Paper....

Yup, another piece of paper. To fill out. To fret over. To forget. To overwhelm the patient and family. Another tree bites the dust.

Actually, it's been about two months since the new piece of paper was introduced. And, I have to admit that it really serves a purpose. A good purpose.

It's a calendar. A blank calendar printed on a piece of blue paper, both sides. We are supposed to fill it out and give it to the patient when we do the admission process. Why? So the patient and family will know who is coming to visit, and when.

Ideally, the family will contribute to the calendar, too, adding doctor visits and other pertinent information. And the other disciplines, too. Sure, we have a calendar for each patient in our laptops, and we are supposed to schedule all our visits there, but that doesn't help the patient.

And so, we have a blue calendar. I wish I could tell you that I always remember to fill it out, or make necessary changes, but I don't. It's another piece of paper for me to forget.

And that's too bad. It's a good communication tool. And worthy of remembering. Some patients already have calendars that they use to remember their appointments. If they do, we just have them mark our visits on that. No use in duplicating things.

Today, I made a discharge visit to a patient that I have been seeing for almost a month. She is doing quite well and doesn't need nursing services any longer. I did her wound care one last time, and took wound measurements one last time, and was giving instructions to the daughter, via the interpreter, when Junior came in the room.

I am ashamed to admit this, too: I don't even know Junior's name. He is three years old, with dark brown, dancing eyes and a ready smile. Starting with my first visit, he has developed the habit of showing me something each time I visit. It might be a new toy, or a DVD he likes to watch, or, like today, a “Toy Story” inflatable float for the pool. Oh, and his “light saber” too....

As I looked at him, showing me his treasures and telling me all about them in another language, I realized something: I didn't have the calendar. The blue paper. Junior is the one who has taken it off the fridge and brought it to me for every single visit. Except this one.

I guess he read my mind: he stopped talking and ran out of the room. In a couple of seconds, he was back with, you guessed it, the blue paper. And there, on the paper, on today's date, was my name and the word “discharge.”

At three, he can't read yet. He was so happy to have a “job” to do to help me, and I always thanked him profusely for his help. Today, his older sister, my interpreter, told him what it said on the calendar. His smile disappeared.

I finished the wound care, gave the discharge instructions, and prepared to leave. By now, his smile had returned and, as usual, he walked out to my car with me. “Bye!” “Bye, Junior” “Bye!” “Bye, Junior” over and over again, as always. One last wave as I drove off, and I was gone.

Bet I don't forget the blue paper again for a long time....

Adios, Junior!