Patience with Patients

pa·tience

ˈpāSHəns/

noun

1. 1.

   the capacity to accept or tolerate delay, trouble, or suffering without getting angry or upset.

   
   

   
   

   My patience was tested last night.  It was the first time in a year and a half I had to go to someone and ask them to go deal with my patient because I was getting frustrated.  An 18 year old should be dealt with at an adult hospital.  I understand some of them are seen at a Children's hospital and followed because the hospital knows them, but when they need resources that our hospital does not provide they need to be transferred out.  

   
   

   There was no working telephone number for a family member so the history was vague.  Who drops their child off no matter what their age and does not fill in the medical personnel that will be taking care of the person?  It took myself, two nursing assistants, another nurse, and two doctors to try to get through to the patient and we were still unsuccessful.  

   
   

   Why did I get so frustrated?  I usually can deal with most and have no issues, but I struggled.  I need to learn how to not get frustrated and remain calm.  However, I am glad I was able to walk away from the situation and find other help for the patient.  Some people cannot walk away from frustration and they end up becoming violent.  We must be able to tolerate a lot in our field and patience is something we can always work on.  

What is your purpose?

Do you ever ask yourself what is your purpose in life?  I have been contemplating this question since July.  When I was in a relationship with Ale, it felt like it was "the one."  After many months of a boring relationship and a guy who was unable to keep up with my adventurous self, I decided to move on and focus on me.

In the past few months my focus has been children.  Every time I go to work I want to bring a child home.  I have baby fever.  The only thing is….there is no baby daddy.  I contemplate finding a sperm donor and having a child that way.  But then how do you explain to your child that you bought them off of the internet and created them that way.  Ever since I have taken care of a child that was abused, I have thought about fostering a child.  Our camp director has fostered two children and I see the love she gives this little boy and the difference she is making in his life.  

The other morning there was a little girl who was diagnosed with T-cell ALL.  She is sick.  When she woke up at 4 am crying from a stomach ache, she was all alone.  I decided to get some cinnamon toast crunch and milk and sit on her bed and talk with her while she ate.  She immediately felt better.  I asked her if I could take her for a ride.  We went down to the main lobby and sat and watched the snow fall.   She rested her head on my chest and I played with her hair.  She looked up at me and said, "I wish you were my mom.  My mom thinks that my other brothers and sisters are important but what if this is my last Christmas?  She is not even here to watch the first snow with me.  You are taking care of many kids and you find the time to make my day."  She wrapped her arms around me and I started crying immediately.

The next day the papers I inquired about for foster care over two months ago arrived.  Obviously this is a sign.  The paperwork is in process and hopefully in about 6 months I will be able to foster my first child.

Our life may not be picture perfect like we imagined at 16 years old.  However, you will figure out what you are meant to do to contribute back to this world.    

Interact with love

Love and Interaction.

I feel like these are the only two words that you need to learn to become a parent.  After spending the past two months working in a pediatric setting I have learned a lot. 

Ever since I was young, I always played the mother in a house setting.  I always set my baby dolls up (the few I had because I was usually playing flag football or letting my dad shoot hockey pucks at my face in the driveway) and played house, always being the mother to them.  When I went to Italy, I was called the “mom” of the group because I brought along a TIDE to go pen (Who would go out of the country for 3 weeks without one?) 

A nurse is a mother, a father, a sister, a brother, a family member that you did not have when you walked in the door.  We act as the support for both the patient and their family members. 

All you need to show a kid that you care is love and interaction.  They want you to interact with them.  Nothing makes me more upset than when a child is trying to talk to a parent or cuddle with them and they are more worried about checking facebook or updating twitter.  When I was young, my mother never had technology to turn to instead of interacting with me.  I think I turned out just fine.  Next time you are in a cafeteria or out to eat, try doing this for me, look to see how many families actually interact or how many have ipads out or iphones.  It is obsurd to me how we rely on technology.  Call me old school but I believe in no telephones at the dinner table or in public places while interacting with others.  

Love and interaction.  Do not ignore the little things in life.  Interact with strangers.  Show your love to those you do not know.  You never know when the interaction of love will make a difference to someone. 

I've got confidence

Ive got Confidence.  I know my friends believe in meeee.  No matter what the day may bring, I know I can believe in me. 

Confidence can be destroyed very quickly.  I was confident in my nursing skills before.  When I left Henry Ford all that confidence was quickly lost. 

IV’s and blood draws…piece of cake for me.  There were times when other nurses would ask me to start their IV.  It was just something I picked up on because of my great preceptor, Matt, at St. Charles.  When I was told I had to draw blood on a two month old I almost passed out.  Where was that confidence that I used to have?  Suddenly what you know is out the door and you are afraid.  Why was I afraid?  I have no clue, maybe because it is unfamiliar. 

We tend to become afraid when there is an unfamiliar situation.  However, why be afraid when we have support all around us?  God was not perfect, he failed at times so why can’t we fail?  We have grown up in a society where failure is looked down upon.  Failure is actually the best way to become stronger and more confident. 

I did not fail in that situation, I actually got the blood right away.  Thank god because the mom was staring at me, the baby was crying, and I was sweating bullets.  Another thank god that I did not pass out, as I have done in a hospital oh, three to four times before in front of coworkers. 

My confidence is now back where it was when I left Henry Ford Hospital in some aspect.  I do not give myself enough credit and I was reminded of that when this email popped up in my mailbox:

Hi All,

I just wanted to forward the kind words extended to Megan Maiani, one of our brand new IRP orientees.  Thank you, Megan, for stepping up and doing such a great job.  We are glad to have you here at CHM and part of the IRP team!

Thank you,

MANAGER (name removed for privacy) RN,BSN, ANM
@ Children's Hospital of Michigan

---

From: D, C
Sent: Sunday, December 01, 2013 10:38 PM
To: B, J
Subject: IRP Megan Maiani

Ms. Bowersock,

Hi I am the alternate charge RN and occasional fill in preceptor on 5 West.  I had the wonderful pleasure of precepting Megan a week ago or so and she was AMAZING.  She critcally thinks on the fly, takes wonderful care of pts and was on top of everything it was refreshing to precept her.  On 11/30 I was in charge and she was my IRP RN, when I found that out I wanted to do back flips.  I unfortunately had to give her the split assignment which she took with no complaint.  At 11p the NAM decided I can keep her for the whole night and I had an on call RN come in, so I unsplit Megan and brought her down to 3 pts.  Later that night I was paged with two pts both of them had different diagnoses but they oddly enough both had scabies, yuck!!  I assigned one to Megan and one to another RN but Megan volunteered to take both so only one RN would be exposed to the scabies.  I absolutely love working with Megan, kind of sad she is an IRP and not a 5 West RN.  Megan is an amazing team player and a very skilled RN and just a joy to work with.  I just wanted you to know that we on 5 west appreciate the IRP help we recieve.

Thank you,

C D, RN

This boosted my confidence overnight.  It is not something that makes your head bigger, but it makes you realize that you do not give yourself enough credit for what you do know.   Even though patients are different sized and experience different illnesses than what we are used to, they are all the same, they need help.   We criticize ourselves too much and try to always be better.  Sometimes we need to be content with what we have/are and know that we are making a difference, big or small.

So next time you are doubting your confidence, know that someone somewhere is appreciate and recognizing what you do.  You know more than you think, and you are better than what you expect.   

Use your words wisely

"Stop it, you guys are trying to kill me," is not a quote you would like to remember.  However, the events that transpired in this encounter have changed me for the better.

I was in the ED and we were covering trauma, which can be very boring if nothing is coming in.  My adventurous self decided to wander down to one of the pods and offer my help.  Little did I know I was signing myself up for two holds for IV starts on 5 year olds.

The little girl touched me the most.  She was five years old, and weighed more than I did.  I thought about how this all was going to go down as children are usually small and sometimes easy to hold.  Well, I held, another nurse attempted to started the IV.  IV's are not as easy in people who have an excess amount of skin on them.  It is a lot harder to feel for veins let alone see them.

I crawled up on the stretcher and started to ask the patient questions to keep her mind off of what the nurse was setting up.  She kind of half answered me and then we grew silent and started watching Curious George.   She grabbed my hand and started to play with it.  Where else can you watch cartoons and snuggle with a child at 4 am while working?

She started to cry and get upset….this is when the battle began.  Her mom held her and I held her arm.

We found a great vein.  The other nurse went for it and there was no flashback of blood.  As she tried to find the vein the little girl was screaming louder than any child Ive ever heard.  She was thrashing, kicking, screaming, hyperventilating and I had to remind her to breathe.  She would stop every so often and go, "Hey guys," "yes, I would say," "Just take it out."  It was hard not to laugh at this little voice and smile trying to break through.

Unsuccessful.  Begin second attempt.

I let her feel my veins and showed her how we figure out which vein to pick to distract her.  I came up with the explanation that our blue squiggles are like straws.  When we drink juice through a straw it takes the juice to our stomach where we need to get the vitamins.  Our blue squiggles take our blood through our body like a straw to help us live.  I told her we needed to put a straw in her blue squiggles to take the water through her body to help her live.  She looked at me like I was crazy.  However, it calmed her down.

She would say, "It tickles," while we were trying to start the IV and it just made me laugh every time.  The second attempt she wanted to sit by herself.  As soon as we started to go for the IV she became violent.  I had to sit behind her wrap my legs around her and hold onto the stretcher around her waist because she was bigger than me.  It kept breaking my heart to watch her become so traumatized by this experience.

Success.

Another nurse had come in to see what the commotion was and the little girl told her, "They are trying to put straws in my blue squiggles to help me live.  Its kind of like when you drink through a straw it helps your body live."

Kids listen to everything you say.  Use your words wisely as you never know what someone will comprehend from them.