Pullman Regional Hospital - Saturday April 3, 2021
These entries will be a bit odd as I (Jess) will be transcribing text messages from Dusty of the events as they happened and he had time to reach out to myself and the family. I will have him come back and edit/add more when he can.
9:16 a.m. Dusty: Dusty on site at Pullman Regional Hospital (PRH). Checked in with day shift doc Helen Carlson and day shift nurse Janine.
9:17 a.m. Dusty: Joyce potentially will be discharged today, they are wanting to do some additional tests with equipment ( sonogram/ echocardiogram?) Before pursuing release planning. To see how much damage/ if any was done to Joyce's heart.
9:18 a.m. Dusty: Current info from labs pulled every 4 hours since Joyce's admission show heart enzymes within acceptable levels so current belief is that heart attack didn't so any damage.
9:19 a.m. Dusty: Joyce currently being administered blood thinners previously listed last night (last blog post) and aspirin.
9:20 a.m. Dusty: Joyce working on eating breakfast at the moment, not sure how she arrived at PRH. Knows who Dusty is and appears to be in good spirits all things considered.
9:21 a.m. Dusty: Very concerned with the amount of wires and tubing hooked up to her, keeps trying to remove them.
9:23 a.m. Dusty: Dr. Helen Carlson will reach out to Craig via phone about care planning and options for Joyce in the near future.
9:25 a.m. Dusty: PRH admins directed by Dusty to request advanced directive paperwork from Gritman as Joyce appears to have moved/ hidden the bag of documents at the farmhouse in one of her unsupervised cleaning bursts. June 2020 paperwork at Gritman should be the most current.
9:39 a.m. Dusty: Joyce apparently has opinions on smooth Jazz. (No further explanation on this comment. Hopefully Dusty will enlighten us on her opinions later.)
9:42 a.m. Dusty:
9:43 a.m. Dusty: Joyce laughed when Dusty told her it is "proof of life" like in the criminal abduction movies.
9:45 a.m. Connie: Tell Mom we love her and glad she is doing better.
9:46 a.m. Dusty: Done and done.
9:55 a.m. Shelly: Tons of lovins/hugs for both of you
10:33 a.m. Dusty: Joyce is attempting to get Dusty to sneak her out of the hospital. "just bring the car around to the window there and we can go. They said it was okay."
10:34 a.m. Dusty: She is now in quasi panic stage, fidgety, everything needs to go into the trash, she is naked/not dressed, "well how should we make our escape?" and attempting to remove all the cables and sensors.
10:35 a.m. Dusty: Pharmacy tech arrived and confirmed home medication with Dusty.
10:38 a.m. Dusty: Joyce decided she had enough of breakfast and upended her plate onto the tray, trying to use the charger instead of the plate cover. Now pouting in the chair after Dusty stopped her trying to get up to go find clothes.
10:53 a.m. Dusty: Joyce now concerned about looking for the "school book" she had for preparing for H&R Block work. Dusty reminded her she hasn't worked at H&R Block for years.
10:55 a.m. Dusty: Janine arrive to administer aspirin. Dusty had her check cables. Joyce has been tugging at, confirmed al wireless system are working.
11:06 a.m. Dusty: Joyce upset and emotional "about messing up class" (not H&R Block) and she sees cars driving by her window and says "the rest of my group is leaving! I need to be leaving too!" So, potentially thinks she is in grade school? Sulking in chair resumed.
11:23 a.m. Dusty: PRH social worker current family care plan for Joyce and is going to provide options to explore for insurance covered care assistance if family would like to pursue them.
11:24 a.m. Connie: Are they checking into her hallucinations?
11:38 a.m. Dusty: Not yet. Potentially just dementia.
11:41 a.m. Dusty: She is currently upset after being stopped from pulling her cables again, wanting to go home. Back to pouting and being confused. "We have to go home!" She is in unfamiliar setting which may be exacerbating her poor mental state. Still trying to convince me to sneak her out.
11:54 a.m. Dusty: Was just informed by Joyce that she won't have docs come visit her because "she is in a lumberyard" and docs don't work in lumberyards.
12:02 p.m. Dusty: Joyce succeeded in yanking out cables while Dusty was on phone with Jess. Janine is seeing if doc will have cables removed as Joyce is in a bad mental state, switching to taking EKG every 4 hours instead to collect monitored data.
12:19 p.m. Dusty: Allison (social worker) arrived and provided list of resources family may be interested in exploring for insurance covered care options for Joyce (day, overnight, gaps in family care shifts, etc.):
- Family Resource Home Care
- Idaho Commission of Aging
- Care Connection Home Care
- Meals on Wheels Moscow
- Alternative Nursing Services
Phone numbers will be added when Dusty is able to update it.
12:45 p.m. Dusty: Joyce removed her cables again while Dusty was on phone with Craig. Dusty stopped Joyce from pulling IV line with blood thinner but she is now fixated on removing that now.
12:48 p.m. Dusty: "There are plenty of rooms on the farmhouse. Let's go, and you can put me in one of them and no one will find me." Latest attempt to negotiate sneaking out of the hospital.
12:51 p.m. Jess to Dusty: Can they sedate her to help with her stressing out?
12:58 p.m. Dusty to Jess: Not an option at this point. Concern over her heart.
12:59 p.m. Dusty to Jess: I sat opposite her on her walker holding her hands to keep her from pulling the cables till she passed out. But she was playing possum. She is awake again now.
1:00 p.m. Dusty to Jess: I (Dusty) told Joyce that she could die if she takes out the IV. That didn't sink in. I may as well have said sugar will giver her an upset tummy.
1:02 p.m. Jess to Dusty: Did you bring her coloring supplies? Have you tried using her name not Mom?
1:24 p.m. Dusty: Respiratory tech came through, fixed oxygen line Joyce disrupted.
1:25 p.m. Dusty to Jess: No coloring supplies with me. Yes I tried her name. She just isn't focusing.
1:25 p.m. Dusty: Joyce engaged respiratory tech in conversation about baking, attempted to convince tech, who bakes, to go bake brownies. Joyce trying to get hospital staff to abandon their posts so she can escape.
1:39 p.m. Dusty: Lunch order placed for Joyce with room service (Tomato soup, egg salad sandwich, cream pie slice) by Janine
2:05 p.m. Dusty: Lunch delivered
2:22 p.m. Dusty: Joyce severely hostile, refusing to eat lunch.
2:30 p.m. Dusty to Jess: Bathroom trip using commode right now.
2:31 p.m. Dusty to Jess: Mom very hostile, if she is like this at home going forward it is going to be very hard to work with her.
2:46 p.m. Dusty: Lunch paused for bathroom use, lunch resumed but Joyce still refusing to eat.
2:48 p.m. Jess to Dusty: I'm sorry! Want to tag out for a while?
2:49 p.m. Dusty to Jess: Nope, they will kick me out in 3 hours. I don't think they are going to discharge Joyce today.
2:50 p.m. Jess to Dusty: With her being this way and not having 24 hour care I don't think so.
2:51 p.m. Dusty to Jess: Yeah and we are not nurses. Dr. Carlson expressed concern this morning that there is no overnight care for Joyce.
3:16 p.m. Dusty: Lunch abandoned after efforts at negotiation failed. Joyce only ate 1/4 of sandwich.
3:28 p.m. Dusty: Tech with portable ultrasound equipment arrived. Electrocardiogram underway now.
3:54 p.m. Dusty: Ultrasound images collected and being sent to cardiologist for review.
4:49 p.m. Dusty: Urinary incontinence issue while nursing staff bust with hostile/violent patient a few rooms down. Joyce starting to attempt physical escape from hospital room. Dusty preventing.
4:51 p.m. Connie: Oh wow.. do you need a break... I can come over.
4:51 p.m. Jess to Dusty: I am so sorry she is being hard to deal with today.
4:52 p.m. Dusty: Nope. All good. There is just no reasoning with her about anything.
4:52 p.m. Dusty to Jess: There is just no reasoning with her. If she is like this at the farmhouse there is nothing we can do. Janine said her acting out is most likely due to being confused about the environment.
4:53 p.m. Dusty: Nurse Janine Believes it is because of her being in a foreign environment. Nothing familiar so she is trying to find something familiar. Dementia brain.
4:54 p.m. Dusty: Got her swaddled in a blanket now. She hasn't napped at all since I've been here so I imagine she has stress exhaustion and soul mood from that too.
4:54 p.m. Jess: This is some of the behaviors she exhibits at the farm. With the food and fixation on certain things.
4:54 p.m. Connie: Ok... if you need anything let me know.
4:55 p.m. Dusty: Thanks Connie, nothing to do but wait thinks out :) I don't think she is being discharged today. She kept taking out the wires to the sensors through the morning and afternoon so they haven't been getting data logged.
4:56 p.m. Dusty: and the druggie or whatever he is down the hall pulled almost all the staff's attention away this afternoon it seems. Yeah, Jess, same but way more exacerbated.
4:58 p.m. Connie: I didn't think that she would be coming home... hope her night starts getting better.
4:59 p.m. Dusty: I'm hoping the cardiologist gives the all clear to give her a sedative or something to be honest.
5:00 p.m. Connie: That would be good.
5:30 p.m. Dusty: Janine stopped by, dinner order taken (requested something soft like mashed potatoes to see if Joyce would eat that), still dealing with troublesome patient down hall. Will be back to check on Joyce for all things missed during interruption.
6:16 p.m. Dusty: ICU calmed down, Janine arrived. Blood Glucose @ 143. Diaper changed. New Gown. Room service delivered same time. Joyce eating after being concerned that Craig and Carol are in the kitchen and aren't eating.
6:18 p.m. Dusty: Dinner Mashed potatoes, diced steamed carrots and what appears to be stuffing and diced chicken with gravy.
6:50 p.m. Dusty: Dinner finished, all food eaten. "Okay, now where is the car?"
7:17 p.m. Dusty to Jess: Joyce thinks "people from the 'stone house' are here"
7:17 p.m. Jess to Dusty: Did she elaborate on the stone house?
7:30 p.m. Dusty: Sam (evening nurse) arrived at shift change. Checked Joyce. Reported to Dusty that she didn't think Joyce had slept last night at all, so if Joyce didn't sleep at all during the day time today her state of mind could be addled by insomnia effects.
7:41 p.m. Dusty to Jess: Nope.
7:51 p.m. Dusty: Joyce Still having difficulty in identifying where she is, why she is here, and articulating pain levels.
7:52 p.m. Dusty: When asked how she was, Joyce informed Sam that Dusty had taken her "to lots of places today."
7:53 p.m. Dusty: Sam contacted the powers that be and received permission for Dusty to stay past visiting hours to help manage Joyce with her current state of confusion and desire to escape PRH. Whenever Dusty leaves, PRH staff will put someone into room room to monitor Joyce if she is still super awake and attempting to leave.
7:54 p.m. Dusty: Joyce's room is immediately opposite to the nurses' station. As all other visitors have been escorted out, room wall (sliding glass door) has been opened so Sam can assist Dusty and keep direst eye on Joyce.
7:55 p.m. Dusty: Sam in room now checking Joyce's vitals and administering evening medication.
7:56 p.m. Dusty: "It's fun to have the group together again," said Joyce to Sam. Joyce currently does not know who Dusty is.
8:01 p.m. Dusty: Dusty asked about sedative, Sam said they are going to see about administering Melatonin.
8:02 p.m. Dusty: Joyce attempting to negotiate with Sam about going for a walk to get grapes.
9:30 p.m. Dusty: Joyce finally passed out. Sam will monitor her, other night shift nurses aware of Joyce's needs. Dusty will return to PRH tomorrow morning.
9:56 p.m. Shelly: <3
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