Long Haul Seeing Some Light

When I got to work (SNF) on Friday it was to the happy news that our long term patient in a "persistant vegetative state" had woken up and pulled her trach out.

We have been caring for her for over a year, and she has been in respiratory isolation since admit d/t MRSA in her trach. The family quickly lost interest in even visiting her and we didn't even have current phone numbers to tell them the news. Their lack of care and interest led to the decision to not treat any infection, that included the MRSA. The family stopped all treatment except tube feedings.

Friday, the MD decided to see how she did without the trach, we were to monitor her room air O2 sats every 30 minuted for 24 hours, with the option to send her to the ER to replace the trach if she showed signs of respiratory distress.. She satted in the mid 90's the entire weekend and never once showed that she was having problems. As a matter of fact, she has appeared more comfortable this weekend than she has ever appeared since admit.

She has been tracking us with her eyes for about two months and we have been getting half smiles on occasion. This weekend she laughed out loud when I tripped over the mat on the floor by her bed and almost lost my balance. She has been responding to verbal commands, i.e. when seen picking at the dressing over her trach site, she stopped when I told her to leave it alone. I also saw a glint of mischief in her eyes when she was pulling at her nebulizer mask tubing and let go of it when I asked her to. I even explained to her why she had the treatment going and once I did she quit messing with it during subsequent treatments.

Anyway, this has been an exciting weekend...makes everything worth it. I would also like to thank my co-workers, nurses and CNA's, for their efforts...we make a great team! :hatparty: