I have been thinking recently about how to help parents deal with the stressful situation of their child being in the hospital. Here are few tips that come immediately to mind. Some of these stem from being the nurse and some come from being the mother, but I hope they can help some one get through the overly consuming stresses of helping your child get healthy.
Be Freaking Nice: If your baby or child is in the hospital this is not the happy event that you were hoping to be doing this week/month/year. It sucks. Your pissed, annoyed, and potentially fighting with your spouse because of the emotional/financial stressors this is all causing for you. Things are not good for you right now. But your kid needs you. So be nice to those nurses. Be lovable to them. Nurses who take care of kids are almost always women and are usually very maternal people by their nature. Use that. Make us love you. I'm not talking about bringing in candy every day (but that doesn't hurt), I'm taking about making us your allies. Ask us who is the best doctor. Ask us what we would do if it was our kid. Use the insider tips we have about a night shift attending that might be an idiot. We may not be able to make it all 100% clear but we will push you in the right direction. We know whats going on - we deal with these Dr.'s every day. If we have even a grain of connection with you we are going to give your child extra attention. Maybe not on purpose, but it always seems to work out that way. We are going to fight harder for you behind the scenes. Talk to us. Make yourself a partner with us. Don't pick fights with us. We are trying to help your family. Keep in mind that you catch more flies with honey than vinegar. It's true. If you are the primo mom bitch of the unit, we will consider it punishment to be given your child as our assignment for the day. I will still give your child good care, but I will not want you back the next day - nor with anyone else. In the long run this disjointed care leads to a lower over all quality of care.
Ban the students: Nursing students are not the bad ones. They come in for one day or so at a time, and they are mostly just doing observation. I have had a nursing student at three out of my four deliveries. On Max she was holding my right leg by the end. The students that are problems are med students and residents. Doctors have to learn. I can not even imagine how difficult it is to learn to be a doctor - but get out of my kids room. As the parent you have the right to ban all residents from your child's care. Do it nicely and do it the second you walk into the hospital. Tell the first person you see, "Please no residents or med students." Its that easy. Just say it. You will never regret you did. Don't be rude - don't do it in anger after the bad experiences you are destined to have with a resident. Be proactive about banning med students and residents. I am always a big wimp about doing that and it almost bought me an emergency hysterectomy once. Let them learn on some one else.
Child Life: This is one of the many good reasons to take your child to a pediatric hospital. Child Life Specialists are people who specialize in playing with kids. They are not medical staff. Their job is to go around and help kids deal mentally with the procedures that are going to be done to them. For example the nurse came in and put lidocaine cream on Lily's hand and left it to soak in for awhile. When she came back to place the IV the Child Life person came in with her. She told Lily all about what was going to happen. Then while the nurse placed the IV she showed Lily a flip book and asked her rapid fire questions about the visual puzzles on the page. The IV was in before Lily really even knew it was going. No tears, no problem. The hospital I work at recently hired a Child Life Specialist. (Which makes me love them even more.) I ADORE HER!!! She comes in and preps the kid mentally for me to place the IV, or what ever else I may have to do. Then she and the kid plays with bubble wrap while I pop in that IV. No tears, no trama. The whole world is a better place with child life. If the child sees the equipment ahead of time and is not afraid of it then they have a totally different experience.
IV's and painful procedures:
I promise you that we crazy NICU and peds nurses do not want to hurt kids. Pinky swear. We as nurses have the choice of were to work. We might "end up" as a med surg nurse, but you don't "end up" as a NICU/peds nurse. You chose that field. Which generally means you desire to help these little people. Just like adults - some kids have great or easy veins and some kids are not so blessed. If your kid has been cursed with crappy veins - I am sorry. The unfair truth of it is that your child will suffer more IV sticks than the easy veined kid. But not all people attempted the IV placement are created equal. Nurses have what we call "the two stick rule." We get to try two times to get an IV, if we can't get it over those two sticks we need to stop and find someone else to try. Some days I am the go to IV stick person and some days I can't hit the side of a barn. Not every nurse follows the two stick rule, and there are some very rare exceptions to this rule (codes for instance). But if you see the same nurse try to stick your child four times, you need to NICELY say some thing about it. "Thanks for trying to get her IV in. Is there any body else here tonight that might be able to give it a try?" Do not say, "You stupid ass hole! If you stick my kid one more time and miss, I will kill you." That is a quote that a dad said to a Dr once - true story.
Make a plan: Every time you get face to face time with the doc have your questions prepared. Keep a notebook and write down questions as they come to you. Write down notes after they leave the room about what they just told you. Ask them to spell bizarre words for you or have them tell you what abbreviations stand for. If you are not medical and you know what PVL stands for - I will give you $100. You don't want
the doc to leave the building for the day and then remember your
important question. You are not getting tons of sleep usually, so use
that notebook to keep yourself organized. Use your time away from them to get online and look up more information about what is going on with your child. Take the things you get off the internet with a grain of salt. Just because one site has a story about a 22 week baby that weighed 350gram that they say "turned out fine" doesn't mean it went down just like that. In NICU I find some of the first questions I always get from parents are "When can she go home?" and "Is he circumcised yet?". This is usually from a family that is so shell shocked that they don't know what to ask yet. Keep asking these silly questions and a good nursing staff will help educate you into some better questions.
PS - the questions about going home is not that silly, it leads to a good conversation about what a baby needs to do to go home. But think more short term, like - Is my baby breathing on her own? How is my baby getting nutrition? What do you hope to see from her today? What is the next big improvement we can be watching for? The circ question, however, is a silly question. When a baby is hanging on to life with white knuckles lets focus on that issue before we look at elective procedures.
Pain Meds: Any time I work with kiddos that need pain meds parents become immediately concerned about addiction. That is a realistic concern. BUT - we never give narcotic pain meds to babies or children unless they are essential. Addiction does happen. We sometimes have to wean a baby/child off of those pain medicines. Ask lots of questions about these medicines, you need to be informed. But if a child is suffering severe pain they deserve the hardcore stuff to deal with it. We will help them deal with the physical withdraw after their life is no longer in danger. With babies this kind of withdraw can be no problem, quick and easy - or I have seen some kids that were addicted to pain meds need more time to wean off. We will help keep you educated and informed, but ask us lots of questions. Every kiddo is different.
This does not relate to kids that are born addicted to drugs the mother took. That kind of withdraw is totally different and makes me want to punch the birth mothers in the face. Those kids suffer. They scream, they arch, they are very difficult to soothe. We give both kinds of kids the the same kinds of drugs to wean them off, usually methadone at my old job or morphine at my current job. It just seems to me that USUALLY the kiddos born addicted via good old crack head mom take longer to wean. I can think of an exception or two, but in my general experience that is how it rolls.
These tips are just a few that come to mind. They are not going to cover everything you may encounter in your baby's or child's hospital stay. I am hoping they will help you at least get started in the right direction. When Lily was last in the hospital I put out an all points bulletin on facebook. My medical and some non-medical friends were sending me tips and thoughts all day long. It was wonderful. I felt like I had my own personal consultation group on hand. Not every one has access to such a broad group of medical professionals, so utilize your resources. Ask questions, be organized, and BE NICE. Please be nice. Except when drunks yell at me in ER and I crack up laughing, please please please - BE NICE.
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