OK - I promised tales of woe from the hospital so consider this my bitch session, which will prepare me for the letter I shall be writing about the standard of care I received while in the hospital. This is long and you should probably skip reading this if you do not enjoy the rantings and ravings of a post-partum crazy lady who is sure she is about to be charged millions of dollars for care and attention that is rivaled only by the local TravelLodge.

In my letter, here is what I will suggest they do and/or inform patients of in the future:

Front desk staff should not offer their "guesses" for what's going on upstairs when it's clear that they have no way of knowing the truth. The first thing that happened when we walked into the hospital to the visitors' desk. I said, "We need to go to Labor and Delivery" and the scared little man at the desk said,

"You can't, there's a lock down. CODE PINK."

KoH joking: "You mean someone tried to steal a baby?"

Scared man: "No, no, no, no, no, no, no, no, no! Someone just got too close to the door with the sensor. That's what happened."

Yeah... that's the ticket. We knew there was no way he could possibly know that that's what happened. It was a LOCK DOWN. I heard two different stories later on for what happened and neither was even close to that. In my favorite - and now the most believable - story, the parents of a child didn't appreciate the standard of care they were getting and tried to leave AMA (against medical advice) with their child which set off the alarm.

Nurses should carry a pad of paper in their pockets. And when a patient says, "Can I have... [insert name of request here, i.e.: water, pain medication, an explanation, a doctor who gives more of a damn than you people, turn off that damn IV pole because it's been beeping loudly for more than three hours and while I'm guessing you are able to sleep through it I am not, oh and by the way shouldn't the IV be dripping?]" they can WRITE IT DOWN and remember that when such a request is made, it would be helpful to actually DO it at some point in time. I cannot begin to count the number of things I asked for - serious things, not just 'hey man can you fluff my pillow for me' - that were never responded to, even after I hit that damn call button numerous times. At one point the person on the end of the call button admitted to me that she was just there to take the call and relay it to my nurse - she could not actually do anything for me. She might as well have been a technical support person in India.

There is no point to the chatty 'get to know your patient' requirements if it does not improve care. When the intake nurse was taking my volumes of information, she stopped at one point, rolled her eyes and said, "Now, I know this is silly but what are some things that are important to you?"

"Excuse me?" we both said to her.

"I know. The hospital wants us to (airquotes) 'get to know' the patients better and understand them, so we have to ask this question. 'What are some things that are important to you?'"

Awkward silence as we both thought, Is this some kind of test we're about to fail?

"You know," she offered, "like friends, family, faith."

Me: "Oooooooooooh. I see. Will you accept 'not dying in surgery' and 'TV'?"

She started to put that in the computer. "No, no, no," I said... "just put family and faith."

So anyway, by the time I got to my actual room after my six hour recovery, I understood what this sign was for. But it amused me that for the first two days I was there, I liked to be called "Sally" (not my name) and I had no things that were important to me. Also, there was no marker with which to change it. I wondered how many weeks ago Sally had had her baby. Finally on day three, one of the nurses came in with a marker and tried to fill it out. She put my name at the top and asked where I was when I wasn't in the hospital. I said, "at home." (I was pretty grumpy by this time.) She didn't fill out the rest. After that the nurses came in and put their cell phone numbers down by their names each time there was a shift change, but I don't think I called one of those numbers once and actually got through to someone.

Please tell patients to BRING THEIR OWN PAIN MEDS. It will save a lot of grief. I think it's a well-known fact that the medical profession is under fire for and has a whole new philosophy about responding to patients' pain. It is no longer acceptable to simply ignore people who say they are in pain or tell them to tough it out. To this end, this sign is on the wall of every room in this hospital. But, it seems that in this facility, this is the extent of the attention they will pay to your pain after you are there. In recovery, I was told if I wanted something for the nausea to simply ask and they would bring it. I didn't experience this in my first two c-sections, but man it got to me this time. So when they moved me to a permanent room and I still could not stop throwing up, I called and asked for Reglan. This was about 4:30 pm. They finally brought it at 9:45 pm. Once they administered it, it worked like a charm, but I'm guessing not even the best placebo works until someone actually gives it to the patient.

I was on a six hour schedule of Motrin, (MOTRIN - you know, like the stuff you buy in the grocery store and take yourself all the time?) which I got approximately every nine hours and Oxycodone PRN, which basically means they don't give it to you automatically, but when you need it, a nurse could give it.

One night in the middle of the night, I woke up in the most excruciating pain I've ever felt. Let's remember, I am no stranger to c-sections... this was new. I pushed the call button for the nurse and got an immediate, "What's wrong?" over the intercom. I explained that I needed something for the pain and she said, "OK." By this time, I've gotten wise to the system though. Twenty minutes later, I pushed again. Same process. Ten minutes later, again. Five minutes later, again. Finally my nurse came in and gave me a couple of pills and berated me for waiting too long to ask for pain meds. I should "get on top" of the pain rather than "chase behind it".

"I've been calling for over an hour now," I said.

*surprised* "Really? How many times did you call?"

"Four."

"Oh... I only got this last request. Hmmm."

Hmmm, indeed. So the next day, I was determined not to be put in that awful situation again. I knew that it took on average 1.5 hours to get anything I requested, so I started keeping track of my meds schedule and asking 1.5 hours early for each medication I knew I could have. That lasted until the afternoon when I told the day shift nurse that was going to need Motrin at 4:00. At 5:30 when she still had not brought the Motrin, I again reminded her and told her at 6:00 she should be ready to bring me the Oxy. She lectured me that I was not on a "schedule" for Oxy and it was PRN and did I even know what that meant? I told her yes, it meant that I could have it when I needed it and since I was in pain now because my Motrin was now almost two hours late so she should just count on my needing the Oxy when the time came. Needless to say, she never came back with either. So I had the KingOfHearts smuggle in his own Motrin for me. I just took that for the remaining day.

If you're going to require that patients be responsible for obtaining their own meals, you should tell them. The first day I was on a liquid diet so appropriate meals were brought to me. The second day, my IV became infiltrated and my hand blew up like a Mickey Mouse glove. This has happened to me before so I knew the signs and had a nurse take it out quickly. But then she didn't want to put the IV back in because she thought I'd be off the IV by noon anyway. She said, "Why don't you see if you can tolerate some solid foods for lunch and then if not, I'll put it back in. That's pretty much what your doctor ordered anyway."

So noon comes by. No lunch. One o'clock. No lunch. Finally at 1:30 the nurse came in and said, "How was lunch?"

"Beats me, it hasn't come yet."

"Well, didn't you order it?"

"Order it? You mean I have to order my own lunch?"

"Yeah, you choose what you want from the menu, call it in and they bring it."

"Well, seeing as how no one told me this, I don't have a menu, and I don't know what number to call, I guess I haven't done that yet. That would probably be helpful information to tell someone ahead of time." Next time, I'll just order a pizza.

Having lactation consultants in the hospital does no one any good if they refuse to come to your room. I had a very (VERY) difficult time breastfeeding The Dormouse, so, determined to avoid some of those issues this time, I asked to see a lactation consultant when I was in the intake process, about twenty minutes after I was wheeled into recovery, and about thirty times once I got into my room. When The Caterpillar came out of the NICU, they had had to give her formula to help her transition and later when I tried to feed her myself, I couldn't get her to latch on. It looked like I was going to go through all the drama of a child who wouldn't eat again. I asked every nurse who entered when I would see the LC because I really didn't want to start her on formula immediately, but also didn't want her to get dehydrated and/or to go through months of weight gain fears like I did with The Dormouse so I was unsure what to do. And I knew the minute I gave that baby a bottle, the lactation person would come in and yell at me for it - but what are you supposed to do in the absence of any help whatsoever? The nurses sure weren't offering. They all claimed the person would be around. Finally, on day two, a person came into my room and introduced herself as the lactation person. I started rapid-firing questions at her and she stopped me mid-sentence. "Oh, I'm not the in-hospital person. I'm just here to tell you about the outside hospital services." She threw a few pamphlets and clichés at me and promised to send the in-hospital person, who didn't come until six hours later and then got impatient because the pediatrician was there too. I asked her to wait because I'd been waiting to talk to her for more than 24 hours by then and she said she'd come back in five minutes. Five minutes later a nurse came in to tell me she decided not to come back and would send the evening person by so I'd have to wait another few hours to even see that person, making it now about a day and a half after The Caterpillar was born. And yes, when she finally showed up, she did yell at us for giving her formula. Gee, I wonder why people give up on breast-feeding so easily?

Post-partum, hormonal women who are having post-operative pain and nursing a child should have 'climate-controlled rooms', not 'rooms controlled by the climate'. I should have known right away that something was up when every single nurse who came into my room said, "Whew! It's hot in here!" accompanied by a dramatic wave with the chart across their faces. You can't see it here but this thermostat for the room I was staying in shows a current temperature of 80. Add to that, hormones, post-operative pain, nursing a new baby with a core temperature of 100, and no air circulation you get an approximate room temperature of 900 million degrees Fahrenheit.

Here is the individually controlled AC system for the room: Here is the system that replaced that system: And here is the system that replaced that system: Here is the plastic pillow they gave me to lie on in the 900 million degrees Fahrenheit room: Here is the plastic bed they gave me to sleep on on the 900 million degrees Fahrenheit room: Here is Jesus, sweating: Seeing a pattern here? Finally on Friday night, it got so unbearable that we asked for another room and threatened to move my bed into the hallway until a maintenance guy finally showed up. He came in, fiddled with the controls (like we hadn't tried that already) and then went out mumbling that there was something wrong with the main frame coil thingy bob and if he could fix that it'd get more comfortable, otherwise he'd come back with a new window unit. Over the course of my stay he proved the only person who actually kept to his word and did, in fact, come back with a new unit... five, count them, FIVE MINUTES before they released me the next morning.

Rooms with plumbing problems are probably not the most sterile or useful. Here is the oh, so sanitary sink where water wouldn't drain out in under thirty minutes:
On the first day a nurse noticed this and said, "I'll put a work order in for that." I never saw her again. If I had, I would have asked her to add to her imaginary list of things she intended to do but never would, the fact that in both the sink and the shower, when you turned on the hot water control, hot water came out. And when you turned on the cold water control, hot water came out. Made for a lovely shower and pericare, because don't think for a minute that the nurses let the water cool down before using it, let me just exist to be a witness to THAT.

I'm not saying that sink is what caused the post-op infection that I'm currently dealing with; I'm just saying it probably didn't help.

Don't send patient advocates around to ask how the care is going if they are going to be completely blindsided by the honest answers they're given. I have to say my favorite part of the week was when Monica, KoH, and I were sitting in my room and a woman came in and explained that she was from Patient Advocate Services and was just checking in to see if everything was going well and I felt like I was getting good care here. She looked like a deer in headlights when the three of us together said, "Uh... you might want to have a seat."

Oh and by the way, there's a spot on the drywall. I'll bet KoH could have fixed that while we were there if you'd asked him.
We are not amused.