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Really "Wonderful" Roxann

Some very interesting things have occurred today in my mother's care. The highlights have been both very horrible and also with a glimmer of hope. To set the stage, though, you must learn about a very evil, rude, obnoxious woman named Roxann.

Roxann was my mother's "nurse" today. More accurately she was a petulant, surly, obnoxious little cur, with whom I am extraordinarily, vehemently angry with.

I arrive at the hospital to see how my mother is doing. I had called earlier in the morning (around 7am) to make sure breakfast was ordered for her (the hospital she is at has adopted the same sort of "room service" food plan that most hospitals in my region have adopted... the patient must order his/her food when he/she wants it. I arrived shortly after 11am to help her in ordering lunch. I actually dreaded going in to the hospital today... I feared there was no hope.

Surprisingly, my mother was talking and acting reasonably close to her old self. I was quite shocked and rather amazed. She was still very weak and tired to be sure, but SHE was THERE and acting like her old self. Then she nearly knocked me on the floor by saying...

"Help me order lunch, I'm hungry!"

I ordered for her and she ate! For lunch she ate a bowl of strawberries, a kaiser roll apiece of angelfood cake, and some decaffeinated coffee (please bear in mind this is remarkably good for her). Within minutes of finishing her lunch, in strolled Roxann with a small paper cup and water.

"Here, take this, we forgot your dose this morning after breakfast." she said in a brusque, abrasive manner.

My mother reached for the cup, I glanced inside and saw a rather small, aqua-green capsule.

"My mother does not take Indomethacin any longer." I stated in even tones, although I was flabbergasted at what was in the cup.

"It is on her medications chart." she said, pushing the cup at my mother.

"Well, it is not supposed to be, she has been taken off the medication since Friday... nearly a week ago." I said with more firmness.

"I don't know about that. It is there now." she said, again pushing the cup at my mother.

Indomethacin is a common medication give to people who have gout. Gout, a painful inflammation of a joint or joints often in the feet and toes, is a result of build-up of uric acid crystals in the affected region. My mother had started to take the medication a week prior to being hospitalized. In rare cases, Indomethacin can cause debilitating nausea, ulcers, and drowsiness. After only three days on this medication at home, it was easy to see that my mother was one of those rare cases. I had called our family physician and he said to stop the Indomethacin as well as the Allopurinol (another gout medication) immediately. This was the Friday prior to my taking her to the hospital.

When my mother goes to the hospital, I have written out all of her major medical history (see the simplified version in yesterday's post), plus a listing of all her long-term medication and another page of her temporary medications. Examples include her hypertensive medication (she takes this every day and is therefore on the long-term list) and an antibiotic (taken for a period of 7 days). On the list of the temporary medications I had indomethacin listed and below it in BOLD PRINT in a font size double that of the previous writing I had typed "THIS MEDICATION IS NOT CURRENTLY BEING TAKEN, IT WAS WITHDRAWN BY HER DOCTOR ON JUNE 30TH". I did the same for the Allopurinol.

So, back to the story at hand.

"Do not make my mother take that medication. You need to go double check her medical record. She should NOT take that medicine. Call her doctor if you do not believe me." I stated, with a very firm tone.

Ms. Roxann then gave me a rather impolite look and walked out of the room.

Roughly two hours passed when my sister Dora (who is an RN) arrived. I relayed the information of the past few hours to her, and she was of course, equally flabbergasted and wanted to speak to the nurse and see my mother's exact medications profile.

We approached the nurses station where Ms. Roxann was chatting it up with another nurse, laughing and joking about some incident involving a microwave. Both my sister and I stood there waiting to capture someone's attention. Another nurse at the station approached us and asked:

"How may I help you."

"Our mother is in room 702 and her nurse is Roxann. We would like to speak with her, please." stated my sister.

At the mention of her name, Roxann turned and her face soured. She came over to us and brusquely said:

"Yes?"

We went through our questions stating that we would like to check her medications profile because we know there is an inaccuracy at least in Indometacin.

She acted quite huffy, but pulled out my mother's profile. In the profile was the VERY SHEET I had typed that stated IN BOLD PRINT that she was not taking Indomethacin any longer.

I pointed out to her the very words I had typed. She became very defensive. She became very angry and told us that she would not speak to us now as she was very busy. She would perhaps have time later and that if we wanted to, we could wait in my mother's room.

By this time, her behavior was rude enough I was ready to blow a gasket, but both Dor a and I complied with her demand.

An hour went by before she came down to the room (I suspect she thought we might have left) and the first words our of her mouth were:

"I will not tolerate that type of behavior."

My blood boiled, I was about to tell her off, when she continued,

"My work is concerned with [spoken in dramatic sarcasm] her care and well being, not yours."

I glowered at her and replied in very low, even tones, "The same is true for us. My mother is my concern, not you."

She then showed us that yes, indeed, she had now made a change on her chart to halt any more Indomethacin. She then left in a huff.

So... in a nutshell, we found a very major problem. My mother had been put back on the very medication that was likely responsible for her disorientation, severe nausea and unwillingness to eat or drink. She started to receive this medication again on SUNDAY, the day we brought her in.... so she stayed in that horrible altered state and refused to eat or drink. She was on this medication for four days that were unnecessary and VERY HARMFUL.

I am hoping and praying that her improvement is long-term and real and not just a temporary improvement. If she stays in the mental and physical condition she was in today, then I think she CAN recover to her old self. Medicine and health is such a fragile thing and often ambiguous that I do not want to count on her being able to become well until after it happens, but I am feeling a bit of hope... which is something I never expected feel about the situation.

Please do not get me wrong. Mistakes (horrible as they can be) do happen in the hospital setting. I do not fault Ms. Roxann for that. Heck, it *probably* is not even Ms. Roxann's fault that Indomethacin was on my mother's medications profile. I do not fault her for that at all either.

What I do fault this rude, nasty, foul woman for her BEHAVIOR. As a professor who trains many future nurses in how to think (and indirectly on how to behave in a professional manner), her actions were nothing short of asinine and horrid. Ms. Roxann displayed behaviors that were the very antithesis of the role of the RN. She was not interested in caring for her patient, she was not the least bit concerned with the global perspective of her patient nor her patient's family, and she was flat out rude and crude. She is a disgrace to the nursing profession.... and she would not listen to a damn thing my mother, nor anyone who was a representative for my mother would say. That is why she is horrid.

I have debated on and off all evening on whether or not I should write her a letter (and cc copies to her nurse manager and the upper administration of the hospital to be included in her permanent record) telling them basically what I have stated above... but in much more eloquent, well thought out wording. I have decided NOT to write this letter, perhaps because it will be easier for me, perhaps because I do not feel like taking the time to do so, and also perhaps because after 7pm tonight (shift change) she was out from taking care of my mother. I asked, and found that she was not working for the next 8 days.

I just hope and pray that my mother may actually recover... something I had not thought possible only a day or two ago.

PipeTobacco