It is nearly 4am. I have just arrived home from Wal-Mart and gotten things put away. I didn't get out of work until nearly 1am. See? I told you this was going to be a quick trip to work and then to the store. And you doubted me! LOL

I ended up having the guy who had respiratory problems yesterday sent out tonight for respiratory distress. I really don't even want to go there right now, but I must. Not only did the nurse who had him tonight (same one as last night) fail to see the need for the patient to be sent out for evaluation, but the two staff (same two as last night) who were in the apartment failed to see the need to call the nurse to come examine him to see if he needed to be sent out for evaluation. I came through the back door of the apartment at 11:15pm. This patient's room is clear on the other side of the apartment, right by the front door. I could hear him breathing as soon as I got inside the door.

According to the nurse, he'd been breathing like this for well... he didn't really know how long. He was in the apartment, and his breathing was loud and labored, but he saw no cause for concern... And, he was in the apartment for maybe 10 minutes about 15 or 20 minutes ago... (I can't believe he walked out and left in the first place...)

According to the staff, he had been breathing OK while he was up but started breathing like this after they had put him to bed. When questioned, they said they had put him to bed a little after nine.

According to my coverage assistant who was in the apartment last at 10:20pm, his breathing wasn't labored but he was breathing with a slightly irregular rhythm and it seemed a bit shallow. She had instructed the staff to make him a 10-minute check.

So, for somewhere between 25 and 50 minutes, this guy had been having respiratory distress and no one bothered to pick up the phone. What the fuck!!??!!?

They were lucky to have caught me as I was in the process of collecting my stuff and heading out the door. Had I not been down in another apartment talking with the staff for a few minutes about what was going on with one of the ladies and would have been in the office when my relief arrived at at 10:45pm, I would have already been gone.

I don't often make a report to the health care coordinator when stuff doesn't go the way that it needed to go. I did make a phone call about this particular scenario. I didn't include the other nurse's account of their actions. I'm going to let that nurse hang according to their own account.

I have seen the guy the last couple of days in passing. I took a break about 9:45 tonight and called him. He sounded tired. He was studying. He laughed when I told him that I just missed hearing his voice. He apologized for being so busy with school and being so stressed by everything he has to get done for school. I told him it was OK, I understood. There are only about 7 more weeks left in this quarter. Then, it will be on to the next one. I'm going to go cook him dinner Tuesday. Also fix some things he can take to school to eat during the day. I really do need to help him take better care of himself so that he doesn't get really sick this winter.

It's nearly 5am. I hadn't planned on being up this late. I need to get to bed.