BBM This is one thing I kept wondering about. I had a surgery this summer where I was intubated. It wasn't for tonsils so I did not have the throat trauma but I was in recovery until I had some toast and a Pepsi, then I could go home.
Jahi was in the recovery and then taken to ICU, why wasn't she taken directly to ICU? In recovery, there is not someone there at every moment where there is in ICU. Also, when she started bleeding, why wasn't she attended to by a doctor right then or taken to ICU or back to an OR?
BBM. Every hospital does things a little differently. I have worked in hospitals that sent planned ICU admits directly from the OR to the ICU, and I have worked at hospitals where all ICU-bound patients spent time in Phase I recovery. The sicker, intubated PACU patients do indeed have 1:1 care-- sometimes 2 nurses and CRNA's and Anestheisologists as well.
Some states have mandated ratios on their nursing units, others don't. Some hospitals have mandated ratios; others schedule 1:1 or 1:2 in ICU's based on census and patient complexity.
As I look back on several pages here, there is an urge for some posters to say "this and such thing always happen this way", and then give a personal anecdote. Another example given is that complex throat surgery patients "should" always have a pre-emptory tracheostomy-- which is far from what the literature recommends, nor is it commonplace. Or the example that certain organ systems "always" fail in a certain order, because of a personal experience with a loved one. There is a fair amount of misinformation flying about on these pages.
I am also personally very offended at the suggestion that the surgical team would willy-nilly just "add on" elective procedures as they go, just because they "felt" like they were necessary, and not obtain informed consent ahead of time. Or that the surgery was somehow "unnecessary" and the family was "duped" into going thru with it.
I am personally very offended at the suggestion that highly educated and experienced ICU nurses are just scatterbrained dimwits who don't know what surgical procedures their patient has had, and whether or not they have sutures or can be fed a popsicle. Nothing could be further from the truth.
I really don't understand the animosity toward these hard working, highly educated, and experienced professionals AS A GROUP. Dear god, nobody, but NOBODY, wanted that little girl to be okay more than her surgical, postop, and ICU team-- except her family. Health care professionals DREAD complications with children-- I have NEVER met a careless or complacent professional involved with the surgical care of children. I am just so deeply offended at the suggestion that we are all idiots haphazardly slinking our way thru thru cases, withholding vital information from families, making mistakes right and left, and just waiting for our lunch break or something. Walk a mile in OUR shoes, please.
This family is heartbroken, angry, and extremely adversarial, in addition to their voluntary denial. I am not at all sure I believe that their perceptions and account of a number of things is accurate. There are so many things that are red flags, and so many inaccuracies in what they have told the reporters, that I can't believe them without much more information to validate their version of the truth.
I understand they are angry in particular with Dr. Durand, the chief of pediatrics. I believe their actions with regard to recruiting social media harassment for this man are highly unethical, deplorable, and potentially illegal. I believe the "march on the hospital" was a tremendously selfish, ill conceived, insensitive, and worthless maneuver. Apparently they are not unhappy with ANY other member of the surgical team, or the postop and ICU team, as they have not mentioned ANY of these other professionals by name.
The hard truth is that Durand, as Chief of Pedes, was most likely called in to try to get thru to this family in extreme denial, after a hoard of other docs and social work professionals tried. They were most likely already very upset before Durand ever spoke with them. The situation escalated until the only one left to try to get thru to them was the Chief. He took the fall for his entire hospital team, and stepped up to work with this family. I have no doubt that they perceive him as abrasive and rude-- his job was to tell them their precious child was dead following an elective procedure. That is the most awful news any family could receive.
I have compassion for this family, for the horrible death of their daughter. But I have little approval for the way they have chosen to conduct themselves in the awful aftermath. They have made the situation, IMO, much, much worse that it ever was, for themselves, and everyone else. And IMO, they have tremendously exploited their precious daughter in the process.
If they truly believe she is alive and should be cared for, they need to take her home and take responsibility for her care, instead of blaming everyone else for not taking her body in transfer. That is the easiest and quickest path to getting her body out of the hospital with the heart still beating, which is their stated goal. And it could happen before 5 pm tomorrow, and be within the $20K budget from their fundraising. At this point, CHO might even give them the ventilator if they asked for it. They would have complete control over her care if they take her home, and their community of supporters would step up to help. They can't force so many other people to do what they want, just because they want certain things to happen. The child is legally dead, and no facility or doc will take responsibility to do what the family wants. So the only answer left is to either let her go and remove the vent, or take her home and take responsibility for her care. JMO, IMO, etc.
Thank you for a wonderful post. Thank you for your eloquence where I only had lots of tears at the memories of taking care of patients much like Jahi for weeks at the time as an ICU RN.
