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“Our mother died last year,” the older of the two women said when her father looked helplessly at her. Talking required too much energy, and he didn’t have the strength. Perhaps he had trouble talking about his deceased wife.
“Dad lives by himself now,” the younger daughter added, giving her father a concerned glance.
“After he’s released from the hospital he won’t be able to stay alone for about a week,” Daniel advised, looking directly at the women. “When he goes home, I’d recommend an alarm system that he wears around his neck just in case he has problems.”
“He can stay with either of us,” the older offered. “My daughter just left for college. He could stay in her room.”
The younger woman nodded her agreement.
“After the pacemaker placement, he’s not to do any pulling or tugging. He’ll possibly be able to go home the day after tomorrow if the procedure goes as expected.”
“That soon?” the women asked, looking back and forth at each other. Panic registered in their eyes.
“It’s what we’ll plan on, but of course it all depends on how he does during surgery and how he responds afterward, but I don’t foresee any problems.”
The women gave each other a frightened look. “That seems so quick. We don’t know CPR or anything like that. Are you sure we should take him home that soon? That we can take care of him?”
Daniel shook his head. “Nothing’s for sure at this point, but if it makes you uncomfortable, not knowing CPR, there’s a class offered through the hospital. Basic first aid and resuscitation is good for everyone to know. You should stop at the front desk and sign up for the next class.”
Both women nodded.
“I would feel better if I knew what to do if Daddy couldn’t breathe.”
“Me, too,” the other agreed, her gaze going to Kimberly. “Are you a doctor, too?”
“No.” Kimberly shook her head. “I worked as a cardiac nurse in Georgia for five years, but currently I’m employed by the medical company that supplies the pacemaker Daniel, uh, Dr. Travis will be placing in your father’s chest.”
“Really?” The woman looked fascinated. “I guess I never thought about where doctors got stuff like that.”
Kimberly smiled. “Most people don’t.”
“I…need…a…drink,” the patient said between pants, calling their attention back to him. Both of his daughters immediately jumped to their feet to do their father’s bidding.
“I’m sorry, but you can’t have anything by mouth tonight. I can get one of the nurses to swab your mouth to moisten it, but that’s it.”
Daniel handed Kimberly the electronic chart and she glanced over it, skimming Evert’s medications as that’s what Daniel had pulled up and must want her to review.
Immediately, she spotted a problem. “Daniel?”
“Hmm?” He didn’t glance up from checking the man’s feet and ankles.
“Did you notice anything on his medication list?”
The hint of a smile told her he had noticed and was testing her. Either the attending physician in the emergency department or the medical transcriptionist putting orders into the computer had mistakenly left Evert on his high-dose oral medications for fluid, despite the fact that he was now receiving them by IV. Evert would have been double-dosed when the morning nurse gave him his by-mouth meds.
If he got any oral medication in the morning, which was unlikely as Daniel planned to write a nothing-by-mouth order until after Evert’s pacemaker placement.
Daniel finished checking Evert and answered some of the family’s questions. When they stepped out into the hallway, he grinned.
“Good catch on the medication list. I’ll stop the oral meds when I write the nothing-by-mouth order, but I want whoever entered the order to be notified so the mistake won’t happen again.”
Kimberly nodded. Had the error not been caught and the nurse given the medication, Evert’s electrolyte imbalance would have worsened. It could have thrown him into muscle cramps, organ shutdown, or even a heart attack.
She followed Daniel to a small dictation room and watched as he entered changes into the computer. He meticulously went over the record and put in orders of his own to prepare the patient for the planned procedure next morning.
He also spoke with the nurse in charge of Evert’s care, making sure she was aware of his plan to take the patient into the cardiac lab for pacemaker placement and the medication error.
The computer would have sent a message to the pharmacy to cancel the oral doses, but Daniel liked to be thorough. Kimberly appreciated that. Too many times she’d seen assumptions made that had led to mistakes being made.
