Suggestions for New NICU RN

Anna57 · Aug 11, 2003

Oh, Kristi, you have to keep sharing.... I even had my husband read your reply to New2NICU. I was ready to go to work today in NICU! And I am only a 2nd semester student! :) Please, keep talking.... I LOVE your posts!

Mithrah · Aug 11, 2003

Me too! I want to hear your posts! I love hearing what goes on in the NICU. I plan to work there after I graduate.

Pediatric Critical Care Columnist · Aug 13, 2003

I'm with the crowd here, Kristi. Crying is good for the soul.

I came to nursing in my 30's, a wife and mother of three. My youngest child, who is now 20 years old, has had more heatlh care crises in his life than ten people deserve, starting with an uncomplicated transposition of the great arteries. He didn't respond to the usual palliative measures and went to the OR at the advanced age of 38 hours, for total correction. His time in NICU was a revelation to me, and I began to believe I could be a nurse. He recovered with amazing swiftness and grew into a delightful toddler. Then life changed again.

When he was 26 months old, he was diagnosed with Stage IV Langerhans cell histiocytosis, and given no guarantee of a cure. Almost two years into his chemo and radiation regime, his liver began to fail. We tried taking him off chemo to rest his liver, but the disease was just waiting for us to do something stupid like that. He was accidentally given too much vinblastine following his relapse and ended up septic. After that his chemo dosage was very carefully calculated and he ticked along, not really better but certainly no worse. His liver continued to deteriorate and by the time he was 5 1/2 he was listed for a transplant.

After only 10 1/2 weeks on the waiting list he was given a new shot at life and I met my destiny. He spent eight days in PICU following his transplant, and I had a million questions. The place just fascinated me. Little did I know that in four short weeks we would be back, this time for a much sadder reason, and for a much longer time. 40 days after his transplant he stroked. His brain was so damaged it was thought he wouldn't make the night. He did, and was extubated on Day 6. But his kidneys had taken a hit and over the next little while they shut down completely. He had ongoing ascites and in a sense, he was dialysing himself, but continued to worsen a little more each day. On Easter Sunday, he was reintubated for respiratory failure secondary to pleural effusion and pneumonia. Five days later it looked like we had reached the end of the road. He began seizing and he was in multi-system failure. Biopsy of his liver was highly suspicious of chronic rejection and in his condition, a second transplant was out fo the question. The staff doc took me to the quiet room for a conference and it was decided that if his renal function worsened much more, we would discontinue treatment.

It seems that came to the brink, had a look and decided he wasn't ready; within two days he was starting to improve. He told me years later that he had met Jesus and was told he had to come back. His creatinine peaked at 297 and his BUN at 74, just shy of our threshold. Eleven days after our conference, thirty eight days after his readmission, he left PICU for the last time. Today his health is excellent, and he copes very well with the limitations placed on him by his brain injury. His LCH reared its ugly head only once more, eleven years ago, and was beaten into submission again. Oh, and he's still on that same liver!

Three years after we brought him home, I started nursing school and two years after I graduated, I started my first PICU position. I feel like that is where I belong. My role models are the nurses who cared for my son all those years ago, and their names and faces are as clear in my mind as if I just saw them yesterday. Sometimes I will tell parents of my experiences, particularly if they're faced with a difficult decision. It helps.

I could not imagine working anywhere else, even on our worst days. Stacy, you will be a great NICU nurse when your time comes. You've walked in their shoes.

neonatalRN · Aug 13, 2003

janfrn,

I loved your post! I agree about the nurses, Ethan's nurses are my role models, too. What you said about your son saying he met Jesus comforted me so much, I was picturing my little Ethan meeting Jesus. I was thinking, maybe if we had just held on a little longer Ethan would have made it, too, but then I remember, no, his preliminary autopsy results said his bowel was unrecognizable from necrosis.

Heidi

Pediatric Critical Care Columnist · Aug 13, 2003

Heidi, thanks for your kind words. I'm sorry that Ethan didn't make it. I'm sure it gives you comfort to imagine him cradled in the loving arms of the angels. I know it helps me to have that image in my mind when a patient dies. My head knows that there are times when no matter what we do, it isn't enough, but my heart needs to believe that even so, love lives on.

It freaked me out when Adam told me of his chat with the Lord. Part of me already believed, and I wanted to be sure he was telling me what happened in his own words. It started with me telling him that a little boy we knew from the transplant clinic had died, and that we wouldn't see him again. He said, "When he comes back we will." Thinking that this was a developmental thing, I said that people didn't come back from Heaven. That's when he said, "But I did." He told me that he met Jesus, and Jesus said to him, "That's not the way it's supposed to be, son. You have to go back". I asked him where Mommy was while this was happening, and he described the room and the events exactly as they happened. Then I asked him if, knowing what he was coming back to (months of rehab, painful treatments, more surgeries but oh, so much love), would he still have come back. He hesitated a second, patted my hand and said, "No." Still makes me tear up. I don't think he feels that way anymore, and I know I have no fear of death anymore... my own, those that I love or those that I care for.

neonatalRN · Aug 13, 2003

Wow. That makes me feel better. Maybe Ethan chose not to come back. He sure would have had a lot of suffering with his Osteogenesis Imperfecta.

It is amazing how many our inspired to become nurses because of our experiences. I can't wait until I am done with school and can be a NICU nurse. I start in just 10 days!

Pediatric Critical Care Columnist · Aug 13, 2003

Good luck!! It's hard work but well worth it. Study hard.

NICU_Nurse, BSN, RN · Aug 14, 2003

Jan, thank you for sharing that story! I'm fascinated by what motivates us all to come to these jobs, and I've loved hearing all of your experiences, even the painful ones, because they remind me what we are all working so hard to do. Here's a big hug to all of you for being my inspiration! You make me proud to be a nurse.

((((((((((((all of you for being so strong and compassionate))))))))))

Noney · Aug 14, 2003

Thanks everyone for the sharing from your hearts.

New2NICU · Aug 14, 2003

When I started this thread...I asked for suggestions on what I would see as a new NICU nurse (coming in January)....Little did I know I would get replies from all of you (especially those NICU mommies) that would not only tell me what I would see, but actually take me through some of the emotions I would feel. I love your stories, and I will remember the families and their thoughts and emotions, and not just policies and procedures!! Thanks everyone!!

Dublin37 · Aug 20, 2003

I became interested in nursing from my experience with my own baby. Little David had Anencephaly, and I delivered him when I was 5 1/2 mo. pregnant. He lived for 3 1/2 hours. The nurse that walked us through that difficult time made it a beautiful and meaningful time. Slowly but surely that came back to me, which ultimately, made me become interested in nursing, and even more so in NICU. I can't wait to help someone bring their babe to health, or to help them let go. Heather

NICU_Nurse, BSN, RN · Aug 20, 2003

Heather,

Welcome to the forum! I'm so sorry about the loss of David. All of you have been so open and have been sharing such personal stories! Thank you! Hearing what you've all gone through, as painful and horrible as it is, reminds us all that there is much work to be done and makes me feel like I'm doing a good job- working to bring whatever I can to the families who love these babies so much.

Thank you all for sharing, honestly. Your stories stay with me.