Dedication

Dedicated to Intensive Care nurses everywhere

Sunday, December 6, 2015

A Day in the Life - Rehab by the Numbers - part eleven

Continues...







Initially we were restricted to day leave on Saturday or Sunday but eventually we were afforded an opportunity for weekend leave.  This required a house assessment by occupational therapists.  During the visit we agreed strategies for managing Carolie around the house.   

Longer term modifications were necessary, including rails for a bathroom, the front porch stairs and internal staircase.  Our toilets had to be fitted with a unit that raised the seat and provided built in security rails.  These became permanent fixtures.  In the short term a shower chair and an adjustable toilet module was provided by ACT Health.  Some stroke victims have a high risk of falls and most strategies revolve around fall mitigation.  It was agreed that Carolie would sleep in a downstairs bedroom with easy access to a toilet.  

Weekend leave tested my caring abilities to the hilt.  I purchased a baby monitor to alert me to any issues during the night.  It provided a visual and audio signal that helped me monitor Carolie's sleep periods, which were extensive.  She continued to tire easily and nausea bouts were frequent.  She had weak bladder and bowel control, which required regular attention.  On a few occasions I was changing sheets in the middle of the night.  Her drug regime was intense, including stomach injections at night and a plethora of drugs. 


Carolie at home on leave


I made a few mistakes but nothing that seemed to cause major concern.  A drug schedule was provided on taking leave of the ward, which was acquitted on return.  It would be easy to disregard the schedule and mishandle drugs – assumed responsibility and common sense combine to ensure the relaxed protocol around drugs issued to carers is effective.  This aspect of patient management was empowering, in stark contrast to much of what we had experienced.

Another scenario emerged we had first become aware of from other patients at mealtime.  The Rehabilitation Department had another unit, which was available to patients who displayed a degree of self-reliance.  It was aptly named the Rehabilitation Independent Living Unit or RILU.  I was encouraged to visit the unit, which is in a far corner of the TCH domain – a labyrinth way station for those looking to take their leave.  It had an inviting ‘holiday camp’ feel about it.   

The relatively compact building had a rustic, welcoming facade surrounded by bits of tended garden, in stark contrast with the architectural behemoth of the main hospital building.  The holiday camp theme continued inside. There was a homely lounge room and open kitchen/dining area.  Each patient was allocated their own bedroom that could best be described as ‘Spartan’.  Inmates had ready access to the kitchen and an adjacent gym/workshop facility.  They could come and go as they liked within the confines of the unit.   

On the surface it seemed preferable to the stifling ward regime.  Why did this facility have such a different operational culture?  This was low security incarceration with perks and a degree of self-management, held out as an aspiration for those subject to the strict discipline of the ward.  My worry was that a transfer would mean too much adjustment for Carolie.  Our best result was going home.

To be continued...

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