Initiative

 I really feel as if it would be unfair to leave the topic of Tim's care without pointing out that we met some very wonderful medical people along the way. 

The night shift ER staff seemed very 'hands off' and unconcerned. You could hear them laughing together at the nurses desk (it was a very quiet night). Meanwhile, we were keeping a vigil with Tim. They addressed our needs, but only when we walked out for help. When we asked for another chair, they found one. When the IV ran empty, they came in and shut off the beeping alarm and left the room. That was concerning because his blood pressure would begin to drop when the fluids were stopped. You could literally watch it. We were told that a new bolus could not happen until the doctor ordered it. Tim needed toileted. They handled that. 

We knew that he was going to be transferred to Erie as soon as there was an available bed. We knew that it was a waiting game. He could not be transferred upstairs to an empty bed there due to insurance reasons. So. We waited in the ER. 

It was a discouraging and frightening night. 

Shift change. 

Blessedly, blessedly. Allie and Amy came on board. When an IV ran out, Allie called the doctor and got the okay to start another. She was the one who recognized the c-diff and reported it to the doctor. Her abilities were respected enough that the doctor accepted this without questioning it. Treatment for that began immediately. Two days after he was home, the hospital called to tell us he was positive and that we needed to start treatment. I shudder to think what would have happened if this had continued on untreated for those five days. 

In short, Allie took initiative. She was in and out of the room continually. She encouraged us to ask questions. I always have questions and she always took the time to answer them. She always took the time to find out the answers if she didn't know. Amy was quieter, but she was right there, every step of the way. When Tim said he was hungry, he wasn't told that the doctor hadn't left any instructions about dinner. They called the doctor and asked. The doctor gave the permission. Tim was having a grilled cheese sandwich and tomato soup in the matter of minutes. 

Small things, undoubtedly, but they were critically important. At least they felt that way to us. 

Initiative is the difference between good medical care and bad medical care. Initiative. 

If a nurse or doctor takes initiative, things happen. They become the driving force. A lack of initiative allows the nurse to wait on the doctor instead of calling the doctor. (note that there was a doctor in the ER that night, just a phone call away). A lack of initiative allows a nurse to say, "It's not my responsibility to correct a phone number." 

It may sound simplistic, but I believe that is the key to good service. When one person steps up and takes responsibility, things happen.