News from the Nursery Lab 2008-10

It's been awhile since I've updated you all on the happenings in the NICU. I'm sad to say that in the last ten days we've lost two of our long-time babies; I'd just as soon not tell you much about their time on this earth. Suffice it to say that one set of parents wanted everything possible done to keep their child alive. It was a decision I'd hate to have to make, but in this case, the less selfish choice would have been to let the child find peace.

The other fought the good fight. Sadly, dialysis couldn't save him. In the few days prior to his crossing, we were blessed to be able to see intelligence in his gaze and feel his little fingers curl around ours. It comforted him...and those of us who cared for him.





Every time you hear a bell, another angel gets his wings

Be at peace, Ezra and Peyton











I've just finished training a new Lab Tech to work the overnight shift. She's just awesome. She came to us as a former research lab rat, so I was able to easily breeze through many of the training items that bog down others who've had little lab experience. She was ready to "stick" on Day Two and didn't look back. She absorbed the computer work like a sponge and boy, I wish I'd get more trainees like her!

Right now, we're on a "hiring freeze", and thus, are working short-shifted. My boss keeps saying, "Kate, I owe you..." and I keep telling him he's running up quite a tab. I've also told him what the payoff will be. Let's hope he delivers when I'm ready to push for it. (A promotion, a pay grade raise, and fewer weekends are the plan.)

I love most of the nurses I work with; there are, unfortunately, a few that are going to take some time to get off my "stupid" list. Today was an example. I was in doing a scheduled draw on a baby who was taking great offense to the whole concept of me poking a hole in his heel. A pacifier and a wee bit of sugar water, aka "baby crack", soothed him so I could proceed. But, new babies aren't very coordinated, and soon the binky popped out of his mouth, resulting in extreme sadness and shrill wails designed to give one fingernails on chalkboard shudders.

By this time my hands are both occupied with capillary tubes and feet. The nurse comes in, leans over my shoulder, close enough that she's actually touching my shoulder, no less, and observes, "You're really making that baby angry."

Nooooooooo....really?

"He'll be just fine if you'll take a moment to put the pacifier in his mouth for me...my hands are full."

She looked at me, turned around and walked out of the room. GRRRRRRR.

Last week, one of the nursing assistants showed up in the room with me.

"Kate, we're starting procedural support again...can I help you with the draw?"

Procedural support is a theory that the babies will be much better off if someone makes sure to be there to provide binky support, keep a comforting hand on the baby, sing, coo, or do whatever it takes to keep the baby calm during the draw.

It's great...in theory.

In actuality, though, there are very few kids who require the support. An experienced vampire can be in and out of the room, get the stick with minimal discomfort and trauma to the kid, and many times do so without the child even waking up.

When procedural support comes in, they wake the kid up, unwrapping them, dragging them out of their blankies and clothes to make sure we don't get blood on anything. We'd much prefer it if they would stand quietly by and observe to see if they're needed, and step in to comfort if need be.

I used to be pro-active on procedural support; administration asked us to try it out, and we wasted a lot of time tracking down folks to help us, only to find out they were busy with other things. We don't have time to watchdog; we've got labs to draw. If "they" want procedural support, they're gonna have to be willing and able to get themselves to bedside to help. And, as stated previously, we don't much care whether they're there or not.

Besides...it boggles my mind that the NA's are asked to do this. NA's have so much stuff to accomplish in a shift it's ridiculous. I can't figure out why the nurses, who're sitting outside the room anyway, can't get off their duffs and help. Let the NA's step in when the nurses are actually busy with patient care. I'm sorry, but internet shopping does NOT qualify in my book as "busy".

I had to giggle at a conversation a gaggle of nurses was having last week. Seems they had a staff meeting to get an update on any complaints that parents might have. (This was in one of the healthier baby units, btw.) Seems the two major complaints the parents have are that the nurses spend a whole lot of time gossiping and the parents also think that the nurses should dress a little more professionally so the parents can tell they're the nurses. Scrub pants and non-hospital t-shirts just don't cut it in the parents' eyes. Gossiping - yeah, they have a point there, too. We all enjoy indulging in non-hospital banter, but it should be reserved for times when the parents are not around.

But then, I'm old school on a lot of things. Just not 'hip' anymore, I guess!

In a cruel twist of fate, we currently have a patient whose mother must have missed the "what to name your baby" class. To get the full effect of this, I have to tread the edges of HIPAA and actually state the baby name.

But first, for your television brain, you must be made aware of more of the outside influences in this child's world.

Mama is, of course, a woman. A *LARGE* woman. Over 450 pounds of large (I spelled that "lard"ge the first time...)

My first visit to the child's room found me stepping gingerly around C-Pap equipment, blankets and sheets, dirty clothes on the floor. Candy, soda cans, etc. were scattered on side tables, and other flat surfaces.

Baby, of course, being a NICU child has an assortment of bells and whistles around her bed, too. More things to try to avoid stepping on.

Mama is doing her level best to change the diaper. With her bulk, she's trying desperately to grab a diaper, reach into the bed, do the necessary cleaning. She can't get out of the oversized recliner to even stand up - she's far too heavy for her legs to maintain the bulk.

Puff, puff, pant, gasp, gasp. Repeat.

"It's been so long since I did one of these, I'm not sure I remember how."

This made me think that she probably had kids at least ten years old. So, I asked.

She has one other child...a two year old. And she's forgotten how to change diapers? Excuse me? You can't convince me that a two year old...and a boy at that...is potty trained...at least, not completely.

She seemed like a fairly upbeat woman. She had a ready smile, and a deep, almost whisky-tinged voice. Until she spoke the child's name, cooing to her in the way that parents do.

She's named the girl child "Precious". Yep, that's her legal name.

But when she says it...there's no deep, whisky voice. Instead, she takes the timbre of her voice to a level the makes my hackles stand straight up.

"Ohhhhhhh, my Prrrreeeeeeeeeeecccciiiiooooooouuuuuuussssssssssss!!!!!!!!" Let mama change you, my Preeeeeecccccciiiiiioooooouuuuuusssssssss!!!!!!"

I'm whimpering inside my head, trying to escape the room as quickly as possible.

It's a 450 pound Gollum.

Help.