We've been patient with this morphine dance, truly, more so than most might be. We have had faith in the professionals here at MGH and have learned more about NAS scores, respiration rates, heart rates, and oxygen levels than I care to keep track of.
I'd say we are being good god damn sports.
That being said it's wearing thin and these bitches don't know what they are in for, cause while L has taught me patience, I'm no fool and I'm certainly no saint.
Last night L's scores went up to 4- however as it has been explained 100 million times, scoring for withdrawal is subjective. So as people come in they can score one thing, one way and another can score in a completely different way. I understand that- and it is frustrating but it is what it is.
Last night she threw up... it could be withdrawal. It could also be that she breastfeed for 40 minutes, STILL got a tube feeding and was being held by Dad and he may or may not have not been the most graceful putting her down. Result- a little puke and a bad score.
Last night she got the hiccups... it could be withdrawal. It could also be that she has had the hiccups since she got here- hell she has had the damn hiccups since she was 25 weeks old.
Last night she sneezed... it could be withdrawal. It could also be that the bug pulled up her dang feeding tube - and the tube sat behind in her throat where it was would cause consecutive sneezing that she was scored for.
Now, she scored 4s which is STILL "4 or below" and they did bring her down last night at midnight. Instead of going .15, they went .10.
"Why not the .15 decrease?" I asked the nurse.
The nurse started babbling about the fact that nurse before gave her a 2 and a 3 and after that she added another 1 so the first score was a 2 and the second a 4.
I interrupted, "both of these are 4 or below. What is the point? She is to go down by .15."
Insert nurse babble.
I interrupted, "You have got to be kidding. This is a joke. A terrible joke."
The nurse, innocently enough, began explaining the NAS scoring system.
I interrupted her, "I know."
The nurse, innocently enough, began explaining how typically we go down .10 when weaning.
I interrupted her, "I know."
She became disorganized, looked like she might throw up, maybe even had a loose stool- all the signs of withdrawal or maybe just a nervous nurse coming up against a sick and tired mom at 12:30 am.
I held onto the crib, to keep my balance and cool, and carefully constructed my sentences- kind of like how a loony on a Law and Order episode gets calm before he throws a chair at Stabler or Mariska.
"I can not tell you how increasingly frustrating this is. I had the team come back in yesterday afternoon to discuss this plan which is that every 12 hours we are going to come down by .15. I understand this is not your fault, but you are here telling me something that is not what I was previously told. So, I'm going to need you to go and talk to a doctor and make sure this is the case."
She did and returned with the same ol' same ol'. That crazy b even tried to go back to her speech about what a NAS score is and how they get to it. Ultimately the order was never written- however I know it was because I SAW IT. Where to find it was another story- but the doctor and nurse on last night did not have it.
This twiggy little intern that does the rounds in the morning and was part of the team to come and re-explain the wean plan to me the night before- she was on the floor I know she knew the orders however because they claim they weren't 'written' no dice. Plus she sucks and I've always disliked her- she is quiet, mousy and her voice annoys me. This experience with her has not helped her standing on my list.
She did get weaned, however by .1 (and through out the day that's .2 which is MORE than we originally anticipated each day being weaned).
The nurse then had the audacity to say, "I know it doesn't seem like it but really it's not that much that .5."
My reply, "You stay here and go through this and tell me what is small or not. Every day is another day, another story, another plan, another way to do things and another thought. I'm done with recommendations. Please tell the nurses that I will no longer be nursing, as when I do you can't tell how much she is taking so then she throws up - and she gets scored badly because you pump more food into her anyway. I will pump and she will take it in a bottle so we can see it. I want to go home. I want to take her home. If you can tell me how we can get home, fine otherwise, thank you anyway. And please make a note that we need to revisit the weaning plan and how to communicate that."
"I know you... " she started.
"NO you do not." I finished.
She started apologizing, I have no idea- I tuned her out and crawled into my stupid little nook in the back of the room as I cried and emailed Chris with the subject line "I'm going to cut a bitch."
I’m fairly certain one day he’s afraid he’ll come in and they’ll tell him that L is doing great, but I on the other hand had to go visit another floor and will be staying there for awhile.