Today was an awesome day. It was my first 'official' day on my home unit. Yesterday, I did 9 pages of prep work that consisted of my patient's orders, medications, history, my nursing care plans and assessments I would carry out the next day, and a teaching plan to give to the parents of my patient. It was a 42 day old boy with Meningitis with a Spanish speaking family. I got to the unit, and sure enough, he had just been discharged. Yay for baby, boo for Becca. Nevertheless, I took on two other patients with a somewhat young nurse.
My first patient is 18 days old. She was admitted for septicemia, but currently do not know why. When the baby was starting to feel sick, the mom gave the baby water. Needless to say, we gave the mother some lessons about NOT giving an infant water. I didn't have as much interaction with this baby, except I did a successful straight catheterization on her for a urine sample. My face was hot with nerves, but my nurse told me I did an awesome job so yay!
One of my patients had just been admitted for exacerbated Nephrotic Syndrome. He is 2 years old, and was diagnosed 2 weeks ago when he had pneumonia. The 2 year old's older brother also has this disease, but it is not a genetic disease, so I feel really bad for the stressed mom. The boy is pretty small naturally, which I am still not sure if it's due to inadequate nutrition due to the low income of his parents or if it is because of Nephrotic Syndrome. His normal weight is 23 pounds, but was admitted at 30 lbs. (side note: your nephrons are like the tiny filters in your kidneys. In NS, the nephrons are damaged and leak protein into your urine which is BAD. Kidneys need to keep protein in the blood to absorb fluid from tissues and filter out old fluids.) Okay but my point is, this little boy is carrying an extra third of his body weight practically. His eyes were swollen shut mostly, his belly was like a balloon and his skin was so tight. He was put on a sodium restricted and fluid restricted diet. I was with a really nice nurse, but I have got to say, I knew more than her. I ended up teaching the nurse most of the afternoon about sodium restrictions and what foods are low sodium. I impressed the nephrologist by telling my nurse I didn't think it was a great idea to give the kid sodium substitutes because it actually contains high potassium, which the kid couldn't filter right now.
My NS boy's Mom left for a little bit to go get some food. He started sobbing and seemed miserable. My clinical instructor thinks highly of me (not quite sure why yet, but she told me she gets the impression that I am quick and can handle a lot of things) and kept pushing me to pick up Josh* and just cuddle him. "I don't know if I can do that? He's a big boy and what if the Mom sees me doing that??" Maddie (my clinical instructor) grabbed the boy, told me to sit in the rocking chair, and threw him into my arms. Josh wailed for awhile, and I started getting really hot trying to calm him down and well, kids are hot!! I held him a little tighter and started singing in his ear. His cries got a little quieter. I grabbed my stethocope and put them on his ears and put the bell over his heart.
"Do you hear your heart beating? What is your heart saying to you?"
"Boo boom"
"Good good. Now listen to my heart. What is it saying to you?"
"Boo boom"
"Good job! Our hearts say the same thing!"
That seemed to gain his trust in me. We listened to the rest of a show that was on TV, since his eyes were mostly swollen shut and he couldn't see, and we continued to play with a few Fisher Price thermometers and ear speculums. His mom came back, and it seemed I had gained her trust as well. She asked me questions about sodium and I taught her all that I could. "So I can't give him a few of these french fries if he doesn't like his dinner tray?" No ma'am. I didn't say this, but I was thinking "Ummm that could kill him and create more fluid that will compress his heart and lungs." After chatting with them a bit more, it was time for me to leave, and Josh's* swollen hand gave me the fist clenching wave that makes anyone smile.
I called my Mom and recapped my day. I explained in detail everything and when I started talking about Josh* I started choking up. "Oh my gosh I am such a dork I don't even know why I am crying right now." Turns out, I love kids. I love how innocent they are and how accepting they are and how strong they are. I love that they have their whole lives ahead of them (hopefully) and have the potential to do amazing things. I love that working in Pediatrics gives you the opportunity to do what I consider 'traditional nursing', meaning you are there for the patient emotionally, physically, and spiritually, and not just running and getting medications all day. Today definitely showed me I could work in Pediatrics, but I am just not sure if I want to narrow my options to pediatrics just yet, which is why I am still strongly considering adult emergency department. Tomorrow, I am in Same Day Surgery and don't really know what kind of patient experiences I will have but I am very excited!
3 comments:
I *knew* you'd be awesome in peds because you love kids that much. That's what those kids need - someone who is emotionally invested in their recovery. Yay Becca! My Joel's sister Melissa just had surgery and the surgeon said he takes his time because years ago he was told to view each one as if he was working on his mother or his sister. That's how you provide the best care - treat each child the way you'd want your nieces or nephew to be treated and those families will remember you for the rest of their lives. Good job, poops.
Yaaaaaaay poops! What a great little nurse you are. And I'm sure you'd be great in adult emergency too, but would you have as much emotional interaction with your patients as you would in peds or something similar? 'Cause it seems like that's one of the things you excel at the most, and what makes you such a good nurse. Anyway, I'm glad it's going so well!
You are a natural nurse! If my boys ever need a loving and caring nurse I will request to have you.
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