Mommy and Nurse, blessing and curse.

[PeepnBiscuitsRN]

If this is in the wrong area please forgive me.

I've found it a blessing and a curse to be a mom...and a nurse. For 4 years I was an LPN and I worked in pediatrics- when I had my son, I found that the spirit of my job had changed. I felt more inclined to want to hug the little children I just hurt by gagging, poking or by sticking things in various places. When I was in school for my RN, I found myself diagnosing the poor little kid with everything under the sun, from ALL to Tetralogy of Fallot to Meningitis (or the fear thereof).

When we had our daughter, almost a year after I graduated nursing school (and a few months before I began working) I realized I was hyper-aware of her every cough, sneeze and fumble. I recall a time when she was maybe 3 months old and she was coughing, and I took her temp- borderline-low grade, checked her respiration- normal. Color-normal. I listened to her lungs, because you know EVERY parent has a Littmanns Classic II sitting around their house, right? Her disposition- grand! Jolly, cooing, nursing heartily. So all of those reassuring things (her lungs were clear as a bell, by the way) said- what did nurse mommy do? Call the triage nurse, and proceed to answer every question she was going to ask before she could ask it (luckily this was the clinic I worked at as an LPN, so I knew the nurse on the other line, we had a good laugh).

Fast forward to this past weekend (my daughter is 12 months now) she spiked a temp of 103 (102 under the arm). She looked deadpan, her eyes were dull and glassy. It was a Saturday evening. All day long she had been peachy: eating, drinking, wetting, pooping and just as merry as can be. I gave her Tylenol, and despite all of the evidence telling me she was probably fine, I whisked her away to urgent care where we sat for 2 hours, just for the doc to say her ears looked fine, her lungs were clear, and her urine was fine. She had a cold last week, with the ucky green thick goo and I figured it HAD to be OM (even though she wasn't pulling at her ears or giving me any indication that her ears bugged her at all). She had been taking a lot of baths with baby wash- the organic kind, so MAYBE it was a uti- even though her diapers were just FINE. In fact, by the time we got to the clinic, her temp was down, and the sparkle was back in her eyes, and she was toddling around and socializing with anyone who would look at her.

I won't even go into what happens when my "I fear nothing (except Bears and the sound of the Emergency Alert System)" 3 year old does his thing.

I have this running argument and debate that gets worse than political debates at times in my head: Mom versus Nurse. Sometimes Mom is freaking out while the nurse says "look at him/her, yeah he just smacked his head, yeah she has a temp of 103, but they're running around and eating and drinking and are merry- and their pupils are equal, round, reactive, their lungs are clear. Sometimes Nurse feeds too many facts into Mom's head- "you know...left untreated, OM can turn into MENINGITIS (and "Meningitis" is said in a booming, echoing ominous voice too just for effect!) and we're off to Urgent Care.

So I don't know if this is a narration of recent events (never figured out the temp- she's fine now, except she smacked her head on a table and has a goose egg on her forehead and I had to fight myself to not do q4 hour neuro checks, figured one time was enough). Or if it's asking you other parents who are also nurses- how do you strike a balance?!

[DemonWings]

I have to admit I have performed many a nursing interventions on the poor babies. I push fluids, monitor urine output (well I dont measure, I just make sure to be aware of how many times they are going), I have evaluated stool for blood (diarrhea is sometimes orange/pink depending on what they ate) so it always freaks me out. I monitor color and consistency and color of respiratory secretions, have monitored respirations, lung sounds, and HR.

Its hard to turn the nurse brain off thats for sure, sometimes I think I know too much, well I know a little about alot which makes me bonkers.

Here are a few things I have learned from experience

1. when you bust your head on something, it will bleed...alot and it does not always mean that they have ruptured an artery a few stitches at urgent care will do the trick.

2. When they have a headache, they may be just tired it does not necessarily mean that they have a brain tumor.

3. When they puke when theyre sick, it happens and they are not dehydrated after one episode of vomitting.

4. If their belly hurts, you dont have to meticulously monitor for right-sided pain or palpate McBurney's point, it might not appendicitis, they probably just have to poop.

5. Loss of appetite might have a lot more to do with the spinach you are serving for dinner, it is not cause for concern, especially when they ask for a peanut butter sandwich 15 minutes later

6. When they are say they cant walk because their legs wont move, they are probably not having a stroke, more likely they dont want to clean their room.

[badmamajama]

i have to admit i have performed many a nursing interventions on the poor babies. i push fluids, monitor urine output (well i dont measure, i just make sure to be aware of how many times they are going), i have evaluated stool for blood (diarrhea is sometimes orange/pink depending on what they ate) so it always freaks me out. i monitor color and consistency and color of respiratory secretions, have monitored respirations, lung sounds, and hr.

[color=#ee82ee]yes, yes, and yes!

1. when you bust your head on something, it will bleed...alot and it does not always mean that they have ruptured an artery a few stitches at urgent care will do the trick.

[color=#ee82ee]thank goodness i do know scalps and faces are easy bleeders or i would have had many panic attacks. still, there is still closed head trauma to worry about once i have assessed and found no crepitus. how fast can i get a head ct???

2. when they have a headache, they may be just tired it does not necessarily mean that they have a brain tumor.

[color=#ee82ee]are you sure? my 6-yr old has been c/o ha recently and it's all i can do to not call the peds doc. see above about a head ct.

3. when they puke when theyre sick, it happens and they are not dehydrated after one episode of vomitting.

[color=#ee82ee]why are they vomiting? is it food poisoning? is it just the virus that is going around or did they hit their head and have a bleed and that's why they are vomiting? see above regarding head ct.

4. if their belly hurts, you dont have to meticulously monitor for right-sided pain or palpate mcburney's point, it might not appendicitis, they probably just have to poop.

[color=#ee82ee]my kids are all learning what rebound tenderness is. my 6-yr-old preempts me by saying "mommy my tummy hurts but all the time, not just when i push and let go." still, an abdominal ct wouldn't hurt, right?

5. loss of appetite might have a lot more to do with the spinach you are serving for dinner, it is not cause for concern, especially when they ask for a peanut butter sandwich 15 minutes later

[color=#ee82ee]loss of appetite? does my kid need a psych consult? ok, i haven't come to this yet, but they are still young...

6. when they are say they cant walk because their legs wont move, they are probably not having a stroke, more likely they dont want to clean their room.

[color=#ee82ee]this one i've got, i just say "too bad you can't walk, then you won't be able to make it in the kitchen to get a cookie. maybe next time. "

seriously, you're not the only one who does this! it's hard to know what things could be

and separating that from what they most likely are. i just don't want to be the one who blew off a symptom then it turns out the kid is actually sick. then again i don't want to take my kid to the doctor for nothing and have them exposed to something at the peds office.

its hard to turn the nurse brain off thats for sure, sometimes i think i know too much, well i know a little about alot which makes me bonkers.

[color=#ee82ee]i keep trying to explain it to my husband, that i know just enough to make me dangerous. he is of the mindset that he can evaluate the kids and decide if they are sick and need to see the doctor. (he is an accountant. give me a break.) this has led to many arguments, including the time our then 10-week old daughter had a fever x3days. don't even get me started.

[color=#ee82ee]

[JourneyRN]

"Look for horses, not zebras"... that always helps me! In other words, consider common conditions first before less common (headache vs brain tumor). Also, check your gut. If there is something absolutely "wrong" despite logic then go with it. Balance those concepts & you can be a happy mommy-nurse.

[Spidey's mom, ADN, BSN, RN]

I'm the opposite - I "poo-poo" symptoms most of the time.

My kids get little sympathy from their nurse mom.

"Get over it".

I've missed a broken arm and a very bad ear infection doing that.

I've also gotten a $1400 ER bill for taking a screaming child to the ER after hours of pain because I started to think "appendix" . . .to find out it was constipation and gas. :icon_roll

I'm overly cautious most of the time about making mountains out of molehills.

Sometimes you get caught though.

[GinRN77]

I am the same way. Sorry kiddo, you WILL go to school today. My kids often say it's no fair their mom (and stepdad) both work in the ER. They don't get away with anything!!! :)

[Purple_Scrubs, BSN, RN]

I have a 5 month old foster baby and totally do not trust my own nursing judgment with him. Yes, we whisk him off to the MD quite regularly, in fact we were in the office 3 days in a row when he had bronchiolitis (but in that case, he was really sick and they considered hospitalization). I am super proud of myself that his last URI I only called for reassurrance and managed it at home with his nebs and a humidifier!

My hyper-vigilance may have a little to do with the fact that I feel extra responsible because he isn't my own kid, but I have a sinking feeling I would react just the same if he was!

[noahsmama]

I always figure it's better safe than sorry. I take my son to the doctor every single time he has a fever that lasts more than a day, and I ask them to look in his ears (he has a history of many ear infections). Even if there's nothing they can do but send us home and tell me to push fluids, I still feel better going. I figure that's what doctors are paid for anyway. And yes, I did once take a screaming child to the ER with what might have been appendicitis but turned out to only be gas. Even called the advice nurse first, who told me that because the pain was intermittent and not constant, it was unlikely to be appendicitis. Yeah, tell that to a worried mom with a screaming child -- I took him to the ER anyway.

[PeepnBiscuitsRN]

That makes me feel so much better. MAN, viewpoints change when you become a parent. When I was an LPN and worked in pediatrics, I used to roll my eyes at the parents who would bring their child in for "coughing" or "spitting up".

Guess who brought their 2 week old baby to urgent care because he was "crying and inconsolable"? (IN MY DEFENSE, he had colic, and would cry for 4 hours non stop) who brought the same baby to the ER the first time he had a tummy bug and subjected the poor 5 month old to an abdominal x-ray? And then brought him to the clinic at age 9-10 months because "he just doesn't seem right?" Poor kid....he's 3 now. I would take his temp rectally, and did that until one day when he was 15 months or so, I was changing his diaper and he grabbed the thermometer and started to try to stick it up the rear. I figured then that maybe under the arm isn't so bad (we had a tympanic one, but it sucked...once told me his temp was 95.2 and it was actually 103. something).

I'm not nearly as neurotic with his baby sister, actually.

[tokmom, BSN, RN]

I have 7 kids ages 23 to 7. My husband and I are both nurses.

Our first born spent a lot of time at the pediatrician with various things called colds, viral fevers, etc..we would sit and diagnose the kid to death. Even though our assessment was negative, off we could go to the ped just to make sure he was ok.

Fast forward to the last child. Even though we still monitor an occasional breath sound, we don't get as nervous about symptoms. When child number 3 fell out of a tree and had a small stick sticking out of her head, we examined the wound, cleaned it up and used her hair to loosely pull the edges together. We watched for infection, etc.. and she was fine, lol. Now had that been the first born, we would have whisked him away after first immobilizing his neck, because that 5 foot fall could have injured him, lol.

The only child we do seem to take more to the ped is our special needs daughter. She can't easily tell us symptoms, so when she is screaming in pain we still go a bit into panic mode. In fact, we spent the night in an ED just a few weeks ago. The screaming in pain and refusing to stand up straight was a bad case of gas and constipation found by a flat plate.