Just a few random thoughts...

This past weekend was fairly slow in the NICU. Sometimes I enjoy the slow nights because they are quiet and less stressful, but time creeps by. I was on first admission, but never got one. One of the topics I wanted to write about were how many NAS babies we have. We have had so many over the past few months. I wonder if this is a trend for other hospitals, too. I'm assuming so. NAS babies are challenging to say the least...we have some that constantly cry when you hold them and try to console them. Nothing helps until they wear themselves out and fall asleep. The cries are high pitched screeching. It sounds like a pterodactyl! I've often said, I wish we were allowed to wear earplugs when we are assessing these babies. Every time I have a bad one, I get a headache. I always make sure I have some Excedrin or Ibuprofen on hand at work, that's for sure. Some of these babies are on so many different combinations of meds, it's unreal. Then you have the foster parents, God bless them!! There is absolutely no way I could foster an NAS baby. And some of the foster parents have other NAS kids already at home with them. My hat goes off to the foster fams!

In the beginning of your job in the NICU, as a new nurse you will feel overwhelmed and stressed. You will feel that you are in a totally different world. In a code or emergency you won't know what to do. Sometimes you may think, "What am I doing here?" "I can't do this." "This may not be the job for me."  A million things will be going through your head. Once you think you are in control and feel like you're getting the hang of babies, they will throw you for a loop and you will feel back to square one. Every day is a learning process and if you really love babies, hang in there. Honestly, consider yourself lucky to be working in the NICU. These jobs are competitive and your fellow co-workers and managers saw something special in you when they made the decision to hire you. Working in the NICU has been such a blessing for myself. It takes a special person and people think so highly of you. When I go home in the morning after a long shift, I get so much value out of the work that I've done. The other thing is, once you've been in the NICU for awhile and the first year jitters start to wear off, you can start bonding with babies. When I first started, I was so focused on my task and not making mistakes that I forgot that I was working on a precious baby. A life, my patient. Now I can take the time to step back and see their little personalities and mannerisms. It's rewarding, when you see a baby you've coded, go home healthy and happy to a wonderful mom and dad who are so thankful that you've helped save their baby's life. I've bonded with a few babies. I remember a baby...he was so sweet and good. I told him that when I have children, I hope they are like him. After feeding him, I would swaddle him tightly, lay him on my shoulder and rock him to sleep while he sucked his thumb. I'd never seen a preemie suck their thumb before. It was adorable. He'd fall asleep and I'd pat his back and rock him. You can't do that with adults! :) 

Just Another Day In a NICU

An amazing video of a typical NICU admission. It's interesting to see how other hospitals handle an admission and it's so similar to how my unit functions as well! This type of stuff is what makes my job! Love it! 

You Might Be A NICU Nurse If...

Of course I had to post this...I think I've actually blogged about a couple of these! :) (This is taken from a post on allnurses.com

You might be a NICU nurse if...

*You scrub your hands like a surgeon
*You measure age, not in years, but in weeks and adjusted weeks.
*You plan your day in 3 hour increments.
*You believe that unspeakable evils will befall you if the phrase, "wow, it is really quiet" is uttered.
*You know that ‘Snuggle-up’ is an object, and is not referring to what you do with your boyfriend on the sofa.
*Finding poop in a diaper makes you cheer because you are obsessed with NEC and suspicious all your babies have it.
*You like to give glycerine suppositories out like candy- (for same reason above).
*You recognize that feeding tubes can be time-savers.
*You hear 4 or 5 different types of all-to-familiar beeping in your sleep.
*You recognize that taping is an art-form.
*You wonder why thermometers haven’t advanced with the times...
*The admission of a 28 week antepartum patient makes you antsy.
*You could describe poop about a dozen different ways…(eg. Meconium, transitional, green, yellow, yellow-seedy, brown…)
*The IV team won’t come to your unit… YOU are the master.
*You are a breastfeeding advocate but find yourself wanting to scream, “JUST GIVE THE KID A BOTTLE!”
*You measure weight in grams, and kilos
*You've ever heard, “The parents won’t be coming in today”, and been overcome with joy.
*You know that kangarooing has nothing to do with kangaroos.
*You’ve documented the amount of ‘jiggle’…Yeah, that’s medical jargon.
*You know that “Feeder-Grower” isn’t a description of a lawn care product.
*You’ve ever referred to a baby as a ‘glow worm’.
*You're sure you could write your own “crazy baby name” book using the names of your patients.
*You’ve ever cried at the discharge of a patient, because they felt more like family.
*You take pride in making up a “cute” bed for your patient.
*You’ve been in a critical situation, where the most highly qualified physician offered you the most advice, the least support…and illegible orders.
*You believe: if the baby is quiet, be scared.
*You’re patients don’t use a call bell when they need you- instead an orchestra of 3 or more alarms of different tones get your attention.
*You’ve witnessed a preemie escape mission…they made it as far as the portholes.
*You’ve ever wished for a restraining order to protect a baby from their idiot parents.
*You believe that to refuse a baby a pacifier is cruel and unusual punishment-for both the baby, and you.
*You refer to sweet-ease as ‘a shot of happiness’.

Stress Management for The New Nurse!

One of the things nursing school doesn't teach you is real world problems. The problems you face that can't be solved with a textbook procedure. The times when you are screamed at by a patient or patient's family or the one time a patient's family stole from our unit while we weren't watching...Then there are the times when you have a code. A baby crashes and the nurse practitioner calls out, "Start chest compressions!" The time when a baby dies and you have to take the after death pictures. A baby extubates or it's blood sugar is 16. When you are on first delivery for the night and you have back to back admissions. On top of job stresses, you have home life stresses and hell, even your co-workers can stress you out. 

As one prone to anxiety attacks, I have had to learn stress management by myself. I remember the first time something big happened when I was four days off orientation. I had a 26 weeker extubate and I just about peed my pants. I was shaking, I froze and my brain stopped working. The nurse practitioner was frustrated with me and gave me lots of heat for it. It wasn't my fault and it happens to the best of us. But I was disappointed in how I handled it. I lost sleep and it ruined the rest of my shift. I was so so stressed about it. But it was an experience that I learned from. I now know what to do when a baby extubates instead of freezing up or taking things personally and letting it affect me all night, get the bag and mask. The best thing for me was to expect the unexpected at every shift and go with the flow. Don't get too used to the quiet because that's usually when shit hits the fan. And most of all when things happen, BREATHE and just be in the moment. Focus your mind on your task and not your nerves. Control your emotions with self-talk and if you have to, cry about it later in the bathroom. Been there, done that. This is something I have to tell myself when I get to work everyday. It's going to be ok....refocus your anxieties and calm your breathing. Relax your body while your at work. Drop your shoulders if you're charting and realize they're up to your ears. When you have a minute, slow down...not everything needs to be in a panic. You will get through it. 

It's just in my personality to take things personally. I'm quiet and not one to snap back when I feel that I'm being criticized negatively, thank you nurse practitioner. That's something I've worked on.  I was having some issues with a baby. I was panicking and super busy. So to spread the icing on the cake, a co-worker snapped at me. Now whether or not she was being sarcastic, I was not sure. Regardless, it was rude. I froze and couldn't respond. In this moment, I couldn't understand why she was being rude to me. ME! The nice girl?!! I was already stressed, didn't she see that? It affected me in that I became so mad when I got home from my shift and I couldn't sleep because I didn't stick up for myself. All I could think were things I should have said and how I just let someone walk on my feelings again like the bullies used to in middle school (See previous blog post).  This was a learning experience, too. After speaking with people that I can trust, I realized something...NOT TO CARE WHAT PEOPLE THINK! The less you care what people think is when you will feel better about snapping back. I cared so much about what she thought of me reacting to her, that I froze and couldn't say anything. But now I see things differently. I expect people to lash out at times because it's what people do. I've also reverted a little and know how to tread lightly around certain personalities. And what's the worst that could happen if I stood up for myself? The person not like me? SO WHAT?! Not everyone will like you and you won't like everyone. Nothing wrong with that! Also, when in doubt give em' the biggest, cavity-giving, sweetest smile you can muster! 

Off Topic...

Just recently, I've signed up for a subscription to Netflix and I found a movie called "Bully." Not really knowing how much it would affect me, I watched it without apprehension. "You never know what a person is going through until you walk a mile in their shoes." This can never be a truer quote and it was stated in the movie. "Bully," is an awesome depiction of what happens to kids in school. They get picked on for being different...being "picked on" these days is an understatement. Kids mentally abuse other kids. They physically abuse other kids. It's absolutely horrifying to me that some of the kids portrayed in the movie committed suicide. Imagine what that kid was going through. It had to have been awful and so terrible that they could no longer take it. An 11-year-old shot himself. A 13-year-old hanged himself in his closet...his parents found him and his brother saw him, too. I just can't wrap my head around why there hasn't been anything done about this on a larger scale or why there wasn't anything done to prevent those kids from killing themselves? It doesn't make sense. Through the whole movie I was enraged...I wanted to come through the TV and smack some sense into one of the schools' principles. A boy's parents came to this principle to talk about how he was being physically and verbally assaulted on a daily basis. All the principle could do was say, "I can't promise it won't stop...." then proceeded to show them her pictures of her new grandbaby. Idiot. She seemed so fake and plastic. People don't listen to kids! This other boy was made to shake his bully's hand to make peace. Well, he didn't want to and got blamed for being just like the bully...REALLY?! The boy said, "I'm not like him because I'm not hurting him by not shaking his hand." The principle said, "Well, I think you can be friends." The boy said, "We were until he started bullying me." The principle had NOTHING to say. The same mom I mentioned earlier made a pretty good statement to the principle about being worried for her child's safety on the bus. The principle said, "I've ridden bus 54 and those kids are perfect angels...." or something of that nature. She OBVIOUSLY hadn't seen the movie yet. Perfect angels my ass... death threats? Strangling another child? Stabbing another child with pencil? Those kids sound like angels to me. The mom then said, "Why doesn't the bus driver do anything except drive? When I rode the bus, if we were to get out of hand, the bus driver would pull over until it stopped!" AMEN! When I was a kid and rode the bus, my bus drivers put the fear of God in me. At one point the bus got so rowdy, our punishment was silence for two weeks! WE COULDN'T EVEN TALK ON THE BUS! Where are those bus drivers now? 

Schools and hospitals alike are all about tip-toeing around, keeping quiet, hush-hush, sweeping things under the rug. Today there are too many lawsuits and it's come down to hospitals and schools at times, not being able to take control over certain matters. Hospitals are now customer service oriented. It's called Hospital not Hilton....anyway, that's a new blog post... 

Maybe I'm so enraged and appalled by the reactions of the schools is because it hits home for me. I can relate as I was bullied in middle school from 6th-8th grade and let me say, IT SUCKED! You don't have to be physically assaulted to be bullied and all that "sticks and stones" is bullshit....It's the mental abuse. In adult world you can get arrested and put in jail for some of the stuff that kids do to one another. But back to my story, I was shy and didn't stand out much. I kept to myself and had a few friends but then I started getting picked on. In a quick summary, I was humiliated and embarrassed by a boy. I was made fun of by boys and girls, talked about, backstabbed by "friends," pushed around, got picked last for P.E. games, called names, cruel jokes were played on me, sat alone at lunch, dreaded going to school, came home and cried many many times and thought about suicide many times. No one came to my rescue. No one helped me pick up my books when they fell out of my hands. I felt I had no one. The teachers didn't stop it when I told them. One of the teachers made fun of me and yelled at me for getting answers wrong, calling me a fool in front of everyone. The kids just looked and stared at me. The friends I did have didn't even stick up for me. My grades showed the affects. The only thing that happened was  in 8th grade my mom came to the school...but that made things worse for me, the jokes kept coming and coming. In the midst of the bullying, I think 7th grade, I was really wore down by everything. I came home and just wanted to be alone. I went up to my room, turned on some music so no one could hear me cry, laid my head on my desk and just cried and cried. I remember going to my window and looking out and thinking for the first time as a child at 13, how great it would be if I wasn't here. If I didn't have to endure this anymore...How happy those kids would be if I were to die. Those kids kept me from believing in myself. Those bullies kept me from having high self-esteem. They made me afraid, afraid to go to school, afraid to participate in sports. They made me be afraid to be me. And people say, "You should stand up for yourself." Well, it's hard to stand up for yourself when your"self" is too weak to stand. Then you become numb....you just sit there and take it, hoping that high school will be better. 

Even though those kids pushed me until I had no hope for my own life, somewhere deep inside I knew I was worth more than what those bullies defined me as. I made it through middle school and my family moved to another state. High school was better for me...better, but the damage had been done. Forever, will I have those memories of middle school. They have shaped me into who I am today, for the good and bad. I still have self-esteem problems and have suffered from anxiety and depression. I'm slow to trust anyone and I'm not a second chance giver. I'm learning as an adult to stick up for myself because at this point in my life, I have accomplished many things on my own that have given me confidence. I know that I don't have to put up with negativity from others. I can chose who I want in my life. Speaking up for myself when I sense someone is being a bully to me is a constant struggle and a learning process. One thing I have learned is how to treat people...and I know that my kids won't be bullies.