Baby Lust

One of the most difficult things about nursing in the pediatric setting is realizing that your patients are not your children. At 25, I didn’t think that that would be too difficult considering that I still feel light years away from taking a few laps around the “mommy track”. With the current epidemic of babies having babies, though, I realize that I could certainly have birthed any one of my infant charges. It never fails to astonish me that I regularly have to “parent” parents who are ages 16-21, usually with another child or three already at home. It also never fails to slightly offend me when people ask if I have children.

What? Are you crazy! Who has kids at 25 while they’re in school, unwed, and still living with their mother!?

Oh right…you!

Inevitably, many of these babies do not come to us from stable, nuclear families that provide three square meals a day let alone access to a pediatrician and regular primary care. I’m lucky if I can untangle whatever complicated and contentious relationship mommy and daddy might have long enough to figure out who actually plans to take care of the child. I have cared for one particular infant for months now and have yet to see one of his parents or another caregiver.

Caring for small children who are patients is often like bringing home that stray dog you saw on your way to work – you’ll let it into your heart just long enough to find it a good home elsewhere. But that’s it! You’re certainly not keeping this little creature. And then you spend whole days with this loveable being – feeding and swaddling and bathing and soothing. Your maternal instincts are out of control; your ovaries seem to have taken over your brain. Then, one day, it returns the affection with those big, bright, dark eyes and that smile like a perfect little “O”. Your heart swells and you know you’ve been suckered. Except this little pup isn’t for keeps.

Today, I met this little pup’s dad and felt such sparks of possessiveness that I had to restrain myself from asking “And just where have you been all this time!?” I had really wanted to dislike the guy, but he didn’t look like the evil villain I had conjured in my head. Mostly, he looked bewildered sitting far from the crib in a hospital-issue rocking chair, staring at the television while his son recovered from surgery not 5 feet from him.

When caring for children, it can be hard for me to check my judgment at the door. As nurses, we are fierce advocates for our tiny human patients and it is never pleasant when you have to coordinate all sorts of complicated care and medication regimens with barely involved parents. There are always reasons and excuses and extenuating circumstances that seem to preclude even those with the best of intentions from being the mother or father that they want to be, but sometimes I just want them to tow the damn line, step up, be accountable, and get the job done because it’s time for me to stop doing it for you.

I give each child all the love and support and compassion and empathy that I can within reason within the confines of the limits I impose on myself in order to keep my sanity and avoid emotional meltdowns after a shift. At the end of the day, despite this phenomenon I like to think of as “baby lust”, I’m still not the parent. I’m just the nurse.

 

 

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Hubris: Not Just a Problem for Hercules

The more time I spend in hospitals, the more I am convinced that there is a certain amount of hubris required to be a surgeon. When mother nature stamps out doctors, she most certainly must have a different cookie cutter for “the surgeon”. I realize I run the risk of making one of those overly general, wet-blanket statements here, but I think you’ll be hard pressed to find other nurses who disagree.

In case your desire to be an open-minded, non-judgmental, compassionate human being should try to sway you to side with the surgeon, let me present a brief recounting of a recent interlude between me and him that occurred last week:

I’m standing outside a patient room in the early afternoon writing the most epic of progress notes on a rather medically complex child when I feel a presence behind me. I turn to find a tow-headed man in scrubs, chest hair bared for all to see through the v-neck of his top. He is loudly chewing gum in the most obnoxious manner, a manner neither professional nor appropriate for a hospital setting. Before I can react he’s reaching for the bedside chart to check on my patient’s fluid output from the two chest tubes he had inserted.

I defensively slap my hand on the binder. Hello, HIPAA!? My face clearly says “Who the hell are you?”

“I’m surgery,” comes the reply with a smirk. I’m surgery? Not, I’m from surgery or I’m the surgical resident. Who died and left the profession to you?

I provide a brief update on the progress of our patient. I’m concerned about the chest tube outputs. I have the patient to water seal rather than wall suction.

[Side Bar: For you non-medical folks, water seal is just a technical term we use when we no longer use pressurized suction to remove fluid from a patient’s body. Water seal essentially means the tubes are draining via gravity and the patient is getting ever closer to have the tubes removed. Keep in mind these tubes are about the diameter of a quarter. Yikes!]

Instead of the daily total for each tube being closer to our goal of 200ml, the left side had dumped out a whopping 1060ml of pinkish-yellow fluid. Of course, it could always be worse. The fluid could be frank, bright red blood instead, but as a nurse, you shouldn’t allow yourself to think that thought lest it become a self-fulfilling prophecy.

“Surgery” seems to have left his math skills in the OR and, despite my careful documentation over the past 8 hours, he can’t seem to understand how the hourly totals add up to the cumulative 8 hour total. I have awesome, extremely legible handwriting so I know that this is not my fault.

This is the point in the conversation where he gives me a look that suggest that I am the real moron here.

“Is it putting out chylas?” he asks. Come again? What kind of question is that!? [Side Bar: First of all, it’s “chyle”. Secondly, chyle is lymphatic fluid]

“No,” I say, “it’s sero-sanguinous.”

“But is it chylas?” he asks again.

I am tempted to utter a Meredith Grey “seriously!?” here. How should I know if the chest tube is draining lymphatic fluid versus interstitial fluid? I’m not a micro lab. I observe output, color, consistency, odor…I don’t test to see where the fluid came from. But what do I know? I’m just the nurse.

With an air of exasperation, “surgery” whisks by me and into the patient’s room without a protective gown, completely ignoring the CONTACT PRECAUTIONS sign on the door.

I think about following him in, but then I think “oh well, let the jerk get MRSA”.

 

Reflection on Handwriting

If you want to have a really bad day, I recommend reading the sentiments written by others about your father shortly after he died. Because if there is anything worse than your own personal grief and pain, it’s reading about the pain of complete strangers almost two years after the fact.

When I was walking down the hallway and ran into the chaplain, I knew we were going to talk about my dad and I knew that she was finally going to give me that little book that had been displayed in the hospital chapel so that faculty, staff, coworkers, and colleagues could reflect upon what a {insert your preferred adjective here} guy my dad was. And, of course, it was fitting that she present me with this neat little package of highly charged emotions right before the highly charged, emotional event that has come to be known as “Dad’s Dedication”. Needless to say, the notebook sat in my backpack until I passed it off to my mother after the portrait had been unveiled and canapes had been consumed.

It didn’t occur to me until yesterday when I was thinking of every way possible to procrastinate, and further put off writing a rather tedious research paper, that I decided to rifle through my mother’s room to find the notebook. I clicked over to Hulu on my computer and put on “Parenthood” for background distraction and proceeded through the pages. It’s never good to attempt these things with complete silence. If reading the sadness in another person’s handwriting is much more difficult than thinking about your own sadness, then not being able to fully deduce what someone has written because their handwriting is illegible is infernally frustrating.

Wait, what did you say about the time when _____ happened? Is that a ‘k’ or an ‘r’? Reading someone’s thoughts about another person is like an archaeological dig where you discover things that you never ever knew. Things that suddenly put that life into context and unravel mysteries. Couldn’t you have thought to print neatly? When someone dies, you realize just how much you didn’t know about that person. Even when you shared the same living space with them for 24 years, you still weren’t privy to the day-to-day goings-on of another man’s life. And why would you be? We all lead separate lives to some extent. There is no possible way to completely know another human being. I find myself wishing for just another snippet or anecdote that will allow me to better hold on to those memories that are already seeming very distant and murky.

[This is for another entry, but if I could have a superpower, it would be that I could read minds.]

The best part about reading those two dozen or so entries was realizing how devastated other people felt. When someone dies, people offer their condolences because it’s considered polite human behavior. I am still shocked and awe struck by how sincere and genuine other people’s sentiments have been, how emotional they still become when I pass them on campus or in hallways. It’s almost too much to bear. And that’s the worst part. Because if there are other people feeling as ridiculously awful as I feel, then the whole terrible bad dream of prolonged illness and death must certainly be true.

If some people had better handwriting, though, I’d at least be able to thank them for taking the time to share their sadness.