July 24, 2005

The Real ER - Jersey City

The Real ER - Jersey City
(REALLY LONG, but I have a lot of crap to get off my chest.)

Thursday evening one of my two-year-old twins had a fever of 102, which climbed to 103 half an hour later. I gave her a dose of ibuprofen which usually brings it down fast, but after an hour her temperature was 104.6 and climbing. We literally left the house in about three minutes, headed for the emergency room. There aren't many choices in Jersey City for decent health care, so we opted to either take her to Christ Hospital or Wilzig Hospital, the new Jersey City Med ever since the old one was shut down, to be renovated into haunted apartments.

The dilemma facing us was this, should we go to Christ Hospital which is a facing a multitude of malpractice lawsuits or Wilzig Hospital, which being new may have state-of-the-art facilities but the old Jersey City Med staff. For readers who are fortunate enough to live outside of Hudson County, Jersey City Med was not exactly known for its competent staff. As my obstetrician once said, when I asked him rather dubiously whether he expected me to deliver my twins there, "I wouldn't go there with a paper cut."

Since we were closer to Christ Hospital, we stupidly opted to go there. Hindsight is 20-20. By morning we were kicking ourselves for not driving the extra time to UMDNJ or Clara Maass or St. Joseph's. I mean we waited in the emergency room for 2 hours so it wouldn't have made a difference. Although considering the areas those hospitals are in, the wait might be crazy.

We pulled up to the emergency room at Christ hospital and I brought Angelina to the front. We filled out a triage form and sat down. Apparently you don't get to speak to anyone in the ER directly, unless you walk in holding your intestines in your left hand and your liver in your right. Half an hour later, the nurse called us in for a preliminary examination of Angelina, then sent us back out to be "registered" which is a nice way of saying "Let's see if you can pay for this shit." We registered then sat down to wait some more.

An ER waiting room is pretty much the craphole of society, and a few people who are legitimately hurt through no fault of their own. About half the people are still wasted and bleeding from minor injuries sustained when they brawled with someone over the last drop in the keg. Or as I overheard several times, when a rival drug dealer gets pissed because he thinks they were infringing on his territory, which they were, but it was just a dime bag, so why is he trippin. Some woman looked over at me and, puffed up with self-importance, smugly explained what "triage" was, and how her crackhead friend was going to be admitted first because he had chest pains related to the cigarette he was smoking. Thanks woman, not that I needed the word "triage" defined for me. And if I did I wouldn't have asked someone who looks like she uses words like "supposibly." But I just ignored her because I was too busy stoically waiting for my daughter's name to be called, while freaking out inside.

My friend Andrea sometimes talks about what she refers to as "white hot flashes of mommy rage." I had a couple the last time the girls were in the hospital, right after they were born, but hadn't had any since. This past weekend I was able to emphatically change that statement.

White Hot Flash of Mommy Rage Moment #1: We were called to go into the trauma center, an hour and a half after we walked in. Some 18-year-old skank who had been dancing around in the hallway while we waited and chatting with her mom about their various criminal acquaintances followed us in and bitched at the nurse, "When am I going to be seen? You're taking people who came in after me." What the fuck is this, McDonald's? Are we fucking ordering Happy Meals?? I was unable to reply verbally since Angelina was crying softly in my arms, but I still gave her a look that if it had subtitles would have said "Sit the fuck down and shut the fuck up before I give you a legitimate reason to be in the fucking emergency room." Luckily the nurse responded, saying "We see people on a priority basis depending on the severity of their problem and I have a very sick baby here."

White Hot Flash of Mommy Rage Moment #2: They asked the on-call pediatrician to come down and look at Angelina. He comes down, bitching about having to do it.

Doctor: What have you been giving her for the fever?
Me: Ibuprofen.
Doctor: How much?
Me: 1.875 mL every 6 hours.
Doctor: That's not enough.
Me: Well it says on the box that it's the maximum dosage you can give to someone her age and weight.
Doctor: Well you should have given her more. You should have doubled the maximum dosage.
Me: I'm not a doctor, I didn't realize it was a suggestion so I took it as an absolute.
Doctor: Did you call the service first?
Me: No. Our pediatrician says if her temperature goes over 104 bring her to the ER. It's at 104.6. I wasn't about to waste time calling someone who just wants to get me off the phone, I brought her here.

The doctor walks away still bitching. I was seething but still being civil, because I didn't want to piss off the person who will be responsible for my daughter's health. But it took a LOT of willpower not to follow him and start screaming. He comes back and says they're admitting her into the pediatric ward. I want to yell "Then why the hell did you say we should have called the service first if she's sick enough to be admitted into the hospital and started on meds right away" but I don't. I just hug my daughter and try not to cry and try not to take my fear out on the next asshole that says something stupid. And there were MANY.

An hour later they take her up to the Pediatric ward. She's sleeping in my arms fitfully, having just put up a hell of a fight when they put the IV in her arm. It took three nurses to do it. My daughters are freakishly strong. We enter the room and all it has is two huge, steel cribs from like the 1950's and a chair. I ask if she can get a bed instead because we co-sleep and she's not used to a crib but they say no.

White Hot Flash of Mommy Rage #3: The two nurses look at her IV and start messing with it because they can't understand why it's all taped up (Angelina was trying to rip it out in the ER.) Blood starts leaking into the IV tube and they see it but start leaving the room. I'm like "Um, blood is leaking into the IV tube" so they come back and have to fix it. They're clumsy and begin needlessly pushing down so hard on the IV needle in the back of her hand that she starts screaming. Then they tug the tubes and do it some more. I said "Be more careful, you're hurting her" but they keep at it. I finally snapped "I said be more careful" and snatched the IV tube away from them, to create some slack so that when they pulled on it, it wouldn't affect the needle in her hand which is why she was screaming. Apparently it hadn't occured to two registered nurses to do that.

What was the reason they were tugging on the tubes so hard it was hurting her? Because the tape was not aesthetically pleasing. It wasn't affecting the tube so it wouldn't cause occlusions in the IV drop, but it wasn't pretty I guess. And did I mention those two fuckers didn't use gloves? I didn't notice it until they were leaving or it may have been the straw that broke the camel's back. Wow, two proverbs in one post.

I put her in the crib, complete with a sticker that says "Next inspection date: 2001" and she starts freaking out so we spent the night in a chair. I don't know why they use those cribs anyway, the rails aren't high enough to keep a toddler from standing up and climbing over, yet the crib itself is 4 feet off the ground. And it only goes HIGHER. At least three times I looked up to see Angelina trying to climb out, and the top of the rail is 5 1/2 feet off the ground. Again, not surprised that the place is a breeding ground for lawsuits. Oh and the thing is FILTHY.

So in the future, if I can avoid it I won't be going to Christ Hospital for anything more serious than a splinter. There is a reason they are awash in lawsuits and it has little do with overly litigious people. The ER nurse that helped us was fine (looked like Manny), two of the pediatricians were fine (the jerk turned out to be still a jerk but competent) and two of the 12 or so nurses we came across were competent and fairly knowledgeable, but everything is old, crappy and few people really give a shit. Whenever Angelina's IV started malfunctioning I would hit the nurse call button since I couldn't move her and I didn't want to leave her alone. After about 7 minutes or so I'd finally run down to the desk and then run back. EVERY FUCKING TIME. But I know that's not the standard operating procedure because at St. Joseph's, where I spent 6 WEEKS in 2003, they responded in minutes. And sometimes 6 hours would go by without a single person checking on her, even when her temperature was still high. Fucking infuriating. "Here is your security tag, just in case someone steals her."

So we slept in the chair, or rather and she slept and I sat there, wondering why her fever wasn't going down even with all the Tylenol and antibiotics and fluids they were giving her. I haven't spent such a bad night since June 2003, when I went into preterm labor at 29 weeks and thought Angelina and Faith were going to be born 11 weeks early, weighing 2 lbs each. That morning, the nurse checked her temp and found she still had a high fever. So she wrapped her in cold towels, put her back in the crib and said "Take those off whenever you want to" and left. Um, okay. So I waited a few minutes but then she started shaking so I took them off. Half an hour later someone comes by to change the wet sheets.

White Hot Flash of Mommy Rage #4: Angelina only got a couple hours of sleep on Thursday and Friday. On Saturday morning at around 7 I finally got her to sleep, when the orderly comes in and slamming chairs and wastebaskets around for 5 minutes while she "cleaned" and then leaves the door wide open on her way out. People were laughing and screaming in the hallway so Angelina woke up again. And then I had to dump her crying into her crib, run to close the door then scoop her back up again and calm her down. EVERY TIME. Is it me or is closing the door after you leave just common fucking courtesy if you had to open it to enter in the first place? I mean you don't even have to close it completely, just enough to muffle sound. In the next two hours 2 out of the 5 nurses did it, as well as the lunch tray people, the orderlies and random people who walked in for no reason. Fuckers.

Don't think the abject stupidity and incompetence was confined to the hospital wards. When Mike J and I went to the gift shop to get teddy bears, the cashier sat around for 5 minutes before she helped us, even though she knew we were there. She told Mike they don't take credit card so he ran across the street to the ATM. When he returned he passed her and she said "Oh you're back" then went to the register and rung the person in front of us up. Then, she walked by us, practically walking around me as I stood in front of the register, went to the coffee shop counter and sat down and started reading her newspaper again. Mike went "HELLO??????" And she looked up and "Oh, I didn't know you guys were ready." Um okay, because that's what people do when they're not ready, stand in line with their money out.

Anyway, so yeah. My girls spent their second birthday apart but Angelina was discharged this morning woo-hoo! Happy Birthday to me!! That was the best present. The second best present was laying down for a nap in an actual bed. After sleeping in a chair for three days, a total of 4 hours, and normally with a 23-lb child in my arms, I will never again take having a bed for granted.

One night I walked in expecting to see Geo in the chair, but it was empty. I was wondering where they were when I looked up at the crib. And saw my 5-10, 150 lb husband lying in the crib with Angelina. So that's what we started doing to get her to sleep. I kept expecting the nurses to say something but they never did.

By the way, women who have Munchausen's Syndrome by Proxy and hurt their kids to get attention need to be drawn and quartered in the village square on Saturdays. There is nothing worse than watching your sick child and not being able to help them. The doctors thought it was some kind of infection for awhile, but then she broke out in a rash and they figured Angelina has roseola, a common childhood illness that results in high spiking fevers and rashes. The danger is in the adverse effects of a continuing fever, so I literally cried in relief when her fever finally went down. It broke my heart to see my normally active child so weak and miserable. But she is almost all better now!! The doctors say she should be completely recovered in a couple days. Oh and thanks to Tony, Abel, Mike and Girlie for visiting Angelina in the hospital to cheer her up, then visiting Faithie at home to cheer her up too. Geo and I are serenading you with "Wind Beneath My Wings" even as I type.

Oh and I can't believe people actually read this to the end, you guys are troopers.

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