O C T O B E R 2 0 1 6 O U T P A T I E N TS U R G E R Y. N E T 1 1
We followed the ambulance to the
hospital, where we were allowed into
the trauma room. The attending physi-
cian said he wanted us to sit next to
Logan, to talk to him. His father was
on his left side, just sobbing, and I was
on his right side pleading with him to
try harder and to hang on. I rubbed his
face and his arms. I told him how
much I needed him. Then the doctor
told us that there wasn't anything they
could do to make
Logan's heart start again.
I let out a very loud wail
that frightened even me.
The doctor put his hand
on my shoulder and told
me that it was time to
say goodbye. Logan died
just 2 weeks before his
senior year of high
school, the victim of opi-
oid-induced hypoxia.
Now that it's been over
9 years since Logan
slipped out of my hands,
I have a clearer under-
standing about the
changes that need to
occur as healthcare
providers continue to strive for zero
patient harm. The memory of Logan
and the desire to prevent another
mother from experiencing the devas-
tation I have endured has inspired me
to come up with these 3 keys to
improving patient safety.
1
Establish appropriate-
ness of care
Before patients arrive, ensure
O
n July 23, 2007, my 17-year-old
son, Logan Parker, underwent
successful surgery at a freestand-
ing ASC to correct his sleep
apnea. He received IV morphine
in the PACU: 2 mg administered 3 times over 20 min-
utes beginning at 12:50 p.m. His IV was removed 8
minutes later and he was discharged at 1:25 p.m.,
just 15 minutes after his last dose. A few hours later,
as he recovered at home, Logan stopped breathing.
Although I'm a recovery room nurse at a local hospi-
tal, I never imagined my son would become my
patient. I immediately began to perform mouth-to-
mouth resuscitation. A few minutes later, Logan's
heart stopped and I began chest compressions until
the paramedics arrived. They intubated him on the
floor of my living room before transporting him to a
local hospital.