Ricardo Stops Smoking

Ricardo is so tired of being nagged! His wife is always after him. His kids are on his case. It's not as if he doesn't know that smoking is hurting him. They just don't get it.

Ricardo, like most smokers, began the habit when he was in high school. He only smokes half a pack a day. He never thought quitting could be so hard! He’s tried so many times in so many ways. Now, at 45 years old, this time WILL be different. Now, he has to stop!

Last week was pretty much like usual... work, home, family. His oldest daughter came for dinner on Wednesday with her family. His granddaughter had a cold that Ricardo seems to have picked up.

By the following Wednesday, Ricardo had a constant cough and aching chest. It got worse and worse until late Thursday night, when he almost couldn’t breathe. Ricardo also had a fever of 101 and was turning ashen gray with every coughing spell. An ambulance was called in the middle of the night.

The paramedics came into the house carrying their emergency equipment. They put Ricardo on oxygen, started an IV, and contacted the hospital to inform them of the transport. Ricardo was taken directly to the Emergency Department to be checked out.

Ricardo was wheeled through the double doors directly back to the treatment area while his wife went to the lobby to register. The lobby of the Emergency Department is big and busy. People are being registered at several of the desks.

Others are talking quietly or watching TV as they wait in the lobby. Some are just coming in to check with the triage nurse who will determine how immediately they need to be seen.

The room Ricardo enters is very bright and has lines, hoses, monitors and gear everywhere. Physicians, RNs, CNAs, technicians, and therapists make a continuous stream in and out of the room.

He is given oxygen, a nebulized inhaler, started with IV antibiotics and gets a CXR. Ricardo’s blood is drawn for testing, and a pulmonologist is called in. Ricardo is admitted to the hospital.

Taken directly to the Intensive Care Unit (ICU), Ricardo enters another high-tech room with monitors, alarms, tubes, wires, and ventilators. His condition is getting worse. He’s placed on a ventilator, and supportive IVs while medications are begun to beat the illness as his own support system is failing.

During this time his family has gathered in the ICU Waiting Room. They find this comfortable room filled with things to occupy their time as they wait: TV, magazines, cards, jigsaw puzzles. There is a bathroom and telephone right there. Volunteers come with coffee.

The Pastoral Services staff come by to meet the family. Social Services staff stop by to families about outpatient care and discharge planning.
Ricardo's condition is stable, though he is critically ill.

He has pneumonia complicated by his underlying chronic obstructive pulmonary disease (COPD). This diagnosis includes asthma, bronchitis, and emphysema related to his long-time smoking habit.

Ricardo is stunned! Though he knows that smoking isn’t good for him, he really feels he doesn’t smoke that much! He knows now that even a few cigarettes a day for years can lead to permanent lung injury, and makes him more susceptible to illness. When he does get sick, it’s far more serious than for a non-smoker.

After several days of treatment, Ricardo is improving. He’s moved to the Progressive Care Unit (PCU), which is more private and restful. Ricardo is constantly monitored and receives continuous medication.

He and his family are making plans for his continued treatment after his discharge. He begins a smoking cessation program with the assistance of medications and therapy.

After being discharged, Ricardo spends several more days at home recuperating. He enters the Pulmonary Rehabilitation Program and connects with a smoking cessation support group. He’s determined to stop smoking now. He was scared in the hospital.

He also realizes now how terrible this was for his family. While in this program, he is learning more about COPD, and how he can use exercise and a healthier lifestyle to improve his endurance, strength and general health so he has lots of years left to enjoy his life, his family, and being a grandpa!

The end of this story is happy. Ricardo recovers, quits smoking, and develops a healthier lifestyle. The hospital closes the story in the Health Information Management Department by finishing up the charting of Ricardo's experience.

Doctors use this huge room, filled with medical records, to dictate the specifics of Ricardo's treatment. Coders scour the charts to find all of the conditions Ricardo was treated for, including those that complicated his illness and recovery.

This information is send to the billing office where it is put onto appropriate bills and submitted to insurance companies and other responsible parties for payment. Finally, his records are stored.

Take the Tour
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