And That's How I Almost Cried During Clinical

This week I was supposed to be in the PICU (pediatric intensive care unit) for both days. The PICU has had census problems all term and usually ends up being closed because of a lack of patients. So I was incredibally stoked when they had one Monday evening who would be there both days and who had a lot of interventions that I had never seen or worked with before (wound drains, a colostomy, a PICC [Peripherally Inserted Central Catheter] line). So, Monday night I spent about 5 hours looking up all of my patients labs and medications and brushing up on my skills to make sure I would be able to provide awesome care. And I was very excited to do all these interventions too.

But then I arrived at clinicals. And was told that I could no longer be with that patient because the newly hired nurse would be working with him. Which is understandable, and I was fine with that aspect of it but what I was not fine with was the fact that I had all this pre-clinical work completed and was being switched to a patient that needed no care and was being discharged that day. ARGH!

So, we made the decision at the end of the day to have my second day take place on the regular pediatric floor. And that was an amazing decision!

My primary patient today was a 12 year old who has a BMI of 48 (over 30 is considered obese). In addition he has ashtma, COPD, gout, multiple admissions for respiratory infections including pneumonia, and arthritis. He was admitted this time due to cellulitis on his arm (a bacterial skin infection) and possible kidney failure. Unfortunately they inserted the PICC line before I got there, which was kind of a bummer, but I did get to do a heparin flush (to keep it open and free of clots) which was kind of neat and I got to play many round of connect four (a favorite board game) with him. It was really just fun being around him but also extremely heartbreaking. Many cultural and lifestyle factors are keeping him from losing weight, but unfortunately if he keeps going the way he's going his life expectancy isn't very long.

Other big news: I got to place my first NG tube today! Probably the most traumatizing thing I've ever done to an infant. Getting the tube down the nose and into the stomach was not big deal (first try I got it in the right spot, holler!) but taping down the tube to an extremely angry infant's face and needing to use scissors to trim the tape all during crying and moving on the infants part? Traumatizing. It's good that it happened at the end of my day or I would have been on edge for the rest of the day.

So that was my week! It ended on a pretty cool note I must say. And the further into this I get the more I'm pretty sure that I was created to work in pediatrics. Hooray!