How can this be? How can a hospital with this hospitals reputation be such a mess? How could so much go wrong? No, how could so much be wrong?!
I asked a friend who is a Nurse Practioner to review Meredith's medical file for me. I wanted to find out which nurse gave Meredith the lethal dose of medication.
Shelly spent hours pouring over Meredith's file and used words such as "heartbreaking". Which nurse administered the lethal dose? All of them. Meredith received 3 doses of medication. All doses, by 3 different nurses, were overdoses. No nurse checked the dose against Meredith's weight in a particular book that is used in all Children's Units. Checking prescriptions against this book is protocol. I heard that from Shelly and we've heard it from other nurses as well.
What else? Lab work was to be done before the second dose was administered. This is protocol. The bloodwork sent to the lab could not be tested. The nurse did not send another sample. She just administered the second dose.
Are you ready for more? The doctor who incorrectly wrote the prescription was a resident. Based on information Shelly found, she appears to have been 1.5 years out of medical school. Her time in the NICU was probably at 9 days when she wrote the prescription(due to a rotation schedule I didn't quite get). There is no evidence that anyone was supervising her- no Fellow, no Attending, no Neonatologist. Without a second thought, they allowed a green doctor to prescribe a medication that is not common in the NICU. My daughter is dead and I can only guess the impact on this young doctor.
When the Michigan licensing website is checked, noone has received any disciplinary action. Nothing.
If one nurse had followed protocol, my sweet Meredith would be alive. It would have taken just one. If one doctor with more experience had supervised this green doctor, my daughter would be sleeping in her bed right now. Any sleepless nights would be to take care of her, not my mind racing with whys and hows. I wouldn't be avoiding opening a closet door full of clothes. I wouldn't be wondering about what to do with all the items we purchased for her, including cloth diapers, dresser, and on and on. People wouldn't be avoiding me and avoiding talking about Meredith. So much unraveling because they didn't do their jobs.
March 26 at 1:00pm we meet with the head of patient safety, the head of the children's hospital and the head of the NICU. I have also asked that the head of nursing for the NICU be present. I can't even imagine how this meeting will go.
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Praying for you dear friend!
ReplyDeletethe word Shelly used is right...heartbreaking...it's all just heartbreaking and there's no way around it :( Your heart, Merwyn's heart, your families hearts, your friends hearts...while I know this is no real comfort, Merediths heart is at least perfect...Jesus' heart is simultaneously compassionate toward you and full of rightous judgement for the sins committed. I know His perfect, redeeming love and heart is what you cling to, but I pray you can also feel His leading you through this sorrow...He knows your pain better than anyone else, and knows what you need to keep going...
ReplyDeleteI will be praying for you at your meeting and for all the emotional things you have to deal with every day. My love to you all...