Avoid Kids at ALL Costs! Ch 8

Julie Reyes, DNP, RN

As it turns out, my favorite class is pediatrics. I have four kids, and know a little about basic things (age of immunizations, milestones), but I didn't know a LOT. And it turns out, I really do like to read the textbook and learn everything I can about these munchkins - but I am dreading the upcoming clinicals. I don't want to go to the children's hospital, I don't want to see sick kids, I don't want to see their pain or the pain of their parents.

My patient is a newly turned teenager boy with Down's. He lives in the same city where the hospital is, but he is alone most of the time - his family isn't around much, if at all. Even though I have other patients to care for, I spend a lot of time with this one. He has the mental age of a 4 year old, and plenty of mood swings. I fell in love with this boy and to my great surprise, he began to trust me and follow me up and down the halls.

One morning as I was getting report, I hear a squeal - "JUUUUULIEEEEEEE!!" I look up to see him running down the hallway in his 'tidy whitees'! He runs to me and wraps his thin arms around my waist and hugs me while he jumps up and down. I laughed and told him to go to his room and get some clothes on! I promised to come and see him in a few minutes. It just made my day.

Later on, I have to give him an injection. I get him to take his other medicine, but haven't yet told him about the shot. I gently tell him, "OK, we have one more thing to do and then we can go and play." He looked at me with his big brown eyes and starts crying - he remembers - he gets it every day. He doesn't want it, and cries for his mommy, who has not been to see him in 3 weeks. My heart breaks. I ask him, "would you like to sit in my lap and read a book after, or would you like me to rock you and sing you a song?" He chooses both. He takes the shot, crying the entire time - but silently as if he is resigned to it. I put the sharps away, and sit on the bed, pulling him into my lap. He wraps his arms around my neck and cries. He is a little 13 year old, but he is a huge kid to hold in my lap.

However, I am struggling today. All because of a little patient I had been caring for during the past several weeks.

Her name is "Sarah" (not the real name). She was fixing to turn 3 years old. "Sarah" suffered from being a cocaine baby along with several syndromes. Just 2 weeks ago, she tested positive for cocaine. Yes, just 2 weeks ago.

Sarah had a mouth the size of a dime, and her ears were literally on her neck. She had a feeding tube and a tracheostomy. When I would enter into her room, she clung to me. Either she would not let go of my neck or she would not let go of my legs if she were up out of her crib. She would hide in the corner from anyone else who was in the room, especially her foster family. She would just stare blankly at them and would hide behind me if I tried to get her to interact with them. I was very frustrated with them as they showed absolutely NO interest in her AT ALL. They just watched the soap opera on tv.

I know that I can't save the world, and I know that I am not supposed to get too attached to my patients. However - I had a serious conversation with the CPS workers to see if I could take her home and be her foster mother (but I had not been approved as a foster parent). Of course, the case workers were very excited to have me apply and go through the process. I was determined to care for this little girl and give her the best chance in life. I went home and told my husband (didn't even ask) about my plans and he was concerned, but on my side.

I was off for the next two days, busy doing my Care Plans and assignments. I went to bed and turned on the news to catch the weather before I crashed, and I saw "my Sarah's" face on the screen. I sat up in bed frozen. She was sent home with the foster parents and died in their care. The reason given on the news was that she "removed her tracheostomy".

So today is a hard day, because I keep thinking of Sarah, but I know I can't save every patient - but maybe just make someone's life a little brighter, or ease their pain by offering a comforting touch or hug. I set my mind to the task at hand, to making a difference, to understanding what it takes to make a student nurse into a nurse who is compassionate but thinks critically, and has skills that save lives.

Which brings me to where I am now - in the PICU, and it feels like "home". Somehow, I know that I am going to work here one day. I have written a story about my first experience in the PICU, you can read it at this link: Does God Make Mistakes?

In spite of my reasons to never work in EMS again, and to go into nursing to avoid sick or injured kids at all costs, I have found my calling - surrounded by children on all sides. I am home.