Friday, July 9, 2010

Day by Day

Sunday: This week started by me working the holiday- something I'm well accustomed to as a PICU nurse. In all fairness, I think I enjoyed working and getting paid time and a half, seeing as we didn't necessarily have big plans anyways!! Plus, driving home in the storm validated those thoughts (sorry for all you who's barbeques and fireworks got rained out!). AND- what's more, we didn't have the SLEW of accidents we normally do!! One kid did come in after drinking a cup of lighter fluid (really, what adult puts lighter fluid in a cup on a table!?!?)....but compared to years past, we didn't have the trauma's that we could have.

Monday: DAY OFF WITH JON!! Did absolutely NO school work....Did absolutely NOT think of PICU work : )

Tuesday: 8 hours of meetings...yes, 8 hours! And then I cried for the last 4 hours of my shift! Well, I restrained....but I felt like it!

My patient was a five month old that weighed less than some newborns. She was extremely malnourished...dehydrated...but OH SO CUTE!!! Her mom is young and has six other kids at home. I guess this is her explanation as to why this baby has not been fed for the past 5 months.

Because of something called "Refeeding Syndrome" you can't just let her eat all she wants- it could literally kill her at this point! Instead, you have to introduce nutrition via IV...then add formula VERY VERY slowly.

How about holding a six pound peanut in your arms and feeding her ONE OUNCE of formula...then taking it away!! She gulped that one ounce down in about 10 seconds flat, and then looked at me with big eyes like "Why are you not giving me more!?" Oh, break my heart!! She screamed and screamed for the next hour until she was too tired, and fell asleep. Then an hour after that, the whole process started all over again : (

Wednesday: Time to get down to work: study, study, study. BUT- it paid off b/c I got an A on my test Wed. night!! Yeah me : )

Thursday: Back to work with my trach guy...and his neighbor who has been hard for me to take care of the past two weeks (as if Tuesday wasn't hard enough!). Trach guy is doing well with his now all the teaching begins with his family...that will be INTERESTING!!

Trach guy's neighbor was a 16 year old with a very large, very advanced brain tumor. She no longer is able to move, no longer able to communicate, no longer able to focus her eyes on anything. She now has kidney problems, breathing problems, and severe neurological deficits. And yet, despite being at home on hospice, to die as peacefully as she can, her mom brought her into the ED. And then we admitted her.

I have a very hard time looking at this poor girl, suffering, and thinking if her heart stops, I will be the one to push that code button and begin compressions. I will be the one to inflict pain, possibly breaking ribs, and "save" this girl....but for how long??

Now, I am not a mother. I cannot imagine having to go through this with a daughter. But I also know I could not imagine going through it myself. I hope that when I am at the end of life, those around me will be able to let the suffering end, and let me go.

Thankfully, we had 3 care-conferences with this mom over the course of the past 10 days. While I would say I have complaints that docs I work with are a little "too nice" sometimes and not able to deliver the bad news well, these doctors were very explicit and honest with this mom. At the end of my shift, I had discharge orders ready to send this poor girl home.

Friday: I did one phone triage today, although admittedly I just made a referral rather than a helpful recommendation. I don't deal with skin issues/rashes very least the non-life threatening kind : ) But my referral managed to be a success, so that counts!

And finally, I went to the store to buy gifts for not one, but 2 PICU nurse friends!! Apparently, this is the time for PICU nurses to be having babies!! I wrapped one big blue gift and one big pink gift...and it got me excited for the boy/girl twins that I'm determined to have : )

So that was this PICU nurse's week! Some ups, some downs...but isn't that what this adventure is all about!?

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