Whipsawed
Two days after he was re-admitted to the ICU, my dad was found to have a bacteria called Clostridium difficile (called "C. diff" or "C-diff" or various other iterations for short). C. diff is common in hospitals, but it can spread easily, so patients who have it are typically placed in isolation with "contact precautions" in place.
Isolation is easy in the ICU because patients each have their own rooms. "Contact precautions" means that all visitors, including hospital staff, must wear gowns and gloves when they enter the patient's room and must remove them, and then wash their hands, when leaving.
And nothing that enters the room is supposed to go back into the general population. For example, unopened containers of applesauce or pudding or Jell-o can't go back into the ICU refrigerator—they have to be tossed. By the same token, we're not supposed to bring in jackets or bags or books or anything else that we might want to take with us at the end of a visit, so we have to put all of these things in shopping bags and leave them outside the door.
Yesterday, we were told that the contact precautions had been lifted because my dad remained asymptomatic and had completed the requisite course of antibiotics. This was great news because a) it is a major pain to don and doff gowns and gloves all day long and b) it is a major pain to have to analyze every item to determine whether it's OK to bring it in the room. (How many sections of the paper can I reasonably expect to read while my dad naps? Am I going to want to keep my fleece on under the gown? Will I finish this bottle of water before I leave tonight?)
I, for one, did a happy little striptease with my gown and gloves—and only my gown and gloves—to celebrate. And then I retrieved my bag and coat from out in the hall.
A short while later, we were told that one of the ICU attendings had overruled the epidemiology department and reinstated the contact precautions. He wanted to impose a different standard for lifting the precautions, and it might be several more days before that standard was met.
Back on went the gowns and gloves. Back out into the hall went the bags and coats.
When we arrived today, however, we were told that the contact precautions had once again been lifted. Apparently, someone in Infectious Diseases had overruled the ICU attending. We were skeptical at first, but we were assured that this time the decision was final.
Later in the day, we got word that my dad was finally going to be moved out of the ICU. We were told exactly what floor he was going to be sent to, and his nurse even went up there to retrieve his new bed. (ICU beds are super high-tech, and they stay in the ICU.) Meanwhile, we started packing up his stuff and cleaning up his room.
Not so fast.
About 15 minutes later, we found out that there had been some kind of miscommunication.
My dad wasn't being moved out of the ICU. At least not yet.
The floor to which he was supposed to move has two sections, but only one had an open bed.
The wrong one, as it turned out. So he will be staying put for the time being.
On the bright side, at least we can stop playing dress up when we go to visit.
Isolation is easy in the ICU because patients each have their own rooms. "Contact precautions" means that all visitors, including hospital staff, must wear gowns and gloves when they enter the patient's room and must remove them, and then wash their hands, when leaving.
And nothing that enters the room is supposed to go back into the general population. For example, unopened containers of applesauce or pudding or Jell-o can't go back into the ICU refrigerator—they have to be tossed. By the same token, we're not supposed to bring in jackets or bags or books or anything else that we might want to take with us at the end of a visit, so we have to put all of these things in shopping bags and leave them outside the door.
Yesterday, we were told that the contact precautions had been lifted because my dad remained asymptomatic and had completed the requisite course of antibiotics. This was great news because a) it is a major pain to don and doff gowns and gloves all day long and b) it is a major pain to have to analyze every item to determine whether it's OK to bring it in the room. (How many sections of the paper can I reasonably expect to read while my dad naps? Am I going to want to keep my fleece on under the gown? Will I finish this bottle of water before I leave tonight?)
I, for one, did a happy little striptease with my gown and gloves—and only my gown and gloves—to celebrate. And then I retrieved my bag and coat from out in the hall.
A short while later, we were told that one of the ICU attendings had overruled the epidemiology department and reinstated the contact precautions. He wanted to impose a different standard for lifting the precautions, and it might be several more days before that standard was met.
Back on went the gowns and gloves. Back out into the hall went the bags and coats.
When we arrived today, however, we were told that the contact precautions had once again been lifted. Apparently, someone in Infectious Diseases had overruled the ICU attending. We were skeptical at first, but we were assured that this time the decision was final.
Later in the day, we got word that my dad was finally going to be moved out of the ICU. We were told exactly what floor he was going to be sent to, and his nurse even went up there to retrieve his new bed. (ICU beds are super high-tech, and they stay in the ICU.) Meanwhile, we started packing up his stuff and cleaning up his room.
Not so fast.
About 15 minutes later, we found out that there had been some kind of miscommunication.
My dad wasn't being moved out of the ICU. At least not yet.
The floor to which he was supposed to move has two sections, but only one had an open bed.
The wrong one, as it turned out. So he will be staying put for the time being.
On the bright side, at least we can stop playing dress up when we go to visit.
posted by Jody Rosen Knower at 6:53 PM
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