This evening, Wanda, the home health care nurse, came to our house to start Susan's infusions, and to train yours truly in the intricacies of infusion technology. I admit I have a Ph.D. in science, but I'm afraid that's inadequate for my current job as "nurse Dishman." For example, here's a bit of an exchange between myself and Wanda--Susan's "two" nurses.
Wanda: Using an ordinary quarter give the set screw a half turn to lock the cassette in place.
Me: Is that to lock the battery in place?
Wanda: No. That has nothing to do with the battery. It's the cassette that interfaces with the IV tubing tied to the special spike that enters the infusion bag.
Me: Then what's the story with the battery?
Wanda: Every day you have to take out the old battery and replace it with a new one.
Me: What do I do with the old one?
Wanda: Throw it away. After replacing it you will need to reset the pump by accessing the screen menu on the LCD screen. Remember to reset the RESVOL to the proper level, press start, respond to the 13 questions that will come up sequentially with the proper answers, and then the pump will automatically start.
Me: How should I answer the 13 questions?
Wanda: It will be obvious. Now stay with me: when the first bag is finished disconnect the tubing from the patient and place the special red cap on the end of the tubing. Then flush the patients port with saline and then heparin in the proper order.
Me: Would you mind going over that again, and what about those 13 questions....
Wanda: I'll write it all out for you. In the meantime, don't forget when you install the new bag tomorrow night that you have to step through the same set of questions on the menu as you did tonight. Be sure and sterilize the end of the tube (patient's end) with the alcohol swab prior to connecting it to the IV tubing from the pump. We have provided you with 15 different syringes to do pre and post saline and heparin processing at the proper time and the proper order.
Me: (with eyes now totally glazed over): ...about those 13 questions.....
Actually, Wanda is a very nice lady, and there really weren't 13 questions on the LCD screen--only 4 or 5. And I THINK I can handle the job, but it ain't simple! Please pray for me that I won't mess up the process. Susan will get three one-liter bags of Mg and K for 3 hours each tonight, tomorrow and Sunday. Hopefully this will help her feel better. Today she's felt pretty good except for two severe spells of pain and nausea, one in the morning and the other in the afternoon. Next Thursday we will (finally) get in to see the gastroenterologist who will supervise the TPN. This will be none too soon since Susan is now only eating a little cheese cake and pureed hard boiled eggs with mayonnaise.
Posted by John Dishman at June 6, 2003 08:51 PM