Day 71: PICU

Really couldn't sleep the night before my first peds rotation. I was going to be in the PICU and I was afraid someone was going to die on me or at least go into some kind of crisis. I was lucky. No baby/child/teenager had any major problems while I was working in the PICU. In the med surg, wing next to us unfortunately someone was unlucky. First day and you are hearing Code 99 over the intercom, makes a person a bit jumpy.

I had two patients...strange since its the PICU and I am suppose to have only one patient. But my patients were not hard to handle. The only reason they were in the PICU was because they had compromised airways: one due to bilat pneumonia and the other statius asthmaticus (inhaled fibers from a car that he was working on). The goal for me that day was to monitor their Intake and Output because niether had gone to the bathroom all night. We gave the little one a bolus of fluid because he refused to eat or drink and we gave the teenager lasiks because he was drinking and eating just not going. It was kind of humorous to watch the teenager. Two minutes after he was given the lasiks he kicked us out and jumped out of bed to go to the bathroom! He complained of the pain in his stomach, but what do you expect when you take a diurectic and hold it? I felt bad for the poor guy, he had two female, young nurses taking care of him...I think it was a little awkward for him! I think it helped his dad was there. With the little one, grandma was the care taker. She talked our ear off about how awful her daughter was and how sick he was. It was good that he had someone who cared.

At one point in time I got to see the extubation of a baby. For those that don't know, that is the removal of a breathing tube. The Dr made a bigger deal out of it than it needed to be and the ENTIRE family had to be there to watch. It was not a pleasant procedure. If you mess up, you could colapse the baby's airways and you will have to re-intubate them. The poor child made some of the most awful sounds! But they got the tube out and by the end of the day he was kicking and babbling at his dad. Then there was this other baby that was in liver failure. I had never seen a baby with jaundice before. This poor thing was neon yellow everywhere! He had an oral eversion so he had to be tube feed through his stomach. His poor little tummy was so bloated he looked like on of those poor African kids with the bloated bellies and skinny extremeties. But he was a happy baby. And then I watched a nurse flush the heplocks on a 6 week old. One lock was in the little one's arm and the other in the childs head!!!! The tubing and tape covered a good portion of the child's head! I was really sad.

Here is the thing about Saturday. I didn't have as much trouble as I thought I would working with sick little ones. To be sure I was upset when everything had settled in at the end of the day, when I was eating dinner. But the thing that bothered me the most was the parents. The uninvolved parents, the absent ones, or the ones who felt the proper care of their sick child was an inconvience to them like this one set of parents that complained about how loud their baby's apnea monitor was and was trying to find ways to turn it down, and they wanted to leave the hospital without having O2 delivered to their house simply because they wanted to leave. And the parents that make my job more complicated, like the one that wouldn't let us give her son pain medication, specifically ones that could create dependence, so the kid suffered because NOTHING was working. I am sure I will be a pain in the ass if my child was ever in the PICU, but I will be involved and I will care about my child's home care, and eventhough I wouldn't want my child to become dependent on drugs I wouldn't want them to suffer.

I guess I am kind of happy that next week I am in the regular unit. Maybe I'll get a little one that has the sniffles and is a little dehydrated and mom and dad care. Peds has been eliminated from potential career options.