Monday, June 20, 2011

New dads are great....

Last night was a fairly strange shift for me. I was on committee for most of it, to finish up some computer-based training. Then I hung out in the nursery to help out a little, because we had 4 babies under bili lights and one on the blanket. It's too much for one nurse to handle, especially when they're screaming at the same time.

Around 0530, I finally took an admission, and then another around 0630.

The latter one was a c/section, first baby. Mom, understandably, not moving around a whole lot. I got them settled, and told them to call me if they needed any help. At 0700, when I'm giving shift report, I go into the room with the oncoming nurse.

I see a light on in the bathroom, hear water running, and don't see the baby's crib anywhere. I poke my head in the bathroom, and dad is trying to change the diaper.

He has obviously never changed a diaper before. He's wearing gloves (cute! lol), wiping haphazardly. He's trying to dodge the baby's kicking feet, which have poop on them. There is poop everywhere.

I try to suppress a grin as I ask him if this is his first-ever diaper change, and if he needs some help.

I clean the baby's feet, and show him how to do the one-handed grip to keep them from spreading the mess. He didn't set up any wipes ahead of time, so pretty much I started from scratch trying to explain the process.

He told me he didn't want to call for help because he knew he'd have to be able to do it when he got home. I told him that we are there to teach, and that our job is to make sure they can take care of the baby:
"You can do it by trial and error if you want, but it's generally easier to just learn from someone who's already made the errors...."

Sunday, June 19, 2011

Awww. *gush*

I've been taking care of a particular family for 4 nights now, and they've been through a lot (mainly jaundice/bili lights hell).

Last night they bought ice cream for the unit. Really sweet of them. I am a sucker for ice cream. It's always cool when patients give us snacky-things.

But tonight was the first time I've had a letter written to me. The dad handed it to me, in an envelope made of a sheet of printer paper held together with paper tape lol.

Dear PurpleRN,

Thanks for all the care, support and guidance that you extended during the most anxious and memorable time. We truly appreciate your dedication

- [family]

I'm feeling super good right now. It's a nice thought to fall asleep to.

Friday, June 17, 2011

Gah. Circumcision rant again.

So I had this unfortunate baby yesterday that was born by vacuum-assisted C-section after a failed vacuum-assisted vaginal delivery. Apparently he got good and stuck.

After a vacuum delivery, it's pretty common for the baby to have a good-sized circle of bruise on the head (like a giant hickey) where the suction cup was placed.

This poor kid had actual scabbing and exudate (ie, "goo) on his head around the edges of the bruise. I'm guessing they tried too hard with the vacuum and broke the skin.

So naturally, the kid is kinda grumpy and fussy. His head hurts.

Then the parents decide to get him circ'd. This poor baby was inconsolable. I would be two if I was hurting from both ends. I wish someone would've tried to convince them to at least wait until his head was healed up a bit.

I ended up calling the NICU on-call doc to beg for a tylenol order for the kid. He was finally able to sleep for a whole hour and a half at least. That's all the sleep he got during my 8 hour shift. And they only gave a one-time order :(

Then I had some parents last night who asked about getting their son snipped and when they should do it. My brain immediately went "Never!" but I told them that if they can wait 24 hours until he has a chance to improve breastfeeding, it'd go better for them. Mom's a c-section, she'll be here a couple days. No skin off their back.

And then I go to change the kid's diaper. Poor thing has a mostly-buried penis. I think if they get him snipped, there won't be much of anything left! We'll see how things are when I go back tonight, if they've done it or not yet.... Mom seemed a little on the fence about it. Fingers crossed for them.

According to the latest data, only ~35% of West Coast babies are circ'd now ( ). It'd be nice if we could get it a little lower...

Monday, June 13, 2011

50 Things Your Nurse Won't Tell You....

I was contacted recently by a writer for Reader's Digest who was putting together one of their famous "50 things" lists. She found me through a comment I posted to one of Head Nurse's blogs ( ) back in April.

Apparently she liked my quip, "I may not decide whether or not you need an injection, but I do decide the gauge of the needle involved..." and decided to ask for some more ideas for the project.

I won't share any of them here, of course. That would ruin the article.

But the request got me thinking. It was actually really hard to come up with good "sound bites" within the topic, because, as a nurse, I live for telling my patients things.

Nurses are educators and advocates, and one of the keys to our job is keeping our patients well-informed. Communication skills are right up there with "how to take vital signs" in the list of important things we need to do.

So I answered the topic more along the lines of "Things Your Nurse Wishes You Knew" or "Things Your Nurse Wishes She Could Tell You" with a bit of a twist in the wording.

I'm very curious to see how the article comes out.

Also curious what my readers (all 4 of you lol) would write for this topic? Anything you really wish your patients knew? Or that you'd never tell them?

Thursday, June 9, 2011

A short happy :)

This happened a couple weeks ago, but I just remembered it and it made me smile.

[Setting - almost end of shift]

Patient: Will my next nurse be as nice and helpful as you?
Me: [laugh and grin] Nope. I'm the best one here! All the others are terrible!
Patient: You really are the best one here. I hope you're coming back again tomorrow.

Makes a girl feel good at the end of the day....

[I would *never* actually downsell my colleagues. I work with an amazing bunch of nurses! It's really nice that we have each others' backs, and we always try to upsell the oncoming shift when we do handoff in the room]