So I came out of my mastectomy with a huge horizontal
incision where my right breast once was, and a Jackson-Pratt drain http://en.wikipedia.org/wiki/Jackson-Pratt_drain
installed. On the left side, I had an infusion port for upcoming chemotherapy.
Although I’d expected to go home after the surgery, I was
admitted to spend one night in the hospital because my surgeon expected me to
have significant pain. I even had a
morphine pump.
The nursing staff got me all connected and then checked on
me every couple of hours for the rest of the afternoon. They checked my drain and emptied the
collection bulb once. By that time it
was clear that I was having NO pain and my biggest problem seemed to be
frustration with the lack of anything worth watching on TV.
When anyone looked at the drain again, it was empty. Knowing
nothing about what to expect, I assumed that was good - that no fluid was collecting at the surgery
site. The nurses, in retrospect, should
have known better.
What really kept me from a good night’s sleep was not the
occasional visit by a nurse, but by the incessant dinging of other patients
calling for a nurse. I have no idea how
many RNs and LPNs were on duty, but there were certainly not enough to handle
patient demand.
I don’t know what is an acceptable nurse/patient ratio, but
I’m sure it wasn’t the case here.
Why? Pencil pushers setting
standards for care? Shortage of
nurses???
If you read the previous post, you know that I was not discharged
until mid afternoon on the day after surgery.
I was given oral instructions to empty my drain’s collection
bulb twice a day.
I was given 13 pages of discharge instructions and
educational info. 12.75 pages of which
were general information and thus utterly useless.
WHAT I DID NOT GET
Someone who might have thought that
it was unusual that no fluid was draining out; and who might have at least
asked someone more knowledgeable if it should be looked at further.
Any discharge instructions specific
to my situation – mastectomy, drain, port implant. (After my earlier lumpectomy, the outpatient
surgery center gave me very clear and specific instructions.)
WHAT HAPPENED NEXT
The surgeon had arranged for Home Health Care so on Sunday a
visiting nurse came to see me. My drain
still wasn’t draining and I still had no pain.
I declined to continue with Home Health Care.
Monday morning, my favorite nurse “S” called to ask why I’d
declined the nursing service. After I’d
explained, she commented that perhaps the drain was clogged. (That thought
should have occurred to me, but it never did.)
She asked if the area around the drain was swollen. It was. But I still didn’t catch a clue.
As we were getting ready to go out later that morning, I
inadvertently pressed on the swollen area and released a deluge of fluid – not
through the drain tube, but from where the tube was inserted. What a mess! I called S and she called the nursing
service.
Another nurse came to see me and did what should have been
done before I left the hospital.
She flushed the
drain which freed the clog. Much
draining ensued.
She explained
that not only should I empty it twice a day, but I should measure the volume of
fluid and keep a log so that the surgeon can have some information about how
things are progressing. The hospital gave me a vial for emptying the fluid but
said nothing about measuring and logging.
ALL’S WELL THAT ENDS WELL
The drain is working. I know what to do.
It was a very frustrating couple
of days.
At first I was upset with the
hospital nursing staff because no one thought my lack of draining was
unusual. Then, considering the constant
ding of nurse call bells, I came to fault the hospital for inadequate staffing. Nurses are run ragged with too many patients
to look after. How can there not be lapses
in attention and care? It’s a very
unhealthy situation for everyone.
