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WHEN NUMBERS ARE NOT ENOUGH: HIGH-ACUITY CARE, PHYSIOLOGIC AWARENESS, AND LEARNING TO LISTEN One of the things I continue trying to explain about medically complex home care is that highly individualized physiology does not always fit neatly into task-based or standardized systems. Protocols matter. Orders matter. Monitors matter. Training matters. But there are situations where the greatest safety issue is not simply whether tasks were completed. The real question becomes: Was the situation interpreted correctly? One hospitalization in 2019 at Ohio State really illustrates what I mean. Alex was admitted with a pleural effusion. Right away there was uncertainty about how to handle several aspects of his care, particularly his diaphragm pacer and my involvement in helping care for him. At first, the team did not want me ambu bagging or suctioning Alex, even though I was already ambu bagging him when we arrived. There were concerns about caregiver burnout, concerns about me staying...
