The Theater of the Absurd

Beth was Henry's nurse today. He was doing well. He did a little sat surfing while I was there. I became frustrated, however, by some of the nurses and parents in the pod.

The pod had been relatively quiet since the move to the corner of the room. We had hit a snag a couple days ago when someone activated the very loud ringer on the telephone at the end of the pod, about five feet from Henry's isolette. But Gene deactivated it for me yesterday.

Several nurses once again forgot that they should keep their voices low. I sometimes feel like I'm a character in the theater of the absurd and can't change the script. Here today's events in this theater of the absurd...

(1) Intercultural Miscommunication

Henry's pod holds ten babies. As near as I can tell, at least five babies belong to parents whose english language skills can only be described as limited at best. It appears that very few nurses are bilingual, which causes communication problems. Unfortunately, some nurses simply raise their voices at the parents when the parents do not understand instructions. It hasn't occurred to them that if a person doesn't speak english, speaking loudly isn't going to help them comprehend the words better.

The parents of the triplets (who are stationed close to Henry's isolette) do not speak english well. Two of the triplets are scheduled to go home today. All three have different prescriptions that they need to take. And one of the prescriptions got changed since yesterday, meaning that new medication bottles are needed. But the parents were given one of the bottles yesterday with the wrong dosing on it. The pharmacist did not want to issue a new bottle when the old bottle is somewhere out there. The nurse assigned to the triplets today does not speak spanish. So she was trying to convey this information to the parents and decided that speaking english as loudly as possible was the best way to do this. In the meantime, another nurse came in to help. She gets on the telephone next Henry's isolette to call the pharmacist and all but yells at him to get the prescription.

This puts me in a difficult position. I don't want to offend these nurses, one who has been Henry's nurse before. But I can't have them upsetting my child. And frankly, it isn't good for the other preemies in the pod either. So I talked with Beth and asked her if she could talk with her colleagues and have them take their prescription escapade somewhere else.

(2) The Coughing Man

At one point during my visit, one of the parents (I assume it was a parent) of a new baby at the other end of the pod gets up, walks to our end of the pod, coughs, then walks back to his end of the pod, and visits with his baby. I kid you not. If it isn't OK to cough on his baby, why would he think that it is OK to cough in the area of other babies? The selfishness and stupidity of people never ceases to amaze me. Beth wiped down Henry's isolette cover with a sanitizing cloth.

These were just today's events in the Theater of the Absurd. We've experienced several other events that warrant mention.

(3) Washing Hands Is Over-Rated

As you enter a room that leads into the NICU, there is a station for washing one's hands. Parents and guests are instructed to wash their hands for three minutes. There are two sinks in this room. You'd think that the rationale behind handwashing is pretty darn obvious. And yet, parents and guests are often seen to skip this step or wash their hands for two seconds and then head into the NICU. The instructions at the sink are clear. Even if you aren't planning to touch a baby, wash your hands! Why? Because even if you don't end up touching a baby, you may end up touching tables or chairs that other people touch. Duh!

Believe it or not, I actually had a grandparent of another kid try to get me to stop washing my hands for the three minutes because he was waiting and wanted to get into the NICU faster. Having not met me before, he thought he could pressure me into leaving the sink. He kept saying, "You aren't performing surgery. You don't need to wash for that long." I feel sorry for his grandchild.

My mom has seen the nurses send a father out of the NICU to wash up. Guess he was about to hold his baby but had dirt on his hands.

(4) A High Patient Is A Happy Patient

When I was admitted to intensive care, they asked me what I was allergic to. I said two things: percocet and aspirin (luckily not ibuprofen). I was questioned by just about every nurse and doctor about my percocet allergy. I said that I taken it before, and it makes me severely nauseous. In fact, both of my sisters have similar problems with the codeine family.

While they were sewing me up during my c-section, the anesthesiologist gave me a morphine dose that was to last 24 hours. After surgery, every few hours, the nurses would ask me to rate my pain on a scale from 0 to 10 where 0 means you do not feel pain and 10 means that bamboo shoots have been shoved up your fingernails. I rated my pain a 2 or 3. I was hurting, but the pain was tolerable if I did not move too much. And bamboo shoots at 10 sounded pretty damn terrifying.

The day after surgery, I continued to rate the pain somewhere between 2 and 4. I was asked by doctors and nurses if I was sure that I didn't want percocet. I said no, I was allergic. Having just had my abdoment sliced the evening before, I really didn't want to spend several hours puking over a toilet. The doctor didn't seem to believe me when I said no and and really wanted me to take it. He said he could give me anti-nausea medication to take with the percocet. I realize that we live in an instant gratification society, but considering that I had explained that the pain was tolerable, why would one try to push drugs on a patient? I didn't feel great when I moved, but that was pretty understandable. I believe that one shouldn't take drugs that one doesn't need. Mind you, there are many occasions when medication is necessary. I did ask for ibuprofen, which took the edge off the pain. Sometimes pain is a healthy indicator. In my case, when I got into a bad position or moved in a way that my body wasn't ready for, the pain told me to change positions or stop moving.

I was moved down a floor late on the second evening, no longer needing intensive care. Wendy, a nurse from the ICU, helped move me downstairs. She was aware of the situation and informed the nursing staff on the 7th floor that I should be given ibuprofen and then tylenol in three hour cycles. Again, this was to keep the edge off the pain. Basically, the philosophy on the 7th floor during the night shift was to forget giving any medication, if it wasn't percocet. I had to stay on top of the medication schedule because the nurses didn't. My mom once had a doctor tell her (off the record) that she should bring her own ibuprofen to the hospital since you couldn't depend on the staff. I wish I had kept a bottle handy.

Despite one of my many wrist bracelets saying that I was allergic to percocet and a sign on my door saying the same thing, I was offered percocet several times during my stay there. Apparently, no doesn't mean no when it comes to narcotics in the hospital.

My interpretation of the percocet issue is this. The medical staff like giving patients these painkillers whether or not they really need them because a drugged up patient is one who doesn't complain and thus makes their lives easier. There are, of course, a few nurses who don't fit this description. Unfortunately for me, they were only assigned to me about one-third of the time.

As I got ready to check out of the hospital on the fifth day, a nurse came into my room to give me my parting prescriptions. Can you guess what medication the doctor assigned to my case decided to prescribe for me? You've guessed it. Percocet.

(5) Dr. McCreepy

I slept very little while I was in the hospital. Over the five days, I got less than 10 hours of sleep total. The transition from ICU to the seventh floor was hard, owing to my dealings with the night time nurse staff which I won't chronicle here.

Having just dozed off to sleep, I woke up around 5:30AM on the third day to find a doctor hovering over me. He said that he needed to check the incision. While he was doing so, he asked me: "So, have you and your husband discussed what birthcontrol options you plan to use when you leave the hospital?" If there was ever an event that fit the Theater of the Absurd, this was it. Call me crazy, but I had just had a c-section a little over 34 hours previously and had spent those hours wondering if my child was going to live or die. As handsome as my husband is, sex hadn't been on my mind. I calmly replied, "Honestly, my husband and I haven't discussed it." He said, "You two need to discuss it before you leave the hospital." I said, "OK."

Two days later, Dr. McCreepy (as Jeff dubbed him) was back. I was already up when he entered. He again asked the birth control question. "Condoms," I lied. Jeff and I hadn't discussed it, other than to laugh over the situation. Instead, we had spent the time discussing and worrying about our son.

(6) The "Taking Your Baby Home" Video

Before taking babies home from the hospital, there are two videos that mothers are required to watch. One on baby fundamentals. The second on shaken baby syndrome. On days three and four, I was asked every four hours whether or not I had seen the videos. I explained to everyone that I preferred watching the videos shortly before my son was released from the hospital (a best case scenario placing this time at four months from his birth). After I was asked about this for the billionth time, I relented. So, on the Friday morning of my release, Jeff and I watched the "Taking Your Baby Home" video. It would be difficult to imagine a more inappropriate video to show a mother whose baby could very well die. Jeff and I told jokes throughout it. I also occasionally cried as they showed babies being placed in car seats going home or mothers nursing. Just another event in the Theater of the Absurd.

(7) Jeff Has Postpartum Depression?

The day before I checked out of the hospital, I was given a survey to determine whether I had postpartum depression. They give this questionnaire to all women who have had a baby. If you received 10 points on the survey, you are supposed to notify a healthcare professional for psychiatric counseling. And, you are then supposed to recheck yourself on the survey two weeks later. The questionnaire is called the Edinburgh Postnatal Depression Scale. It contains 10 questions, each with four possible response options that you score from 0 to 3. As a teacher of research methods, I couldn't help but critique the questionnaire as I was taking it.

My conclusion: This is a bad questionnaire with highly problematic face validity issues. If you have ever had a bad day, it is easy to score over 10 points. I believe that I scored a 12 on it. And no, I didn't notify a healthcare professional. I did however have Jeff take the questionnaire. If you believe in this scale, then Jeff had postpartum depression as well. He scored a 10.

Items included gems such as:
"I have been so unhappy that I have had difficulty sleeping." Response options were "Yes, most of the time," "Yes, sometimes," "Not very often," and "Not at all."

"I have felt sad or miserable." Response options were "Yes, most of the time," "Yes, quite often," "Not very often," and "Not at all."

"I have been so unhappy that I have been crying." Response options were "Yes, most of the time," "Yes, quite often," "Only occasionally," and "Not at all."

I didn't bother taking the survey at the two week mark. I was going to throw it away, but I have decided to keep it for my research methods class when we have our unit on questionnaire design. Some of the items have weird qualifiers that make the statements difficult to interpret.

Perhaps this is just another example, much like the "Taking Your Baby Home" video, of an inappropriate fit for my needs at the time. Let me say for the record that postpartum depression is a serious issue. I'm not trying to belittle it in anyway, but I am belittling their scale. As a researcher, I can't believe that they can't do better than this to screen for it.