Mildred Pasek, my friend and colleague died on August 8th 2017 following an anterior approached back surgery on July 28th at the New England Baptist Hospital.
Before you read on, my goal is not to criticize the orthopedic or vascular surgeon’s professionalism, immense skill or personal care of Mildred as these cases affects all providers on a deep emotional and professional level. My concern is for the post-operative care of patients, like Mildred, who have comorbidities, are not necessarily in the ideal condition going into surgery, or at a critical time can advocate for themselves.
As well as the debilitating arthritis, she had hypertension required three antihypertensive medications to control. Those meds were held pre surgery, and never resumed.
Mildred was transferred to Hebrew Rehabilitation Center, less than 72 hours post op, which for a risky patient is unfathomable to me.When I visited her the same afternoon she felt as though she’d “been given the bum’s rush”, meaning there was a sense of urgency at NEBH to have an x-ray, and bowel movement requiring an enema or suppository before she left. The continued low blood pressure, worried her. Furthermore, she felt uneasy about the surgical blood loss requiring RBC transfusions.
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She didn’t look as bright as the first afternoon I saw her and still reported hypotension and lightheadedness on standing. She now also had upper abdominal discomfort. As Mildred had a pulmonary embolism history, alarm bells went off in my head. I asked Mildred if her care team was addressing the problem and if I could do anything. Mildred didn 't ask me to talk to the medical staff and not being her health care proxy or wanting to overstep my boundaries, I didn’t. Also, my voice may have been considered unwelcome and intrusive. Even someone with 30+ years of nursing experience can feel intimidated in these days of ridiculously over zealous privacy