The Ordeal 2

Another tough week, but are screw-ups subsiding?

“Curmudge, a newby who just surfed into this posting would have no idea what we are talking about.”

“That’s the way it is in blogs and in life, Julie.  It’s difficult to put today into context without knowing what went on yesterday, or last week.  But we can’t wait for stragglers.  Time to proceed onward.”

“I understand, Old Guy, that Ann became a ‘frequent flyer’ at the local pharmacy.  Quoted below are some of her comments:

‘Needed several new medications. Local pharmacies do not carry some of the specialized ones; they have to be ordered.  One special one to prevent infection would have cost $3,200!  We did not get it filled.  It had to be ordered from somewhere.  I called the clinic early this afternoon to learn if there is an alternative but have not heard back yet.  Having to run to the pharmacy daily is frustrating—especially with back orders, meds not in stock, or unusual drugs.  Wish there were a better system for cancer patients. The clinic does not stock samples of drugs.  Some days it's multiple trips to the same pharmacy.’

‘Jay had a strong drug reaction that lasted an hour during an outpatient chemo infusion that took 8 hrs last Thursday, and a Neulasta injection that produced severe flu-like aching—very painful. Plus other painful side effects: mouth sores, bad stinging and pain in jaws and throat. Incredible fatigue.’

‘I asked the pharmacy to call as soon as they got the Vicodin order (for pain), and they called us back to say it was ready. Then they also texted Jay's phone.  Nice.  I made friends with the pharmacist today; told them all I'd be a "frequent flier" and that Jay was enduring aggressive chemo. I think they will be ready-on-the-spot now since they know we need help. They were great about the Vicodin—usually that one can't be called in.’ “

“The situation at the pharmacy end of the system seems better, Julie, but things are still messed up at the hospital end.  This is what Ann wrote:

‘Any e-filing or phoning of prescriptions from the hospital side to our pharmacy has not worked.  I asked where the disconnect is occurring, but I’m not sure I got an answer.  I called the clinic to get a prescription, and they said I had to talk to the hospital medical unit.  After four phone calls to the hospital last Friday afternoon, the clinic finally just did the Rx—and phoned it in. The hospital never did do it in spite of three calls from me to the 3rd floor medical unit (they promised it was done, each time I called) and two calls from the clinic to the medical floor!  The clinic staff told me the staff on the hospital floors don’t like to phone in prescriptions.  Nice, huh?  Then why don't they just hand me a written script then?’ “

“Wow, Curmudge!  As in the Book of Job, it seems that trouble keeps coming:  

‘It’s 6 a.m. and Jay was up all night throwing up.  At 2:30 am I called the on-call doc. She said to come right into the clinic at 8 a.m. What a long night.  No sleep again for Jay. It may be a bowel obstruction.’

‘It’s 11:30 am, and he still feels crappy; blocked up. The x-ray showed a mass in Jay’s abdomen. He must have a CAT scan for a better view.  Jay will be an inpatient for the day and tonight.’

‘The CAT scan—where is it?  It was ordered at 11:30 am.  Jay is not able to have any food or water due to the blockage, and he's extremely uncomfortable with nausea. The RNs gave him meds that helped. But the doctor still doesn't know what the problem is.’

‘Jay waited all afternoon; but by 5 pm, still no scan.  Where's the CAT scan? Then we will have to wait for a radiologist to read it.  Now the business day is over, and Jay has a serious blockage that hasn’t been identified.’

‘My patience is wearing thin with delays at the hospital.  Jay has been through hell. The clinic staff and on-call folks have been wonderful—responsive, caring, and attentive, but there seem to be snags at the hospital diagnostic level again.  Where's the urgency with a cancer patient?’

‘Jay just sent a text: He just got back from the CAT scan at 5:45 pm.—6 hours late. He said the CT folks were swamped with ER cases today.  As expected, results will not be available until tomorrow.’

‘Next day: The CAT scan showed that the mass is severe constipation from the GI system’s shutting down due to electrolytes being out of balance.  Electrolytes via IV are starting to wake up Jay’s GI system.’ “

“Curmudge, might some of those ‘urgent’ scans in the CT backlog have been defensive medicine?  And I’m surprised that there wasn’t a radiologist on call.”

“With a name like yours, Jaded Julie, I would not be shocked by your having suspicions.”

“So where do we go from here, Professor?”

“It depends, chère étudiante.  If delays and screw-ups have really subsided, next week we’ll summarize what we’ve learned.  And you and I, who probably aren’t qualified to make recommendations, might make some anyway.”

Kaizen Curmudgeon