I am the youngest of 8 kids. I was born when Mom was 40. So I am always the kid sister. It doesn’t matter that I am an RN, BSN, starting to go for my Master’s. In my family’s eyes I am still, and will always be, the kid sister. As a nurse, I have worked in many areas-med-surg, Pediatrics, ICU, CCU, administration and case management. I have a varied experience, and work hard to keep myself educated and up-to-date about anything new- changes in standards of care, new procedures, different treatments, new drugs, and old drugs being used in new ways.
My Mom is 85. She had been a fun lady, all full of piss and vinegar! She has slowed down much in the last 3 years. She has Alzheimer’s, anemia, Parkinson’s, diabetes, hypertension, and peripheral vascular disease. She had all of these diseases for several years-the most recent being the Parkinson’s and Alzheimer’s-diagnosed 3 years ago. Mom has had many hospitalizations in the past-she had 6 admissions in 2007-2008. Her doctors had her stabilized, and she hadn’t been hospitalized for the past 18 months, until this past Sunday. As a family, we all want what is best for Mom, but with so many voices, it can get complicated.
My oldest brother is one of the greatest guys you would ever want to meet. He is not an alarmist, to say the least. He had received very bad laceration about 8 years ago. My mom was on the phone with me right away to come look at it. I went to their house-he had a dinner napkin-electrical tape dressing on said wound. He said it would be fine once it scabbed over. Now since he had cut it on a large piece of metal, I told him at the very least he needed a tetanus shot. After much arguing, I took him to our local ER. His laceration took 12 stitches and he cut part of his tendon. So, he needed to see a hand surgeon-which he complained was done so the doctor could make more money! This is the family member who has my mom’s Power of Attorney.
I got the phone call while on a Sunday drive with my family. We were about 50 miles from home. My brother said Mom was more confused and just didn’t look right. I asked if her eyes were glassy or unable to focus. He was nervous, and just said her eyes didn’t look right, either. I told him to call 911 and get her to the ER. As I was on the phone with him, my one sister stopped to visit. She grabbed the phone and said, “It is not always appropriate to call 911, call her doctor first!…It is just a UTI!" A Urinary Tract Infection can wreak havoc on a frail, elderly person. I argued , but my brother cowered away from my sister, the dietician (She can be very scary and impossible if she doesn’t get her own way). She had worked in the past in nursing homes, therefore believes she possesses all knowledge of the frail elderly! So I ended up calling the doctor. I got the on-call doctor, of course. I explained what was going on and he said to get her to the ER, ASAP. The phone call and subsequent wait for the doctor to return my call took about 1 hour. I called my brother and sister back and said Mom needs to get to the ER, ASAP. I told them to call 911. They didn’t, and took her to the ER themselves. The entire time lapse from first phone call to entrance to the ER took 2 hours.
On our way home, my brother called me and said he wasn’t sure if Mom was going to be admitted, but that her Hemoglobin(Hgb) was 6. (Normal Hgb for women is 12-16 gm/dl). Basically, mom was bleeding from somewhere. She has had issues in the past with obvious GI bleed-think dark, really foul smelling poop-but she hadn’t really had any episodes in the past 18 months. The last episode she had in 2008, her room resembled the “Texas Chain Saw Massacre”, so my brother would have been aware if that had happened! I told my brother that, yes, my mom would be admitted and she would be going to the ICU. My brother went home then and left my sister to wait with Mom in the ER.
When I got home, I called my brother and he said Mom was still in the ER, but I needed to relieve my sister. I got to the hospital and found my Mom. My sister was there, insisting that it is normal to call your doctor and wait for him to tell you what to do. I asked her why they called me, then. In my opinion, before even knowing about the whole bleeding issue, something wasn't right and it could not wait! If you call and ask what to do about something, and then don’t listen, don’t bother calling me. I was just really angry as that non-ambulance ride could have been a life or death decision. My sister said that she didn’t want to call me, my brother did. She was arguing as my Mom hadn’t cut her arm off it was appropriate to call the doctor and then drive Mom to the hospital or even wait until tomorrow to go to the doctor’s office. I told her in no uncertain terms that Mom should have been taken by ambulance. Mom was weak, she could have hit herself on the arm and leg and caused more bleeding. Even before I knew about the low hemoglobin, her change in mental status alone warranted an ambulance ride. I had told her that as an RN, when I had worked night shift, the doctor would have been called in the middle of the night with those symptoms. But no, they don’t listen to me. They say I overreact.
When my mom had a stroke in 2007, my brother wouldn’t call the ambulance then, either. I drove with them and kept an eye on her, but she was so weak it was like dragging her into the ER-to wait in the waiting room. I told my brother that the next time I tell him to call an ambulance, he better call an ambulance. The one other hospitalization since was the infamous “Texas Chain Saw Massacre” episode, and I called the ambulance.
Well, my brother didn’t listen this past Sunday, either. I am still arguing with my sister-or I should say, she keeps calling to validate her part in the whole fiasco. I told her that because Mom’s hemoglobin was so low, she could have had a heart attack, cardiac arrest, or several other, equally nasty things, happen. I have explained and explained the valid medical reasons behind my answers to their questions, but there is a mental block going on! I only say to my siblings that we all want what is best for Mom. But, I am the one with the practical knowledge, and they should maybe, just maybe, once in awhile listen to the nurse in me, and not keep thinking that I am still 'little Jane'.
By the way, Mom is still in the ICU, but doing well!