I think most of you know that there are several different types of parents of chronically ill children. Some use the hospital admission as respite care and stay home all day. Others micromanage their child's care and question every decision made. Then there are the parents who stay at the bedside, know every detail of their child's care, but are more than happy to let the doctors and nurses care for their kid. These are my favorites.
Here's how an admission assessment went last week:
"So what brought you to the ER today."
"Well, Johnny was napping around 10am. He wears CPAP at night, but not during naps. I noticed he was pulling really hard to breathe, so I put his CPAP on and checked his sats. They were low- in the 80's- and he's normal 94-98. He was still working really hard and his sats were dropping into the 60's. So I called 911. While I was waiting for 911 I repositioned him to get his sats up and checked his temperature. It was 103."
(Wow! I don't get report that good from other nurses!)
Assessment continues. Mom knows the pediatrician's number by heart. She knows every medication he is taking, the dosage (not just the teaspoons), and when he last got the dose.
I asked about his CPAP. She rattles off the exact settings and hours that he wears it.
I asked about his feedings. She gave me a detailed description of the formula, the frequency and schedule, and the rate of administration- including changes when he is awake and asleep.
Elimination: She knew the exact time of his last bowel movement, how frequently he usually has them, and whether or not he's constipated.
And the whole time we were talking, Mom was keeping this very active, developmentally delayed little boy calm, content, and contained. But she let use do whatever we needed, even when it came to trialing him on a BiPAP face mask she knew he wouldn't keep on. Or when she had to help hold him down for a nasal wash, or when I told her we had to keep using rectal temperatures because his axillary temp wasn't correlating. She was wonderful.
I could have kissed her. Major kudos to parents like her. They make my life so much easier. This little boy was one fortunate kiddo.
Apr 8, '12
Wonderful story, nice to read good posts. Any of us COULD so easily respond with my least favorite parents story, but lets stay in a happy place for a while.
Apr 13, '12
Great story to hear!
I thoroughly enjoy having parents like that at the bedside. It makes up for all the times when parents bring in their chronically ill child who has AT LEAST 10 medications but they're "not sure" of the name of the medication or how much they give, and they don't know if they have received X or Y or Z vaccine this year, or ever, and don't know the name of their pediatrician, but they go to "that one building over on main street, you know, the one with 5 floors, that's where the doctor is!"
Parents that have a clue are quite refreshing, and every time I feel myself growing a tad bit cynical, one of these parents shows up with their child in our PICU and it puts me back into my place.
Apr 17, '12
Ditto for good stories. Thank you for this one!
May 8, '12
I work in PICU now - having come from the world of home care, specifically caring for vent-dependent / medically complex kids. The metro area where I work has two major children's hospitals - one HUGE and a smaller, newer one.
The parents of children in the HUGE hospital's system (in my observation) have learned a role of dependency, and 'do what you're told', while the parents from the OTHER hospital's system are taught that THEY will become the expert in their child's care. My 'good' parents have been empowered by nurses, physicians and therapists to become those great parents we all love.
The difference when these children are admitted is staggering.
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