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This is a Article on Tips for Pediatric Nursing: For Every Heartache There Is A Reward in General Nursing Discussion, part of General Nursing ... Life as a Pediatric nurse can be very difficult at times. I remember being in nursing school and...Mar 21, '08 by oreo11Life as a Pediatric nurse can be very difficult at times. I remember being in nursing school and helping to participate in two different adult codes within a couple of hours of each other in the ICU. Later that day I went to post conference and recounted my experience to my instructors and the other nursing students. I was so excited because I got to do something “cool.” I got to do compressions! It was the happiest day of my life because I got to act like a nurse or so I thought. All the other nursing students were green with envy because they didn’t get to do anything that “cool.” Then suddenly I was a nurse and started my career on the Pediatric ward. Codes in Pediatrics are few and far between so I had worked on this floor for over a year before I got baptized the hard way. I can tell you from experience that codes are not “cool.” Though there is a difference between coding an adult versus a child, the grief and pain you feel are both very real. Yet for some reason, I felt far removed from the adult codes that I had participated in during nursing school. Maybe it was because I didn’t actually have their life in my hands. I was simply gaining experience in something that few other student nurses have had the opportunity to do. I wasn’t involved in their day-to-day care and I hadn’t had to deal with their grieving family. It was just part of life! So I thought. Don’t get me wrong, I felt sad for the families, but during the code, it was like I was removed from the personal aspect and was only involved in the code itself much like being in a real code after you become a seasoned nurse except as a seasoned nurse you do all your crying after the code is done. That doesn’t mean you won’t get tears in your eyes occasionally but it does mean you are better at holding yourself together until after the code is complete and you are alone.
The first code on Pediatrics, that I was responsible for, was shortly after my first year as a nurse. I was now the charge nurse for the floor as well as the only RN on the floor. I had just completed the admission process on a very ill boy and was walking down the hall worrying about him when suddenly the aunt of a patient told me that her niece was not breathing. This patient had been in and out of Pediatrics throughout her 18 months on this earth, for different gastrointestinal or respiratory illnesses, but they were never anything life threatening. This aunt had been very playful every time she was on the floor and always pulling jokes on me so I thought she was just horsing around. Then I saw it in her shock ridden face, she was not playing this time. The mother had step off the floor briefly to go and get something to eat and had left the aunt there to care for the child. To this day that really bothers me because I can only imagine the pain she was feeling by not being with her baby when she drew her last breath. Anyway, I ran to the room and started CPR and called a code. From that point on everything seemed like it was in slow motion. The resident physicians, who were over her case, came into the room to “assist” but didn’t really know what to do. I eventually told them if they weren’t going to help to just get out of the way. We have to remember that they are learning too and sometimes that is very difficult for nurses who have been around any length of time. About that time, I hear screaming in the hallway. It is the mother and she wants in to see her baby. The social worker is outside and won’t let her in—telling her the doctors and the nurses are working on her daughter and are doing everything they can to help her. Back then, family wasn’t allowed in the room during the resuscitation attempt. I remember thinking, “Just let her in.” “Don’t you know she just wants to be with her baby??” My heart was breaking more and more with each one of her screams and begging words! Then I get slapped back to reality. The Emergency Room physician wants an intubation tube and we don’t have the right size in the room. I exit the patient’s room to go to the treatment room to get the needed equipment. As I enter the treatment room, I see the mother in the hallway. She is vomiting and then begins to beg everyone to say the Lord’s Prayer with her. I had not shed a tear until I witnessed the mother’s desperation but then suddenly, I fell apart. I just couldn’t control my crying. I was sobbing uncontrollably and couldn’t do anything about it. What kind of Charge Nurse or just plain nurse was I?? What was I thinking becoming a nurse? I’m no one special? I don’t know enough to help save lives. Then just as quickly as I lost my composure, one of the pediatricians, who was known for being especially hard on the nurses, came to my side and said a few words to me that I will never forget. He said, “You have just got to know that no matter what you have done or will do will change the chances of you getting this child back--statistics tells us that there is only a 2% survival rate after the heart stops.” The finality of the situation finally hit me and I pulled myself together and finished doing what needed to be done. After everything was said and done, I became really hard on myself. I asked myself questions like, “What did I miss when I did my assessment this morning.” “Did I do my CPR in the correct order and if I didn’t could I have saved this child by doing it in the right order?” These never ending questions attacked my bruised and beaten heart one after another. Then I had to face the family. What do you say to a mother who just lost the light of her life? What do you say to the rest of the family who has this huge whole in their heart and in their lives?
I left the hospital that night, after a very long 13 hour shift, questioning my career choices. When I got home, my husband had dinner already prepared and on the table and him and my five children were sitting at the table waiting for me. No one knew the grief I was feeling for this small child and her mother. My husband had taught my 7 year old son to say the Lord’s Prayer for our dinner prayer. My son was so proud of himself and yet I couldn’t bare to listen to it. All I could think of was that mother begging everyone on the floor to say the Lord’s Prayer with her--to ask God to help save her precious little girl. I jumped up from the table and ran away in tears.
I ended up taking two weeks off to look very hard at my career choice and decide if this is something I could do. I cried for a solid two weeks and then I decided to go back to work. I went back but my heart was empty and my desire gone. I would later find out I didn’t miss anything in my assessment of this child. The autopsy was ruled as Sudden Infant Death Syndrome (SIDS). I wanted more answers but the answers were just not there. I think that made it even harder for me to understand. I needed to know what caused her death. What I did wrong. What did I miss? Then almost a month to the date after this patient died, I was the reason another much smaller life was saved. I was admitting a one month old infant with RSV when suddenly she made a sort of coughing noise. I asked the mother, “What was that?” She responded, “I don’t know.” “She has been doing that for a couple of days now.” I asked the mother another question and while I was writing the answer down on the admission sheet I got this “feeling.” I felt like I should check on the infant laying quietly in her grandmother’s arms. When I walked over and opened the blanket concealing the infant, I realized the baby wasn’t breathing. All I could think of was, “There is no way you are going to die on me.” “I can’t take another death.” This “feeling” is the one that you hear all the old nurses tell the new nurses about. It is a feeling that something is horribly wrong. You suddenly feel like all the blood is running out of your body through the bottom of your feet. This “feeling” I was later told is one that comes with being a nurse exposed to the type of tragedy I just told you about. It’s the intuition of a seasoned nurse. Life does go on; you have to remember that for every heartache, there is a reward. The grandmother of this second infant kept stopping everyone in the hallway and telling them, “This is the angel that saved our baby girl’s life,” as she pulled me close and hugged me. Little did she know her baby girl gave this “angel” her wings to fly. The near death of this second infant resulted in my staying in nursing and the infant’s mother to become a nurse herself. Here it is 11 years later and I am still working in Pediatrics. I have become a CPR and PALS instructor so that I wouldn’t ever have to beat myself up again wondering if I did something wrong that resulted in not saving a life. I now know that since my first code had apparently been dead for over an hour, there would have been nothing I could have done to change the outcome of this event. I took the information they gave me in CPR and PALS and beat it in my head daily till the skills I needed became almost mechanical. I use my experience with these codes to train other nurses, especially new nurses, to beat the steps in their head by recounting this very story to them. I have seen other children die and each one of them is hard but I have finally come to the realization that I am not God and I cannot save them if God wants them home with him. I can just learn my skills to the best of my ability and use them when necessary. If you don’t learn anything else from this story, you at least need to learn that your CPR skills are very important so don’t take them for granted. You never know when you will need to use them!
By Lori, RN, CLast edit by Joe V on Mar 21, '08
oreo11 has been a member since Aug '04 - from 'Texas'. oreo11 has '11' year(s) of nursing experience and specializes in 'Pediatric'. Posts: 11 Likes: 23
11,466 ViewsMar 25, '08 by blue_yuinaThanks a lot for sharing this... Because of you I decided that after my graduation and board exam I will train CPR and others to RED CROSS... I will never take every trainings and duties for granted, from now on... This article lifted my spirit and determination to become a nurse... that nurses are not just nurses, they also have this love and instinct to fight and save lives to the fullest of their abilities... and I will become one! thanks a lot!Apr 6, '08 by sasha5This was really a heartouching experience.I myself am a pediatric Nurse and can understand how much it pains and hurts when we encounter with a dying child and when you find yourself helpless and all the efforts in vain in saving the life of the child.Many a times i myself have cried back home and whenever i think of those moments I analize did i do my best in saving the child, was there someting missed out in my obsevation and so on...Thank you atleast I could relate myself with the enrichhing experience you have shared.