Swamped....

with babies coming out of the woodwork....

We have been so busy in the NICU lately that it's almost a relief to have the Critical Care Lab assignment just so we can get a break and breathe once in awhile.

And, it's not so much that we've been so busy, it's that a whole bunch of these babies WILL. NOT. BLEED. We're using lancets designed for heavier babies even on the tiniest ones, and it still makes no difference.

We've truly been given a scenario of that old proverb: "You can't get blood out of a turnip." Actually, I think a turnip would be easier.

Warrior Baby is now living in Bay 2. I can't remember if I told you that or not. Apologies if I'm repeating myself! She's suddenly had a tremendous jump in weight: her weight yesterday morning was 1127 grams, which translates to 2 lbs., 7.75 oz. Everyone is just tickled to bits with her weight gain.

I believe I've seen my first "meth" baby. We have a little guy only a couple of days old who had a drug level drawn to test for Tylenol and Codeine. Thanks, Mom, huh?

This little guy is just...drugged. It's different than when they've been medically drugged with morphine or something like that. This is just like a life-like doll in the bed; muscles flaccid, no reaction to most stimuli. With morphine babies you can tell they're asleep/drugged. They still react, but not like they might normally.

We think it's a meth baby because the mother called the baby's nurse and tried to get on her good side. The words were, in effect, along these lines: "Oh, I was taking a lot of Tylenol and codeine because I have seven teeth that are in really severe shape." She indicated that the teeth had cavities. I'm not sure about everyone, but I've never had cavities that were so bad that I had to take Tylenol and Codeine for several months. Yeah. Dollars to donuts her teeth are bad because of meth.

"You don't think I'm a bad mom, do you? I'm going to get my dental work done real soon...I want to take care of my baby. I don't understand why Social Services was called, and I don't understand why the police have put out an order that I'm not to even be allowed to come to the hospital to see my baby..."

We've got another baby whose grandmother and grandfather are praying almost non-stop over their new grandbaby. The baby is a 25 week baby; she's well under 500 grams. The problem is, as much as we love to see the parents and grandparents in the NICU, these folks won't leave. They get in the way of the nurses when things need to be done. The nurses show wonderful patience with them, but no one has been able to make the g'parents understand that micropreemies need to have a lot of quiet time without someone in the room weeping copiously and imploring Deity. "Oh, (nurse), I just can't bear it, she was crying so hard..." The nurse replied, "I'm sorry, you've just got to understand that crying is the only way these babies have to let us know a number of things, and they cry hysterically when they've become overwhelmed because of too much stimulation." Didn't faze G'ma at all...she just began weeping and praying again.

And, what we all did get a whoop out of was when the very head honcho of the department came in to give medical attention to the baby and G'ma wouldn't let him do anything to the child because "she didn't want any students doing anything to that baby." Dr. was suitably taken aback...and very kindly explained to the woman that while he always hoped to be a student in the sense of learning, he'd been out of school long enough to come up through the ranks to become the director of the whole shebang.

Life is never dull in the NICU.

But, on to Critical Care.

Those of you who've listened to my tales of training might remember that I'm thorough in my teaching. I don't believe in withholding information that might help the student in their efforts to make the patient comfortable. I also abhor it when so called "trainers" throw their charges to the wolves, so to speak. Today was a prime example of withholding information.

Our Critical Care lab also serves as the satellite blood bank for one side of the hospital. Blood products are sent to us from the main Blood Bank, then we dispense. A requisition is presented, we check out the blood product through a series of identifiers.

Today a woman showed up at the window and brought a req for blood. I checked and we had nothing for that patient.

"Did you call the blood bank?"

"I guess so, but we need that blood now...it's a STAT order."

(Well, yes, sweetheart, this is a STAT lab. Everying is a stat order.)

I repeated, "Did you call the blood bank?"

"I dunno."

"Why don't I get them on the phone for you and you can ask them."

I dialed the phone and handed it to her. She pulled the phone receiver out the window and around the corner where her conversation couldn't be heard by us. When she gave the phone back, she said she was going back upstairs to talk to her supervisor.

We thought nothing more about it.

But about ten minutes later, an irate unit clerk shoves that req through the window again. We still had not received any blood for that patient.

"Why is that blood not here?"

"Did you notify the blood bank?"

"Yes, they said they'd sent it right down."

We *had* gotten several things in the tube system, so I went to check again. Nope. Nothing on that patient.

The woman gave me a dirty look. Hell, we're vampires. She probably thought we'd had cocktails with the blood she needed.

"Well....do you think YOU could call the blood bank?" Of course I could, and I did.

The BB told me that they were just waiting to send the blood when someone from that floor let them know they were ready. They hadn't called to tell them that. But they had called to gripe about me.

Seems the newbie had gone back to her floor and told her boss that I'd said that we didn't dispense blood for babies any more.

I only found that out because BB asked me about it when I called them. "Uh, Kate...did you tell them that we won't send blood products for babies any more?"

I think she could tell from my voice that I was completely dumbfounded.

I told her what I'd told the new girl...that the floor needed to contact the BB prior to when they wanted the blood so it could be shipped downstairs and that they hadn't called, so we didn't have the blood.

I then tried to talk to the unit clerk, who had the other girl cowering behind her. But, she wouldn't be mollified, because the new girl had been shown where the Critical Care lab *was*.

I guess if you show 'em the window, they're supposed to know everything they do at that window through osmosis.

It's magic, folks. Pure and simple. Give 'em a job and *poof* they automatically know how to do it. And, the magic is even better if you can blame someone else for something YOU didn't teach them!

Time to go. I'll try to post more on my day off.