Monday, March 05, 2007
Too much of a good thingOk, here's the deal. I like having a child's parents at the bedside. It's fantastic. It's the way things should be, with the parents providing care, reassurance, and valuable "insider information" on my patient.
Sometimes, though, you just need the room to yourself. (The following is heavily paraphrased.)
"So, what's that you're giving her now?"
"Nothing new, the dopamine infusion is about to run out so I'm swapping in a new one. You'll see her blood pressure go up for a bit, but it'll soon settle."
"Oh, right. Has she had a suction at all?"
"Not on my shift."
"Did she hoik?"
"Hoik, you know, like cough? Or was it all in the tube?"
(Struggling to keep up) "Uh, her last suction was before my shift, so I really couldn't say."
"Ah, ok." Brief pause. "What's that she's getting now?"
"This is one of her antibiotics." I check the clock. 0120 hrs. Please, please, go to sleep. Your child is sedated. She won't wake up unless... you start... to rub her feet and talk to her in a loud voice...
"So that's one of the ones to put her to sleep?"
"Yes, we don't really want her to wake up just yet, she needs to be relaxed."
Parent gets out own thermometer to check temperature. "Do you use these? These are good."
"Uh, we have some other kind." I am willing you to go to sleep. You are getting sleeepy. Sleeeeeepy...
Pointing to the monitor, where the respiratory rate has fallen slightly. "Where do you want the respiratory, boss?"
Boss? "Don't worry too much about the numbers on the screen. It's normal to pause a bit when you breathe, especially when you're in a deep sleep. You and I probably do too. If she stops for too long, the ventilator will kick in."
"Right, right. So what's that she's getting now?"
Poison. I'm giving her poison, IV stat. "This is another antibiotic. I'm just adding it into the line in a different place."
And on, and on. Don't get me wrong, I'll answer questions with the best of 'em. However, some parents feel obliged to do the heroic guardian bit and stay up all night, completely exhausting themselves and adding to their family's already significant stress levels.
Plus, on night shift the bedside nurse's patience is less abundant.
Posted by PaedsRN at 4:37 AM