Wednesday, October 11, 2006

ends and re-beginnings

Yesterday Karl said the anti-inflammatory (a steroid) was making Ishii so jumpy, so I took him off that and he did seem more mellow last night. Still, I found out that falcons hiss when they're feeling defensive. I've only heard them do the begging call (an awful yark, like a seagull). Ishii looked pretty vigorous and alert, and I had Karl come by. He was pretty pleased and took the bird home. I learned a little about falcons and have a new reason why I don't want one: it'd eat me out of house and home.

The visiting nurse that came yesterday was a dipwad. He was delayed once, rescheduled, and arrived hours later than that with no phone call and no apology. The antibiotics have to go on a schedule to lower the risk of the mate's bacteria turning resistant. We ended up hooking up the bag ourselves. This generally isn't difficult since we've done it many times before, but little details change and you have to figure out the new bits.

When the guy arrived, he proceeded to what we later decided were scare tactics designed to keep him employed. We weren't to change the dressing ourselves, he had to do it, and he changed it even though it was only 3 days old (Just billable hours. PICC dressings are normally changed once a week, and I've done it 4 or 5 times. It's easy.) He dissed the hospital nurses, claiming they did things we have never seen them do, like leaving the connector hanging uncapped, and they did a lot of things wrong. The way he wiped the connector was right. Alcohol doesn't sterilize, the prep pads just "push the dirt around." He was very big into keeping things sterile, yet he didn't wash his hands with the antiseptic scrub. Instead he used the gel, the active ingredient of which is alcohol. And he obviously didn't think our schedule was important. In short, he was one of those people who thinks his way is the only right way. And somewhere in our conversation, the issue of patient compliance came up. We got the impression that if we didn't do things his way, that the insurance would stop paying for a visiting nurse.

This kind of talk works on the old, and the mushy sort of patient who doesn't get involved in his or her own care. We are neither of these types. The mate called today and made her complaint to VNA, and they'll be giving us a different person.

1 comment:

Sugarpott said...

at least you will be getting a different doctor. thats good.
when i had costocongitis, the first doc i went to was a total cook. he put me on 2 different types of codeine at the same time, and it screwed me up big time