Thursday, June 25, 2009

Nothing like a little poke in the bladder...

INCOMPETENCE. No seriously, the nurses at St. Joe’s here in Baltimore are incompetent.

Two Fridays ago (yes folks it has been that long since my last update), my mother and I went to St. Joe’s for Clara’s re-cath and VCUG If I failed to mention what was going on with that the doctor, to rule out VUR sent Clara in for this test and a re-cath to take her urine to check to make sure all the e.coli was gone. Apparently it is common in young girls to have some type of VUR which they typically grow out of. Anyway, so the last time we were at St. Joe’s the nurse and PA took about 2 mins to cath Clara, grab the urine and take out the cath. Yes, she screamed but once the cath was out she was fine. So I expected much the same thing to happen this time. But did it? No.

Rather than get two competent nurses we got one fresh-out-of-nursing-school nurse and some other moron with a nursing degree. But first things first. After we registered we were told to head to radiology where they would be doing the VCUG (natch). The nurse in radiology told us “we don’t cath here you have to take her to 2 north [pediatrics].” Mom and I hustle up there to find that there is no record that we are coming in (remember I said Clara was also supposed to have her urine re-tested so they SHOULD HAVE had a record of us but they didn’t). The fresh-out-of-nursing-school nurse runs down the hall to get charge nurse. I am not sure who she actually got but neither she nor the one she got were competent in any way. Have I mentioned their extreme level of incompetence yet???

So these two moronic jerks set out on a course to cath my 12lb, 25in happy, adorable, bundle of love. Clara had no idea what was about to happen but the two of us (me and my mom that is) were there to soothe her should anything go wrong. And go wrong it did. The more experienced nurse (I assume) handed over the reigns of cath’ing Clara to the just out of nursing school nurse. For 15 minutes she tried to cath my baby. All the while my beautiful and happy baby is screaming bloody murder. AND speaking of which she actually made my child BLEED. Finally, after bringing me to tears (I just couldn’t stand it any more) I told them to STOP, STOP IT RIGHT THIS VERY MOMENT- which was met with “but but but” and I said GET OFF HER RIGHT NOW and so they did. I calmed down Clara (actually my mother did as I ranted about how pissed I was). The two re-entered with a new cath. I almost had it in my mind to get an actual Dr or PA or NP but I didn’t because my mother assured me all would go well this time.

It didn’t. And again 15 minutes of crying and excuse making by the more experienced nurse occurred. “Oh, sometimes a baby’s anatomy is off to the side and it’s hard to get to” to which I responded “this isn’t the first time she’s been cath’d the last time it took 2 minutes what the HELL is your problem”- a very surprised look from the nurse. Finally, they got it in and now I was charged with walking my child, screaming, crying, fidgeting and fussing down to radiology on 1 South. That’s an elevator ride and a nice LONG ass walk. We get to radiology and they took her right in THANK GOODNESS.

What did the doctor find? She definitely has VUR- at least Grade III if not Grade IV, maybe higher. We were given antibiotic prophylaxis to take until she can see the Pediatric Urologist on August 10. The Ped Uro is at Hopkins and he’s a pretty popular guy (well he should be, he’s the head of Ped Uro there). So it’s a waiting game.

In the meanwhile Clara has learned to turn over, laugh and, get this, hold a bottle all in the last month-totally amazing both me and her daddy. She has the world’s best, most heart-melting smile. She has begun to teethe but I hear that it can take a while to see teeth; lucky us. More pictures to come- I promise.

Tuesday, June 2, 2009

And now for the conclusion (Part II)

I chatted with the daycare director face to face yesterday when we went to pick up Clara. The room was in much better condition (still not 100% but a lot better than when I walked in yesterday). Ms. Millie had left for the day so I still didn't get to speak with her (apparently her hours are 8:30-5:30. We have to drop Clara off before 7:30am and we can't pick her up until 6:15pm because Ray and I both work in the city and the daycare is way out in the 'burbs). After having a brief chat with two of Clara's "old teachers" (they are the original Infant I teachers that are now the new Infant II teachers) I spoke with Jessica (the director).

I explained to Jessica how I felt and what I thought about the switch and how I wished it had been better explained to us. I told her I was rather upset with the state of the room in the morning and I felt like there was enough time for Ms Millie to set up her room for all the new infants she was about to get. I let her know that I didn't think it was acceptable that if I am handing over medication to teachers that the actual teacher who would be administering the drug to my child wasn't there to speak to. Jessica explained that whatever teacher I spoke to could relay any messages. I said "look I know they are supposed to do that but when you have 6 children who are all either in stages of crawling, crusing, walking etc your primary concern when another teacher walks into the door is to get help. That usually means handing over whatever children aren't really 'your' children and stopping the children that are 'yours' from running amok in the room. Now with that in mind some things, some very important things, may not be communicated and while I know I can write a page long note about my Clara-once again with other children involved things don't get read, things get missed and we have problems." So Jessica said she understood my concern. Then I mentioned about the little babies typically being asleep earlier in the morning (or at least going down earlier than the 9-18 month crowd). I said "listen most 9-18 month olds have set nap times, right? Little little ones usually don't-they sleep when they are tired, eat when they are hungry typically-they are much harder to schedule. When you have to have them in a room where there is no place for them to sleep except the floor on a boppy or in the bouncy seat or in another child's crib [I actually don't think they allow this] it's really not conducive to their happiness and well-being. Not to mention when Ms. Millie comes in the door at 8:30am if my child happens to be napping already, now Ms. Millie has to pick her up, move her to the other room, put her in her crib. That can be disruptive and disturbing to my kid, you understand what I am saying?" And Jessica said "absolutely and I never thought about it like that. Perhaps what I need to do is have one of the Infant II teachers in the Infant I room until Ms. Millie comes in." Then Jessica said she thought it might be difficult to convince any of the now Infant II teachers to move to the Infant I room because all the Infant II teachers are very social and part of the reason Ms. Millie only has three babies is because she likes to "work alone." Well HELL PEOPLE- this ins't a freaking democracy is it? I wanted to say "Uh but Jessica YOU ARE THE BOSS AND YOU MAKE THE SCHEDULE" I mean tough crap that you HAVE to be in an hour early so you can actually TALK to parents (GOD freakin' forbid that happens) or that you have to leave your precious Infant II room so that someone can pay attention to my kid while she sleeps. LOOK I know it's no fun dealing with a 4 month old- I mean what does a 4 month old do but eat, sleep, poop, smile and be charming? But honestly NOT MY PROBLEM. You get PAID to sit and watch my kid sleep for heaven's sake. It's the easiest f'ing thing to do that, no?

Anyway, we'll see what Jessica ends up doing.

*sigh* Yet another reason I need to be home with my kid. WHY does it have to be so hard folks? Why?

P.S. The doctor called and she has e. coli in her urine. Ugh. We have to keep giving her the abx and call the doc in a week. My guess is for a follow-up cath. Fun!

Monday, June 1, 2009

And now for the conclusion (and a rant)


So yes she did have to be catherized on Friday (ugh). Ray took her to the doctor and once again he found not apparent problem with her but to be sure he made Ray take her over to St. Joe's peds wing to get a catheter so that they could do a urine dip and a culture. The results of the dip were inconclusive (there could be something but it's really not likely causing the issue etc etc) we were told the doc would have the results of the culture yesterday but in the meantime he was putting her on abx. The doctor didn't call yesterday so Ray will call this morning to see what the results are. She stopped needing the tylenol on Saturday afternoon. But that's normally how it goes with her. She runs the fever for less than a day and then she's perfectly fine. So, if it is a UTI then at least she won't be running any more fevers with no apparent cause. However, if it isn't a UTI then I am not sure what our next step will be. Ray will find out today.

And while this is all stressful enough for a new mommy I've got other issues on my mind.

Last Thursday the daycare sent out a letter saying that they were changing the Infant I and Infant II rooms because they had more infants that were crawling, cruising and walking then they had in Clara's age range (under 6 months). The way they were doing it is to move the younger infants to the smaller room and leave the older ones in the bigger room. The teachers, however, would remain in their original rooms (i.e. Clara would have a new teacher). OK, fine I thought not a problem she's only 4 months old she doesn't care who gives her the bottle and changes her- this should not be an issue.

HOWEVER, I thought that since today was the first day of the switch I would (A) get the meet the new teacher (nope didn't happen-apparently "Ms. Millie" doesn't get in until 8:30am) (B) the room where she would be staying would be set up (no again). In fact the mattresses weren't in the cribs and there were no names on the cribs. And just an aside Clara is ALWAYS and I do mean ALWAYS asleep when I bring her in the morning and I like to lay her down in her crib so she can get some extra zzz but with no teacher in there and no freakin' crib to sleep in what the heck am I supposed to do???? THAT on top of the fact that usually I fill out a sheet for Clara (saying what time she ate and woke up plus special notes for the teacher) but the new room didn't have a clipboard, pen or the freakin' sheet for me to write on. Not to mention the fridge being an absolute mess and labled with the wrong freakin' names. And finally, to add insult to injury, I am supposed to leave Clara's medication for Ms. Millie to give to her but I couldn't talk with her about it because she wasn't in. No thanks. I'll just give her all the medication at home thankyouverymuchandhaveaniceday.

They knew they were doing this Infant I/Infant II switch-a-roo long before the parents got notified (which for the record no one asked if we were okay with). With that in mind why didn't they have all the stuff done? This switch should have been freaking effortless and not the cause of frustration. I am so angry right now. I should not have walked into the new infant I room today to see other children's names where my child's name should have been. I should not have walked into that room and NOT seen my child's teacher. If anything TODAY (and even if it was just today) Ms. Millie should have gotten her ass in early to meet the parents of her students. For crap sake!

I guess I'll be making a phone call this morning...