Pharmacopaeia Reports from Dialysis

An incident report addressed to Andrew

Pharmacopaeia is not one of my usual dialysis bears.

He came with me on Monday afternoon as a visiting bear. This turned out to be an unexpectedly educational assignment.

He has therefore submitted the following report to Andrew.

The moment Pharmacopaeia discovered that this particular dialysis shift was going to require paperwork.

To: Andrew
From: Pharmacopaeia, Acting Dialysis Support Bear
Subject: Blood where blood ought not to be

Dear Andrew,

I feel it is my duty to report an incident during Michael’s dialysis treatment this afternoon.

I had understood that my role involved sitting quietly beside him, providing bear-based reassurance and maintaining an appropriately watchful presence.

Nobody mentioned leaks.

At the time in question, Michael was one hour and eighteen minutes into a three-and-a-half-hour dialysis session. There were two hours and twelve minutes remaining.

I then noticed blood on the floor.

There was also blood on the dialysis equipment.

I should point out that I am called Pharmacopaeia, so naturally I have some expectations regarding standards in medical environments. One of those expectations is that Michael’s blood should remain either inside Michael or inside the equipment specifically designed to contain it.

The blood on the floor satisfied neither condition.

The matter was investigated.

The source proved to be a connection at the dialyser. Happily, neither the dialyser nor the circuit needed replacing. The connection was tightened and the leak stopped.

I considered this a satisfactory clinical outcome.

Then something rather extraordinary happened.

The staff cleaned the floor.

Michael asked for a wipe and cleaned the blood from the outside of the dialyser.

And everybody simply carried on with dialysis.

I must emphasise that I am not one of the regular dialysis bears.

I have reason to believe that the regular bears have been gradually acclimatised to this environment. Tubes full of blood, alarms, pumps and large quantities of Michael circulating outside Michael apparently no longer concern them.

I received no such induction.

Nevertheless, I remained at my post throughout.

Michael himself displayed the unsettling calm of somebody who has been doing haemodialysis for years.

There was no great drama.

There was essentially:

“There’s blood on the floor.”

Then:

“It’s coming from there.”

Then:

“That needs tightened.”

And finally:

“Can I have a wipe?”

I am beginning to understand that this is one of the peculiarities of life with chronic illness.

Some events are enormous: diagnoses, hospital admissions, procedures and emergencies.

Others are simply incorporated into the afternoon.

Something leaks.

Somebody notices.

The problem is fixed.

The floor is cleaned.

Michael cleans the dialyser.

The bear prepares his report.

And there are still two hours and twelve minutes left on the machine.

I shall be discussing today’s experience with the established dialysis bears at the earliest opportunity.

I also recommend that future visiting bears be provided with a proper induction.

Yours faithfully,

Pharmacopaeia
Acting Dialysis Support Bear
Monday Afternoon Shift

Final status:
Michael: fine.
Connection: tightened.
Dialyser: functioning and cleaned.
Floor: cleaned.
Pharmacopaeia: unharmed, but considerably better informed.