Jan 18 2008
Hungry for knowledge
On Monday I joined a meeting of frustrated students to write a letter to the school with concrete suggestions about how our Thursdays and Fridays could be put to good use if clinical instructors are not found by the end of the week. We came up with great ideas, such as having optional lectures by a variety of guest speakers who we wanted to hear from (pediatric nurses, advance practice nurses specializing in pediatric diabetes and other conditions, Pediatric Advanced Life Support training, social workers, caregivers of sick children, etc.). We requested a meeting with the powers that be by Wednesday, since we felt time was quickly slipping away.
The letter was well received by the rest of the class, and we sent it off with some hope, a dash of relief for taking some kind of action, and more than a bit of skepticism. We quickly received a reply that didn’t surprise any of us. It read something like: Thank you for the great ideas … your patience is appreciated … Next step plans will follow in the days to follow …
But to their credit, slowly over the next couple days we received news that a few more people would have a rotation through a hospital this week. A couple new CIs had been pulled in. With every announcement, every one of us clamored for an opportunity to see a sick child—and to learn.
Finally, some nursing…
Yesterday I had the opportunity to shadow a Home Health Nurse on a home visit to a newly discharged newborn and mom. The purpose is to check the mom for hemorrhage, infection, and stable vital signs; see how she’s lactating and bonding with her baby; assess her mood; and check her meds. For the baby, the nurse wants to make sure the weight is stable, assess the level of jaundice, and do a complete head to toe assessment. Michelle, the nurse, had worked in Labor & Delivery for about 20 years and had become a certified lactation consultant. Unfortunately she had only one assignment that day, but the upside was that we could spend more time with the family.
The mother was breastfeeding when we arrived (surprise!). The parents were in their early 30s. The baby girl, just four days old, shocked me by how small she was, and how deafening her cry was. She was a full term baby but she weighed 6 pounds so her “newborn” socks and beanie hat kept falling off her (hee hee!).
I could tell the parents were happy but very anxious. They were worried that their baby was feeding every single hour throughout the day and night. Could it be that the mom’s breast milk was not nutritious enough? They had a list of questions for Michelle. Here was where I love the role of the nurse. As she conducted her physical assessments on mom and baby, Michelle answered their questions with ease, confidence, and humor. The parents needed to hear that everything that was happening was normal, that their baby was healthy and strong, and that they were being good, attentive parents.
I finally got to place my stethoscope on a child, and was thrilled by the speed of the baby’s heart and the soft, slight breath sounds. I also palpated her head and inspected her spine. When I touched the baby with my suddenly huge (and cold) hands, I grimaced to myself: Wow, I feel like a real live ogre.
We spent two hours with the family. Time is what Michelle says she loves most about doing home health. Her parting words to the new parents were: Try to be gentle with yourselves.