyce know that if she regained her appetite they can be summoned and food brought up.

Joyce slept off and on following room service hostess' departure.

Nurse's aide came in at 5:01 p.m. to check Joyce's oxygen levels while Dusty was on the phone with Carol.

Nurse's aide (Kandi, the senior nurse's aid for the day shift; junior nurse's aide was Peyton) arrived at 5:02 p.m. to check on Joyce's condition. Joyce stated she does not feel like she is wanting to throw up at the moment. Nurse's aide confirmed with Joyce that they know Joyce did not feel like eating dinner. She will check with Joyce's nurse to see if Joyce's blood sugar levels should be taken now or if she should hold off to take that until later. Dusty asked for follow up information on hydrocodone, if it is in the codeine group to which Joyce is allergic. Nurse's aide said that question was passed onto Joyce's nurse, nurse said that it was not. Nurse's aide also shared with nurse that Dusty had recorded that the hydrocodone was given to Joyce on a previous day and vomiting soon followed that dosage. Nurse said that she was going to look into that and hasn't followed up yet. Nurse's aide will check with nurse about that question and get back to Dusty. Nurse's aide thanked Dusty for being an advocate for Joyce and present to track processes occurring. 

5:38 p.m. - Nurse's aide (Kandi) arrived to take blood sugar test. Blood sugar level was at 208. Joyce asked if it had been running high and Kandi confirmed that it had been. Kandi asked if Joyce was interested in ordering a meal from room service. Kandi let Joyce know that if she isn't hungry now but then became hungry later on they could bring it in for her at that time. Joyce fell asleep while trying to review menu Kandi put into her hands. Kandi concerned that Joyce is diabetic and hasn't eaten much today and so would like it if Joyce could eat something. Joyce indicated that soup might be a good choice? Joyce spoke with room service via phone. Minestrone soup and a banana was selected. 

5:47 p.m. - Joyce received phone call from Connie.

5:53 p.m. - Dusty reminded Joyce of the new plan for her care (transitioning to Good Samaritan) as she indicated she didn't think she was aware, saying to Dusty that "the medicine must be making [her] forgetful." Joyce's oxygen levels remaining steady at 91-92.

6:05  p.m.- Kandi returned to see if Joyce could try sitting in the chair. Joyce confirmed that she would like to sit in the chair. Kandi asked if Joyce would like to try using the bathroom before or after eating. Joyce indicated after. Kandi let Joyce know the shift change will most likely occur before Joyce finishes her dinner and is ready to use the bathroom. Kandi will let the replacement CNA know about the bathroom trip plan.

6:09 p.m. - Overnight nurse's assistant arrived and was introduced to Joyce. Kandi will return to staff the nurse's station desk tomorrow morning and will check in on Joyce at that time. 

6:11 p.m. - Dinner for Joyce was delivered by room service.

6:18 p.m. - Nurse change occurred, Anna taking over from Becky and was reintroduced to Joyce. Anna, who was the overnight nurse last night, informed Dusty that the reason that Joyce wasn't using an IV today was because when they were getting her up during the night to use the commode the IV came out and "a big mess was made." Anna was notified by Becky that they've been trying to get the lidocaine patch applied to Joyce's ribs. Becky was glad to see that Joyce was eating, Dusty informed Becky that only 2 small spoon sips had been downed so far and Joyce then told Dusty she felt she was feeling like she would throw up (just before Anna and Becky arrived into the room). Anna and Becky reported that the current line of thinking was that the constipation is making Joyce nauseated. Joyce continually falling asleep while trying to eat soup (time it takes for her to put soup in spoon, lift soup to mouth, sip out some fluid or a small bean or pasta piece, a few chews or such and she is out). Dusty actively sitting with Joyce, taking to her and coaxing her to keep at eating and not fall asleep in her chair.

6:49 p.m. - Joyce has eaten the entire cup of minestrone soup, four saltines (crushed up and added into the soup by Dusty), and the whole banana that was delivered to her for dinner. Joyce has fallen asleep in her chair.

Message(s) from Joyce:
"I think I will feel much better when this lump on my head goes away," said Joyce while eating.

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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