you guys are going to think i'm anal and depressed all the time. this post will be an attempt to redeem myself in the name of all that is sane. i am in the pediatric intensive care unit (picu) now...still doing this externship at the large teaching hospital. needless to say, it is a particularly stressful unit and i'm not good at "leaving it" when i walk out the door. i am super emotionally involved with these children and their parents, and i come home and cannot sleep because i'm so filled with worry. the past few mornings i've left feeling like i just might lose it and hurl before i even get to my car. now, i can handle bodily fluids with the best of them. internal organs, invasive procedures, gastric contents, poop smeared everywhere, wound packings, sutures, staples and drains: i've never thrown up or passed out handling things like that. but let my 3 kilo ex-preemie continually de-sat on me and keep me hovering over her for 2 hours. THAT i cannot handle. my stomach will not handle my patients trying to die on me.
i was caring for the afore-mentioned ex-preemie, who we will call sweet pea for HIPPA purposes, this week. she has a plethora of complex issues, but her main one at this point is respiratory. she was on a ventilator and needed to be transferred to a bigger hospital where she could have a primary pulmonologist. texas children's hospital is where we decided she would go. they agreed to take her. so we prepared her as best we could for her cross-country flight.
after waiting over 24 hrs. for the family's insurance company to finally okay such an astronomical expense, a team put together just for sweet pea flew over in a leer jet to get our baby. when they touched down in georgia, they did not have an isolette for her. an isolette is the small, clear incubator-looking equipment with all the monitors and temperature regulating device. they had brought a stretcher for her. and they argued with us on the phone, saying "she's 4 months old. she doesn't need an isolette." needless to say, this EX-PREEMIE on a VENTILATOR who weighs 3 KILOGRAMS and cannot regulate her own body temperature and is in ICU cannot be thrown on a stretcher. she lives underneath a radiant warmer. this baby has not been out of our sight since the moment she was born. i think we know what she can and cannot handle. when i relayed this to the physician from texas children's, do you know what she said to me? "we'll bundle her." umm NO, mrs. i-just-took-my-boards and apparently know nothing about this child, you will NOT bundle this baby for a 2 hr. plane ride. she will die before you get there. so after coming all the way out from the airport and looking at this baby for 5 minutes, the medical team flew BACK to TEXAS (at a cost of $1 million that texas childrens' will have to eat) to get an isolette.
and that's not even the most infuriating part. sweet pea was stable the first time they got there. for the last 2 hours before they returned, she became very unstable. she kept dropping her o2-sats and wanting to die on us. by the time they returned, her parents and our medical team thought it may very well have been too little, too late.
SO...when things like that are happening at work, and i leave not knowing if my baby made it somewhere or not, then i get my panties in a wad and am not much fun for a few days. BUT, as of this morning, mom called and told me that they made it to texas okay and she was still stable. so for now, that's good news. but she probably won't make it to her 1st birthday anyway. if anybody has a suggestion for a better way to handle this stuff, i'm open to hearing it. i'm getting opposing views from most people. some say "nurses get too hardened over time. they need somebody as emotionally involved as you." then others are saying "you've got to leave that shit at work or you'll end up with stress ulcers and insomnia." but for tonight, i will sleep well knowing that sweet pea is safe, and my other kids are stable. she's only one of 8 stories i could tell you about this week. all in good time...