"She had a typed up list of meds she was taking and knew that she needed her asthma meds at all times. They knew, they said. It was written and stated verbally more than once. None of her asthma meds were to ever be withheld. Not one time. Everyone eveywhere knew it." A list of a patient's home medicines is taken as part of a history and customarily attached to the chart. But, what I am asking is are you sure they were on her chart as an order to be given? If they were, and she hadn't had them for days, SOMEBODY made the decision not to administer them. One issue is who and why? Since you say she didn't have them since Saturday, did she or you ask that question before her episode? It doesn't feel right that everyone who had given patient care to her would have missed it, and not questioned why that was the case. This is exactly where I was coming from when I addressed the flow of information. If she had been getting her meds right along, was there a possibility this would not have happened? I have to make the assumption the breathing treatment was given as a new stat order. Did I understand correctly that order had issued for a matter of hours and not acted upon? Did any one of the floor staff catch that fact well before she called you? Did any of them try to expedite the treatment by communication to the physician or pharmacy directly or did they leave it up to another department to follow through on it? At the facilites where I worked all the floor staff who were caring for a patient or administering meds would have looked that drug up in the a reference and educated ourselves to it's generic name and likely been in contact with the pharmacy about it quickly if there were an issue. We were required by our own policy to do this with every medication. Good, good policy. Is that a policy in that institution as well? Your description of the actions of the resp tech and LPN still leaves a question in my mind whether they had access to the drug to be administered. If that were the case, how could they give it? Were they trying to calm the patient to decrease her respiratory demand until they could get and administer the drug? Could they have been just as anxious as you or your mother, but doing the best they could under the situation? I guess what I am saying is that I still would question this a communications issue and also wonder if it could also be an accountability issue. Checks and balances likely exist in the system to prevent those things from happening. You might be surprised who "could" be considered accountable. Your doc did the right thing for initiating a complaint, and I'm not in any way saying your anger is inappropriate. You should be upset.......but I'm wondering at this point.......at whom. I'm not implying any particular member of the staff is at fault nor guiltless. I'm saying that an internal look-see is appropriate to address those issues not apparent from the outside. Been there and done that myself as an advocate. I'm very glad it turned out OK.

LOL .. ya Bonnie he will show up .. he is that stupid :o) He isnt looking at a few months in custody he is looking at maybe 5 - 7 years + +. I have yet to hear for the fool .. but its only a matter of time cuz he doesnt even have any clean underwear .. yuck. I got my new kid on the 5th. So far he isnt any problem at all. But he isnt in school yet so the expectations are pretty minimal. Tomorrow I am going to start tightening the screws :o) We are going to go the Humane Society in the morning (7:30 am) to volunteer. He needs to be doing something so why not work on his 40 community hours that he will need to graduate. I would have to say that the other foster parents in our program are a bit jelouse as my kids are hand picked just for me :o) My old social worker deals with all of the kids in the group homes so she knows me well and what type of kid would do well here. It works out great for me as they are usually an excellent fit so we have little issues :o) This kid is pretty explosive (so they tell me) but I have yet to see any behaviours .. you have to love the honeymoon period :o) He really likes all of the animals in our home which is a plus as the pets tend to defuse alot of the emotions a kid feels. Laura

I would be attracted by the privacy of your lot, but put off that the house was not sited in the middle of the parcel so that I was buffered on all sides, now and in the future. In other words, what's the property behind your house (that you butt up against)? How close is your house to the property line? Who owns that property and how is it used? Any future plans for it? If I were looking at your house, I would be asking these questions, so you and your agent should have answers prepared. Are you in an area where forested tracts are rapidly becoming developed homesites? I live in the Northeast, and the next town over is basically forest and conservation land with multi-acre zoning... a few years ago, a very nice home that was barely (and charmingly) visible from the road, seemingly nestled in the woods, was suddenly exposed when a long driveway was cut through and another house built very close by --- the first house had been built backed up against its own property line. Those are the kinds of things I would be asking myself if I was considering your property. I know that you can't move the house :o), but maybe you need a "story" to explain why you sited the house where you did ("to take advantage of the lovely hillside view", etc.), rather than just to be as far away as possible from your neighbors. I feel for you - it's a beautiful house in its own unique way and I know it will really come alive again for the next owner --- I'm thinking wonderful "Martha Stewart"-style holiday parties and cozy quiet nights by the fire. That said, I am not a big fan of staged houses. I like to see a clean slate so I can let my imagination run wild. When I first looked at your pictures, I thought, "hardship house", as in divorce or bankruptcy, because it seemed so forlorn and emptied out. I would clear out the house out completely (but always keep it fresh and clean for showings), leaving one comfortable seating area with good lighting where people can sit to discuss, review your albums, etc. Maybe that area could have some mini-staging --- couch and comfy chairs, pillows, big coffee table, nice rug a la the Ralph Lauren/upscale ski McMansion look! I'm also impressed with your can-do and flexible attitude... you've been hit with some harsh (if well-meant and accurate) criticism here without getting defensive or hurt. I wish you the best of luck. You are getting some great advice here.

I think this is why some GCs prefer to work with the same subs over and over. They've gotten to know and trust each other and they don't pull that kind of thing. Our GC told us this up-front, that he'd get multiple bids whenever the "usual" guy's numbers looked high, and that he'd use who we wanted, but he likes to work with the usual gang. Our house isn't done yet, but I've seen numerous times where the fact that they know how the other guy does things has helped us out or prevented a mistake. I know many homeowners would be suspicious of such arrangements and quick to use the "kickback" word, but these kinds of errors cost someone, either the homeowner or the honest sub who takes pride in his work, fixes someone else's faux pas, and doesn't get paid for that time.