25 February 2022
So it turns out Joyce didn't have a PICC line inserted from her elbow to her heart. Instead, it was a midline inserted from her elbow to her armpit. Details, details.
If you have to have intravenous antibiotics more than five days you need one of those and the midline is less invasive.
More than five days? I think I mentioned six weeks. The nurse charged with instructing me on administering the IV antibiotic was appalled. "Six weeks?!" she screamed. It was more like two weeks. A midline isn't designed to stay there for more than two weeks.
And she was right. Cat the Physician's Assistant had said the course would run six weeks. But the order, which the nurse showed me, was clearly only until March 11.
OK, so what do I have to do?
Oh my.
She had a 12-page printout for me and she demonstrated the procedure before having me walk (well, stumble) through it. Then she left the room so I could review the printout. Because she was going to test me when she came back in an hour.
And if I didn't pass the test, Joyce was staying in the hospital over the weekend.
Sure, you think I passed the test. But she didn't speak English all that well and the written instructions were by someone drunk on bullet points. I had to write my own procedure in that hour to explain what the task was at each point in the procedure.
And there were several.
You have to mix the antibiotic to begin with. And then feed it through the line with no bubbles. Then you have to flush the cannula in the patient's arm before you connect the line. And after setting the flow rate and waiting an hour for the drug to drip into the blood line, you have to flush the cannula again.
I'm simplifying the routine quite a bit, omitting all the disinfectant steps. But you get the idea. This is not something you would want your happy-go-lucky spouse doing to you.
Nevertheless the nurse passed me when she came back (probably because I described each step before executing it) and Joyce was released.
We came home to a caprese salad and garlic clam pizza, not to mention the pills she has to take, after I sorted out the new supplies and medications that had arrived.
I also texted our in-home nurses and talked to the office more officially (as I waited an hour for her to be released).
Thirteen hours from now I will give this a shot. Cross your fingers.