I was Abused!

I was abused yesterday by my patient's parents. Not physically abused, but definitely verbally. But I'm not taking it personally. There are many reasons for this:

1.) I am confident that I am a good, if not great, nurse!

2.) These parents were not put together in their heads

3.) They did this to everyone that walked into their room....docs would peek in and ask me to step out...only to ask "Is mom in there?" What they were really getting at was "I'll just come back when she's not here b/c I'm not dealing with THAT crazy lady!"

But here's the problem. Their child was floor status....this means, they are not really sick (yes, they are SICK, but not PICU sick!) In theory, if the patient was on the floor, that nurse would go in the room once every 4 hours to check on them. So tell me why it's acceptable for these parents to think it's my job and personal responsibility to stay in the kids room....all day. Even when I told them I had another "Very sick" patient to take care of!

Parents just don't get it sometimes! And nurses are the ones that get the brunt of it....sometimes b/c the docs are too timid to deal with it. Sometimes it's simply b/c we're there at the bedside for almost 13 hours at a time. But either way it is DRAINING!!

At the end of the day, these were some of the things I was told (that I remember-there were too many hits to recall each one!):
1.) I am "cold hearted"

2.) I do not know how to identify pain in a baby (correction, YOU don't know how to identify pain in your child....a sleeping baby is NOT a baby in pain!!)

3.) It's a good thing that I "Started out at the bottom" and am still here...eventually I can "Work my way up to the floors" (hello, does this dad know what we DO in the PICU??? They are the sickest of the sick!)

and 4.) I didn't care for the baby while the parents were gone, I just "strapped him down to the bed" (correction, that's called swaddling....babies love it! that's why when you walked into the room he was sleeping = comfortable = not in pain!)

So when I got home, legs throbbing from not sitting all day and head hurting from not drinking water or eating much all day, it was a welcomed surprise to find Jonathan had wine and cheese set out for me....put us on the couch to talk about my day....and an amazing leg/foot massage! Ahh, this nurse is married to the best man in the world!

Sexuality on TV

I just completed a 12 page paper on the effects that sexuality portrayed on tv has on adolescents. I have to say it was a pretty easy paper to write, and definitely got me thinking! Part of the paper was to compare two tv shows that were popular among adolescents today- one "good" example and one "bad" example.

Let me just tell you...coming up with the "bad" example was EASY!! Shows like 90210, Gossip Girl, Secret Life of a Teenager, 16 and Pregnant all jump out at you immediately! Your "everyday" high schooler walking around having sex, sexting, getting into clubs, drinking, getting pregnant, smoking and doing drugs etc. etc. etc. is glamorized and made to look completely normal.

The "good" example was not so easy...ok it was actually really hard! In fact, the ONLY thing I could come up with was Hannah Montana....which I had to REALLY had to prove was targeted for an adolescent audience rather than 8 year olds. I realized when my best argument was "Jon and I tivo it, so if you average our ages with the much younger crowd that also tivos it, it equals an adolescent" I was in trouble (oh wow, did I really just admit that here!?)

So in writing the paper, I was amazed...appalled really...at the incredible amount of sexuality shown on TV. My "bad" example paragraphs (which I ultimately went for Glee because it is a newer show and appears harmless on the outside!) had to be tamed down because literally I found an example of explicit sexuality on EVERY. SINGLE. EPISODE!

Which got me thinking: how in the world am I going to raise children with this going on!? For those of you that know me, I really want kids....like last summer! But with school and work, we're waiting. However, I'm thinking the longer we wait, the more I may be freaked out at the actual raising of my children. Don't get me wrong, I want little Isabella and Isaiah (the twins that I'm hoping, praying, pleading that we have : ) badly....I just wish we could skip from age 10 to 21 or so.

Sex is everywhere. On TV. On the radio. Coming from the windows in our neighborhood! So how do we protect our little angels from this?? How do we get them through the awkward phase of adolescents and into adulthood without promiscuity and sex being "completely normal?" I'm obviously asking this hypothetically, but seriously? Parents have a really hard job these days! Not only are we trying to give our little girls love and attention, we're trying to help them not be complete ho's! And we're trying to keep our little guys away from the ho's that are lurking throughout the high school hallways!

It's crazy that sex is out there, rampant...just waiting for teens to take it and run. I know it's not realistic to think that my little ones are going to be totally sheltered and protected from it...nor do I want them to be completely! There is something to be said about exposure to small quantities to certain bugs and bacteria that help to increase our immune system- see, I'm a nurse through and through!

I guess as Jon and I do have little Bella and Ze (please God, please!) we will learn these lessons more and more. And I look forward to that day....but cringe as well! All I know is they better be singing the lyrics to Beyonce's "Put a Ring on It" before they have sex (although I'm saying two rings!) rather than Rihanna's "Rude Boy!"

Doozy of a Day- parts 1, 2, & 3!

Today was certainly a doozy (do people still say that!?)! In short, part one: my patient dies. part two: lesbian parents chew me out while breaking the rules. part three: best admission ever!!!

Being true to myself, I cannot just end the day's blog that way....but in a nutshell that really was how my day went! Here's the breakdown for all of you interested in details though!

1.) I was assigned to the patient right next to where I was assigned yesterday....the crash cart was out and the patient looked sick (REALLY sick!). So I kinda pawned him (the sick patient) off to the nurse assigned to the kid I had yesterday so I could take him (my kid from yesterday) back...following!? Anyways, the really sick kid was really sick....so I felt bad for trying to change assignments and ended up in the room all morning anyways. The family was called in and they were amazing. If there is ever a way to prepare yourself for your child dying, this family found a way. This child lived a very hard six years of life and at the end the parents were completely supportive of one another, and the fact that their child was facing the end of life. He passed away, beautifully, peacefully. There are some deaths where a calm just washes over you and this was one of them....the parents wanted it that way...this little one's suffering and trials were now over....he could go dance, and sing, and run around in the fields of heaven!

2.) Next up was my patient (same one as yesterday) who I continued to take care of. His mom's both came in and refused to wear the isolation gowns and gloves we require when kids have certain bugs (ie: MRSA, CDIFF, VRE etc.). They told me (not so nicely, not so calmly) that they were refusing to wear any isolation stuff and that they "put that behind them when they left the NICU." I told them this was not something that they could refuse....to which they replied "Well, you're never getting me in one of those things so you can just put that in your charting!" Alrighty then!

What bugs me most about the whole scenario (b/c really, we have tons of parents that give us a hard time about isolation!) was both mom's have told me several times over the past two days that they are nurses!! HELLO!!! Either 1.) you are lying to me....you really take care of your kid at home and really just consider yourself a nurse....or 2.) you are a nurse and suck at following basic rules put to protect the patient, yourself and all the other patients!! Either way....super frustrating!!

3.) And finally....my super cute admission. He came walking in....yes, welcome to the PICU ladies and gentlemen....walking in asking "Where is the playroom?" He then informs me as I'm hooking him up to our monitors that "That one is to monitor my heart. The heart pumps blood to the entire body. Some of it has oxygen in it because we breath oxygen. And earth is the planet that we live on!" This kid was so witty, so funny, and super cute!! He had a trach in which made his voice slightly hard to understand, but that much cuter!! He then proceeded to say, "I have a joke for you. What do you get when you add Band-Aid plus Sticker?" I told him I have no idea!! He laughed "Band-Aid Sticker...get it??? It's a joke!! I'm so funny!!" Totally didn't get it, but the kid really was funny....and I know my story isn't doing it justice but putting up a video of him would totally violate HIPPA!!

So I left work (on time, go figure!) feeling a little overwhelmed but very fulfilled....I was able to care for each of these patients in such different ways...and each of them gave me something different in return!

Ugh!

Here is the rant of the week: Television POORLY portraying medicine!!

Jon doesn't like watching medical tv shows with me sometimes b/c I pick them apart! I'm like "Seriously, that's not how you do that!" or "What in the world...that patient would be dead if doctors really did that!" And I get that! It would be like me watching Chuck or any other tv show with IT stuff in it and Jon saying "You can't log on like that" or "That computer would be crashing right now if you did that" (k, bad analogy I'm sure....I really know VERY little about computer terminology!)

However, it has especially been getting on my nerves lately. Here are just a few examples! (not that I'm promoting any one tv show in particular!)

Accidentally on Purpose: the OB GYN walks into the patient's room who is labor, puts on a pair of regular gloves (NOT sterile) and without lifting the covers actually examines the patient to make a perfect diagnosis as to how far along she is. Nice! When I'm in labor if your putting your hand up my hoo-ha, you best have the most sterile gloves you can find, thank you very much!

Greys Anatomy: (while I LOVE this show....this one is classic for crap medicine!) Perfect example was when Meridith drowned- after "dying" (and not being intubated at that!) she wakes up minutes later miraculously without any problems! And we wonder why parents come in with unrealistic expectations! Then there are all the episodes where they are in the OR without their masks on, breathing their totally unsterile breaths all over the supposed "sterile" field. And inevitably whenever they bust out the defibrilator paddles watch closely and you will see someone still touching the patient, or the bed....in which case they would get the current too....but obviously this is not shown! Great medicine Greys!

And the one that REALLY (REALLY!) has been getting on my nerves lately: The H1N1 commercial with the lady who talks about how H1N1 "nearly killed me!" It is promoting the vaccine, which fine, if that's the route you want to go then I support that. HOWEVER....PLEASE give us ALL the information!!! Like why did this lady get so sick from the flu....typically these people are already immunocompromised or have some underlying disease process going on. But none of this information is given. Instead, it leaves people freaking out about "Swine flu" and gives people tons of misconceptions. If tv is wanting to give medical information to the lay person, they need to make sure they are presenting both sides of it! And just because you get the vaccine, this doesn't guarantee you won't get the flu! Most important thing: wash your hands a ton, stay away from other sick people, and wash your hands again!

So next time you're watching tv and anything medical comes on...please don't believe it!! 99.9% of all things out there are not true. And if you happen to be bringing your child into the hospital, please don't let these tv shows dictate your expectations or conceptions of how your stay should look....this may sound weird, but trust me people, I see it happen ALL the Time!!! Ahhh, to be a PICU nurse! : )

Language Barriers

It is not uncommon for us to have Spanish speaking, Polish speaking, or some other very foreign language speaking families in the PICU. We have a great interpreter program and can almost always get someone to give parents and families updates. However yesterday I had a "language barrier" I had never encountered before!

My patient was deaf...and so was her mom. I had meetings the first part of my day, so I came into the assignment at 3pm. As I walked into the room the mom had just arrived so I wrote down on a piece of paper "My name is Dana and I will be X's nurse until 7pm...." I wrote a short update on how the patient had done that morning and my plan for the evening....then I wrote "Can I get you anything?"

Very shortly after I walked in and introduced myself, Patient Relations walked in. Now, for those of you who don't know who "Patient Relations" is....they are the people who get called when parents are extremely upset with some part of their care, ie: the nurses suck- they never take care of my child, never bathe them, never turn them etc., or the doctors suck- they never come in to check on my child, they never communicate with me, they don't know what they are doing, or this hospital sucks- there is absolutely nothing good about it!! Now while a majority of these complaints come from extremely anal parents who are being over-the-top unrealistic (and not seeing the doctors and nurses who really are providing exceptional care for their child!) every once and awhile there is some truth in their complaints.

Enter deaf mom yesterday. I had a two and a half hour conversation with the mom, the resident (doctor) and the patient relations woman. And by conversation I mean the mom talked and yelled in a way that was very hard to understand (because she's deaf and can't speak well) and then we had to write everything down because she doesn't know any sign language (which we have an interpreter for by the way!). Try writing EVERY. LITTLE. DETAIL. about a patient down...how you are changing the medications...how the patient is really doing...what her test results were...and then having to re-write it down in a way that is easier to understand.

This mom was also very upset about a lot of things because she simply was not understanding. Part of her misunderstanding is because we probably did not do a great job of writing everything down as it happened...part of it is because she is not there all that often so we don't have the opportunity to communicate with her...and part of it is because she is slightly delayed. So trying to calm a deaf yelling mom down by writing down words was difficult!

However, while it was really hard communicating in this way, I can't even imagine being deaf and having a child in the ICU, feeling like I have no idea what's going on! The poor mom just kept saying "I want my baby back" (by the way, her "baby" is 19 years old)..."I want to watch Twilight with her and fight over which one is cuter"..."I want her complain about my cooking again!"

As hard as it was, I learned the importance of communicating with every single parent that we have. No matter how difficult it may be, every parent just wants to know what's going on with their kid! Every parent wants to be reassured that their progress (or lack thereof) is ok. And the times that it's not "ok" the parents want to hear that too! So no matter the language spoken, I want to make sure the families feel like we are (I am!) truly communicating with them.

*Oh, and to validate the mom's complaints, she told the patient relations person that I was the first nurse that had written anything down for her! I was shocked but proud of myself for at least trying to communicate in the only way that I knew how with her!

No, I will NOT look at that!

So here are 3 examples of "phone triage" calls that I have taken from friends over the past two weeks! There seems to be a theme in all of them....not quite sure why people seem to think that I'm an expert on the "down there" area....but I guess thanks for the vote of confidence : )

1.) One friend called to tell me that her husband has a shooting pain on his groin every time he tries to lift something heavy. Ummm, no...I'm NOT coming over to look at that!! So after a few questions...and explaining to her how to assess the area (a mental picture I rather not have had!) things were figured out.

2.) Another friend called to tell me her son's poop was REALLY green....like lime green. No, please do not save me a diaper for the next time that I see you (gross!!)....if he's not acting any different or sick, just think about the new things you've been feeding the little one and I'm sure you'll figure out the color change!!

3.) Finally a third friend told me her little one has a "sacral dimple" and can I look at it?? Sure, fine, I will look at that to make sure it's still closed....however her next comment was "My husband has one too..." Ummm, NO I will NOT look at that : )

I love being a nurse!!

*On a funny side note, one of the above friends and I about a year or two ago almost had her husband convinced that it would be "totally appropriate" for me to assess his down there area b/c he was having an issue!! The look on his face was priceless....a little shock, a little horror, a whole lot of confusion!! Again, I love being a nurse ; )

5 Great Things I Learned Today!

1.) Do not forget to wear underwear under your scrub pants. And by "forget to wear" I mean remember to pack them in your gym bag! Not the best scenario when you've run your 2.5 miles all before 5:30 am, go to take a quick shower at the gym and come out to realize you have two options: put on the sweaty pair of undies you just ran in - OR - wear nothing at all. Since I didn't want to feel like my booty was sweating all day, I went with option 2....and after 16 hours of it, I'm not sure it was the best option! Without details, just remember to put on some underwear before you put your scrub pants on!!

2.) What a "Hotty Totty" is: a mixed drink, generally served hot with whisky. How did I learn this today? I was offered one! By "Drinks and a Snack" grandma....oh yes, she's BAAACK!!!! And with more witty antics this time!!

3.) Don't give your child in the PICU pixie sticks. The blue ones tend to make the nurses and doctors nervous at first glance! Lips in the PICU sometimes are blue for real....we don't like that...we may do things to you that you really wouldn't like because we think you are not breathing well when in reality you just ate a ton of colored sugar!! And to be safe, stay away from the red ones as well!

4.) When a patient's mom tells you that she is leaving for the night but is going to play his favorite CD...and put it on repeat....and PLEASE make sure nobody turns it off....DON'T agree to this right away!! When the CD comes on and it's full out shouting gospel music, this is not something that should be played loudly 24/7!! For goodness sakes people, I love myself some good ol' gospel music but there is only so much one can take!!

5.) When your charge nurse tells you they have an admission for you ("but don't worry it's a TOTALLY easy admission!!") just say NO! There is no such thing as an "easy" admission....or a "quick" admission....or a "mindless" admission!! There is such thing as an admission who will come in with a crazy high fever, feeling really crappy but not able to communicate that in ways other than screaming and flailing (all 45 lbs of him), needing tons of lab work done without the access to draw it from, who will projectile vomit on you (thank goodness for the semi-protection of isolation gowns!).....and who loves gospel music blaring in the background 24/7!!

**Yes, I really did learn these things today!! Obviously it was a jam packed, busy, barely get to eat and not quite sure if I peed kinda day!

Trouble

Today I took care of a patient who I will call "Trouble"- well, technically she called me "Trouble" first. BUT- my day was anything but trouble!! In fact, I got paid a nurses salary (as meager as it may be!) to play games (hence the "Trouble" nickname), take walks, go to the highest floor and sit in front of a large window that overlooks the entire city, and just have fun with the best (and most NON-ICU patient I have ever had!!)

The patient was 20, slightly delayed and OH SO ADORABLE!!! She was wheelchair bound and as fiesty as they come. So, in the morning when I suggested we ask the docs if we could get off the unit and take a walk she looked at me and said "Look at me....do you think I'm going to walk today?? I mean, you're a good nurse, but you're not THAT good!!" And I'm pretty sure my face turned 8 shades of red. Really?? I don't want to be the one that tells the paralyzed girl "Hey let's go take a walk...oh wait, that's right, you can't!!" Nice one Dana!! But then I looked up and she was cracking up....I mean laughing really hard!! And then she said "I love when that happens....it gets people every time!" Hello, she's pulled that one before!?!?

Then later in the day she asked if I had a baby. I told her not yet. She said "Well that stinks because I need a baby fix." (I thought, "So do I" but that's a whole different blog!!) So since I couldn't provide her with this "baby fix" and didn't feel it appropriate to wheel her into another patient's room, she began calling everyone she knew that had babies if they could come see her so she could hold one. This girl was too much!! She sweet talked all those people on the phone!

So finally when we had taken enough "walks" and watched several DVDs of Glee (1st season), and had sat in the sun on the 9th floor overlooking the city....we decided to raid the game closet. So out came all the classics. Clue, Connect 4, Memory and Trouble!! But it was Trouble that we had the most fun with!! We kept sending each other back to "home" and having to start over. Every time she sent me back she threw her head back and cackled in excitement....but groaned with as much enthusiasm when I sent her back home. Hence she kept calling me Nurse Trouble!! And in return I called per Patient Trouble!

At the end of the day I left feeling young in spirit, awake (hello, I actually got to eat all my meals, sit down, and pee regularly like a normal person!), and more like a friend/babysitter rather than a nurse....but it was AWESOME!! Some days us PICU nurses just need days like this. And as I was leaving, I asked "Do you need anything before I go home?"...a potentially dangerous question with this fiesty one! She looked at me with her sassy little smile and said, "Yes Nurse Trouble I do....I need one big hug!"

And that I can do!

A glimpse into the life of a master's student

I haven't really talked about school yet. To be quite honest, most times there is nothing really exciting to write about. The awesome thing about online school is that it can be done all alone, in the privacy of my own house....or park....or coffee shop....or wherever I want it to be!! BUT- the downside is there is no true people connection. Yes, we have weekly "discussions" but it's not the same as being surrounded by people in a class setting.

However, for those of you who have not gotten your masters before, let me give you a look into the extravagant and oh so intelligent life one may live when going back to school!

Every class has a Required Readings section in the syllabus. The Required Reading list for my current class includes: very thick textbook, (small print, very few pictures), a cultural diversity book on families, and Harry Potter. WAIT, did I say Harry Potter!?!?

Ummm, yes I did. Harry Potter is in my required readings section, and there are actually several assignments that I have surrounding this book! You've got to be kidding me! Don't get me wrong...I have read these books (well, ok up to book 5...I'm a little behind!) but how in the world is a teacher really going to make all these masters students read this book over the quarter and apply it to child and family development!

But somehow it is incorporated....in almost all of our weekly assignments!! Next week we focus on the appropriate milestones that Harry is supposed to have met....and explore whether he has fully met them or not! The week after we focus on distinguishing the difference between reality and fantasy. Now I'm sorry, but if I haven't been able to do that in my last 27 years of life, now might be a little late to learn!

Maybe what I should be learning in these readings (in my education to become a Nurse Practitioner!!) is what potions I can best brew up to cure my patient's sick lungs. Or maybe I can teach patients that an active lifestyle is best for their weight, heart etc. and this can be achieved by 30 min of mod intensity cardio 5 times a week...in which quiddich is the BEST sport out there.

So, for those of you interested in seeing what the live's of masters students is really like, there ya go!! It IS as glamorous, intelligent and thought provoking as most of you dream! And if you ever are thinking about being a nurse practitioner in the future....pick up a copy of Harry Potter....you'll be WELL on your way to your new degree! : )

Drinks and a Snack

So my blog is beginning to look exactly like my old diaries or journals! Every January I would decide to write more that year....which would last approximately two or three days. The next journal entry was usually sometime in the summer....and then the final entry of the year was right before New Years....once again, vowing to journal more!!

But I do have a reason that I haven't written in the past week (ok, a little more than a week!). The INCREDIBLE benefit of being a nurse is that if you clump your 12 hour shifts together, you can actually have a slew of days off without having to use any of your PTO (paid time off). SO- that's what I did. Jon and I took off to Atlanta to visit my family for 5 days and we had a blast!! After doing the Shamrock Shuffle the week before we continued our running through the GA hills and parks which was awesome!!

RN advice of the day: if you want to get in shape...I mean REALLY in shape....run up and down the streets of GA...the hills are NO joke!!

BUT (I digress!)- all good things must come to an end....and I returned to 4 days in a row. That was 51 hours of work plus 10 hours of driving (give or take) over the course of 4 days. While I knew that I hated doing this....these past 4 days confirmed that FOR SURE!!! Every night driving home I thought, oh that would make a great story for the blog....and every time I got home the only thing I could physically do was drag myself upstairs and plop myself in bed (Thank you babe for making dinner and packing my lunches all those days for me!) So those stories will have to wait, but they will be included!

But here's one funny one for the road....it's a conversation that I had with a 75 (or so ) year old great grandma. Imagine her voice being SO country....not cute southern belle country, but like out back Tennessee country (nothing wrong if you're from TN!)....just being able to hear it this way makes it all the more humorous b/c that's EXACTLY how she spoke...even though she told me on the last day that she grew up in Evanston, IL (go figure!)

Me: Is there anything that I can get you?
Grandma: Well, like what would you be able to get for me?

Me: I could bring you some drinks or a snack
Grandma: What????

Me: Drinks, like water or juice, or a snack
Grandma: WHAT???
**Now at this point, I'm like "Am I not speaking loud enough?? I know I'm tired...am I slurring my words?? What is she not understanding!?

Me (much slower, slightly louder this time) Drinks...or a SNACK
Grandma: (now hysterically laughing) Oh sweetie, I thought you said "Drinks or SEX!!"

Me: (Laughing, slightly uncomfortably) No, we're a Children's hospital....we definitely do not offer THAT here!!
Grandma: Well, ok, but if you did, I saw a fine looking young man sitting out at that desk over there
**She was speaking of our secretary who's about 40 or so...and who grandmas (or women for that matter) would not be on his "it" list!!

So what do you do with that....a grandma who is not so interested in juice or crackers, but more interested in the "young man" secretary!! Had I brought her a carton of milk with a man on the side, she very well would have taken up that offer....ewww....but get it Grandma! : )