I feel like a weakling...

Specialties PICU

Published

Specializes in PICU, surgical post-op.

Got my first on-the-job injury today. =( I was restraining a combative 18 year old prior to extubation, and he somehow almost ripped my arm out. After it was all over (he flew- yay!), I couldn't feel the last couple fingers on my left hand. I told my charge nurse, who sent me down to employee health. Nothing major is suspected; my back is spasming badly, so I'm just to be in bed for a day or 2 and take my muscle relaxants like a good little patient. However, stupid me went into the room again to sign off with the charge RN, saw loose tape on a IV, went to re-stick it, and the little rat got ahold of that same arm and tried to twist it loose again! Will I ever learn?!

So here I lie, typing with one hand and feeling like an all-around weakling. Not something I'm used to, since, at 6-foot and with no guys working day shift, I'm the muscles around our unit. =( Just needed to vent a wee bit...

Up Vote Up Vote ×
Specializes in NICU, PICU, PCVICU and peds oncology.

OMG alirae!! I can almost feel your pain!!! Got ice on that spasming muscle?? Don't overstay the time in bed, it won't be beneficial. I've had a recurring back injury for 12 years, and I have my Tx plan down to a science. It includes ice on day 1, heat on day 2-3, muscle relaxants only at bedtime, anti-inflammatories the rest of the time, gentle streches and walking. Generally only takes 2 days now to get back to quasinormal.

Now let's talk about the situation that got you there in the first place. What is staffing like on your unit? Do you feel it's safe when you have adult-sized patients? They often are as you describe when we shut off all their drugs to extubate. The likelihood of them getting you in an unbreakable grip is pretty high, and they can really hurt you, as you've learned. (I had an 11 year old Down's kiddie who got me in a head lock twice, then I just didn't go near the bed. Another time I had a drunk 15 year old male try to head butt me from his perch on the end of the stretcher, arms restrained behind him with the leather restraints... I've been pinched, punched, kicked, kneed and bit.) Will your unit be doing anything to limit the risk in the future? And are you covered by worker's comp for this injury, as you should be? I sure hope so.

Take it easy for the next few days and don't push yourself when you get back to work either. Take that weight restriction and hold onto it for as long as you need to. :flowersfo

Up Vote Up Vote ×
Specializes in PICU, surgical post-op.

Is it wrong that, as I hit "submit new thread" I thought to myself "I know my PICU-momma Jan will reply with helpful words!"?! =)

They wanted to write me off for the whole weekend, but I got them to say just tomorrow, with the understanding that I can go back Sunday if I have a baby. Yes, I'm iced at the moment, have a pill to pop before bed (wouldn't dream of it beforehand, since even sudafed knocks me out for a good 24 hours!), and will be taking some meandering walks tomorrow.

Staffing isn't usually the problem for us. We actually had our burly EMS tech on the floor today helping the holding and everything ... it was just one of those freak things. I AM, however, going to bring up to management the fact that this all happened AFTER I had sent a runner to get the docs to pull the tube and BEFORE they decided to show up, their reasoning being that they just "wanted to finish rounds real quick" WTF?! But I'm covered for it all ... just have to submit my receipts for copays to employee health and that will go right back into my next paycheck. This being the first time I've dealt with them, I'm actually pleasantly surprised!

I don't know what the answer is, I really don't. How do you guys go about extubating the big ones? Sometimes we'll start a propofol gtt, turn off the existing sedation and then extubate from the propofol. Not a bad idea, and I think it's a good option for the big, dangerous kids since it's only ever on for an hour or 2. (Have I just opened up too big a can of worms by mentioning propofol?) =)

Up Vote Up Vote ×
Specializes in NICU, Telephone Triage.

I feel like crying now! Yikes! Now I know why a big part of me likes my babies better in the NICU. But, the situation I'm in now, I have no choice but to give the PICU a try. So far, no injuries. But the big kids and diapers can be hard on your back when you aren't used to it.

I hope I don't ever come across a pt. like what you 2 are describing.

That's scary! I hope you feel better AliRae.

Up Vote Up Vote ×
Specializes in PICU, surgical post-op.

Our NP called me today to check on me and make sure I was calling our for Sunday too. Toughest thing I've ever done, especially since she mentioned that there were 5 possible traumas sitting in the ED ... but the night charge texted me later and convinced me they weren't going to be able to give me an assignment with only babies in it, so I'd better stay home (and anyway, maybe only 2 traumas were coming up.) Things like this make me realize how lucky I am to work with the people I work with. They've been so great.

And the NP telling me that the 18-year old is in 4-point leathers after threatening multiple times today to kill his nurse? That helped me call out too. (I need a smiley with its eyes bulging out of its head right about now...)

I think this is a good lesson for me about taking care of myself as well as my patients. It's the first time I've ever had to apply it to ME though, so, as with any new lesson, it's rough. :o

Up Vote Up Vote ×
Specializes in NICU, PICU, PCVICU and peds oncology.
Is it wrong that, as I hit "submit new thread" I thought to myself "I know my PICU-momma Jan will reply with helpful words!"?! =)

That made me smile. I guess I take that role seriously... I have two daughters in their later 20s and I work with a lot of girls their ages, so I just extend that to everyone. (All of my current coworkers who have added me to their Facebook friends are the 20-somethings. Is that weird? :eek:)

I'm glad you've taken today off too. I know that you've lectured parents about taking care of themselves so that they can better care for their child, and how hard it is to have it turned around on you. BTDT... But if you take it a step further, nursing is your career, your source of income, your life. If you don't allow injuries like yours to heal and they become chronic, you might find yourself unable to perform your job. Then what would you do? It isn't really fair to your coworkers for you to be on a permanent weight restriction and it would cause you to stagnate as a PICU nurse. I don't think you'd want that.

There are several nurses in our unit that have permanent weight restrictions, some as little as 7 kg. Yeah, we have a lot of small patients, but there are times when we have far more of the big patients, and it's the same small group of nurses who have to take them. The ones with the weight restrictions also never have to take admissions, because you never know what's coming in the door, and if the kid has to go to CT, they can't push the stretcher. (No porters for peds in our hospital, and our nursing attendants aren't permitted to transport patients...) They can't be the resource nurse, because that role requires helping with turns, diaper changes, ambulation and code response... which might just be for a teenager. So there's a lot of resentment. Especially now that they've told us that anyone who is injured and goes on even a longish temporary weight restriction will have to transfer to NICU because PICU can't accommodate any more. I think they should be transferring the ones who have been on restriction for five years, because obviously they are never going to be able to fully function in PICU again. But that's just MHO.

But I digress. Your concern for your coworkers is admirable. That you'd worry more about them being slammed than you would about setting back your recovery says that. However, it isn't selfish to take the time needed to get back to normal. Your NP obviously understands that, as does your charge nurse. Please take care of yourself! (Glad to hear that your assailant is in leathers. You should consider filing assault charges, you know. He's an adult, and he has followed up his attacks on you with threats to others. Sorry, I just can't help Momming.)

Gotta run and make some pumpkin pies for tomorrow. It's Thanksgiving in Canada and my family is having turkey at my house. DD#2 is cooking the turkey for the practice and I'll be sleeping off a night. I hope my kiddie from yesterday is holding her own. (Burns) Get well soon, Ali.

Up Vote Up Vote ×
Specializes in Staff nurse.

You should CHARGE THAT PT. WITH ASSALT since he got you the 2nd time. Do it!!

Up Vote Up Vote ×
Specializes in PICU, surgical post-op.
(All of my current coworkers who have added me to their Facebook friends are the 20-somethings. Is that weird? :eek:)

(Glad to hear that your assailant is in leathers. You should consider filing assault charges, you know. He's an adult, and he has followed up his attacks on you with threats to others. Sorry, I just can't help Momming.)

Gotta run and make some pumpkin pies for tomorrow. It's Thanksgiving in Canada and my family is having turkey at my house.

We should be facebook friends!!!

If I was ever tempted to file assault charges, this would be the time. However, I can't help making excuses ... he's bipolar and was getting extubated. Hot dang, I wouldn't want to be held responsible for MY actions under that set of circumstances! Besides, I'm leaving the country soon enough. =)

This is the first year we're not having 2 Thanksgivings. Being a dual citizen living in the States usually has tremendous perks, but we have a houseful of guests for a conference at our church this week, so no thanksgiving until november. =( Enjoy the turkey for me!

Up Vote Up Vote ×
+ Add a Comment