Saturday, July 11, 2009

Advocacy and AMA Forms

At about 3:30am,BBZ's nurse came into his room and woke me up. She said that the doctor has ordered a shot of antibiotic to treat BBZ's ear infections. She said she asked if they could wait until tomorrow to give it orally and the doctor said no that he needed it now. She suggested we wait until 4am when he was due for his vitals and I said ok. When she walked out I woke up completely and started thinking...he has an open IV line, why would he need a shot? So I laid here and thought about it for a while and decided that he does not need another thing to stress about and went out to the nurse's station and told her that I did not want him to have the shot. She was so nice and explained that she would talk to the doctor, but she had already asked about delaying it and he said no. She said she would tell him my concerns and let me know. Let me back up just a little bit. When BBZ was admitted on Thursday, he had a double ear infection. He was supposed to get a shot to treat the infection (through the IV) at the second ER we went to. The issue with his stomach took charge and I think everyone kind of forgot about the ear infection. During yesterday's rounds at about 3 or 4pm the doctors came in and I reminded them of his ear infection and asked if anyone had looked at his ears. They looked as though they had no idea what I was talking about. They said they would come in and look later because they didn't have the thing you use to look with them. I guess the surgical floor doesn't have them in their pockets like pediatricians do. A few hours pass and no one came in. Around 9pm (I think, I know it was dark) the doctor came in and looked into his ears. He confirmed the ear infection and talked about trying oral antibiotics tomorrow (today). I told him that I didn't want the first thing in his stomach to be medicine and hoped we could wait and give it to him after we see how he does with the liquids he is hoping to start today. He basically said we'll see. So when I came back into his room after telling the nurse I didn't want him to have the shot I got all fired up thinking of all the reasons he should not get it. All of a sudden at 3am it is an urgent situation? It sure didn't seem urgent when they were dilly-dallying around waiting to find the thing to look into his ears. And there is a perfectly good IV line right there waiting for the medicine to slip slowly into his little body without him ever knowing. I channelled the intense advocacy skills of my office mate and started to rehearse in my head what I would say if the doctor said no to my simple request. She always says, bring me the AMA for (against medical advice) so that was definitely part of my protest speech I was writing in my head. But I didn't need to throw around any fancy words or give my good speech...the nurse came back into his room with the medicine and hooked it up to the IV. It is going into the little man as I type and he is none the wiser. When she came in at 3am we talked about having a chair ready for him to sit in with me because he would probably need to be held an comforted for a while isn't this a better outcome? I learned a lesson in my birthing class and from my advocate/office mate, always ask what the harm is in waiting, does this have to happen right now and are there any other options. Because of this, one less traumatic experience happened for my little boy today. Today will be a good day.