Yep, yep! It’s all you can do at the end of the day.
HAPPY THANKSGIVING EVERYONE!
There are many things that I am personally thankful for: family, friends, and of course another year being a nurse!
But I would be remiss if I didn’t send out a special thank you to all of you who follow this blog and like, and share, and comment, and correspond on the posts made. I am absolutely overwhelmed and humbled by everything you’ve given to me. So thanks. Thanks for sharing in this journey with me. And to you, I give this picture of an adorable baby in a turkey costume. You’re welcome.
Happy Hanukkah (Chanukah) to all of my Jewish followers!
While I am not Jewish, I do come from a blended family and am proud of my step-family’s heritage. I found a Jewish Proverb that I felt was appropriate for all of us nurses and nurses-to-be out there so I hope it’s okay to share… It really gave me something to think about as we enter the holiday season especially.
"Pray that you will never have to bear all that you are able to endure."
When my older sister was born a little over 5 weeks early with her lungs and other parts not fully developed the doctors told my mom that she may not grow up normally. That was almost 20 years ago, and she has grown up one of the smartest people Ive known. My question is how often do you (as in nurses and doctors) tell parents that there may be a problem in the mental development of a child. Is this often the case with ICU babies?
First off, glad to hear your sister is doing well!
There are a couple of things I wanted to address with your question if that’s okay.
First, your direct question of: “how often do you (as in nurses and doctors) tell parents that there may be a problem in the mental development of a child? Is this often the case with ICU babies?”
Speaking personally, unless I have hard evidence, there is rarely a time when I will out and out say that a child will have concerns with mental development. This conversation only occurs when I’ve seen diagnostic data, seen clinical symptoms manifested by the infant, and built enough of a relationship with a family to have such a hard conversation.
There are always the easy ones to say, “Yes, this baby will definitely have some level of mental acuity issues”. This can include a genetic diagnosis such as cri-du-chat syndrome or holoprocencephalies or even such a diagnosis as Trisomy 21 aka Down Syndrome. Other times, we may see something diagnostically on a head ultrasound or MRI.(Click on bold-typed for links to more information.)
Infants born more than 10 weeks early are at high risk for intraventricular hemorrhage of the brain. This brain bleed (graded 1-4 based on severity) cannot be cured. We do everything we can to prevent it. Often times, the less severe bleeds resolve on their own. Sometimes though, these bleeds can be so severe that there is a shift in brain structure. (i.e. A “Grade 4 with a mid-line shift” would prompt a conference between the health care team and the family about the long term outlook of the baby.)
There are other issues including hypoxic events that can lead to seizures or cerebral palsy. Unfortunately, these cases are often a wait-and-see what the infant will do with occupational, physical, and speech therapy. We often tell the parents that until the first two years of age the infant will most likely be behind. For example, if an infant was born three months early, even though they may be 9 months old chronologically, we’d only be expecting them to meet the milestones of a 6 month old.
The other thing I wanted to address was about your sister’s lungs which leads us to talk about respiratory distress syndrome (RDS) and chronic lung disease (CLD) of the newborn. One percent of the newborn population will have RDS. Which doesn’t sound like a lot, and overall it’s not. But when you start talking about the premature population those numbers jump significantly. “About ten percent of premature babies in the United States develop RDS each year. The risk of RDS rises with increasing prematurity. Babies born before 29 weeks gestation have a 60 percent chance of developing RDS.”
So here is where the concern for your sister may have emerged. NICU medicine is still a relatively young science. The first NICU in the United States was back in the 1960’s! And surfactant therapy, commonly used in the NICU now to prevent RDS, was only widely recognized as legitimate therapy in 1980!
If a 35-weeker like your sister came into my NICU I would not be nearly as concerned about her as the staff was 20 years ago. That’s because we’ve come so far in a relatively short amount of time. We’d help her lungs develop if needed, give her rest and medicine to ward off infections and provide nutrition until she was able to feed well on her own.
I hope this helps to give you a peek into why those things might have been told to your family as well as that NICU care has many things to balance out for the neonate. I could go into much further detail but I don’t want anyone to go to sleep out there and start drooling on their keyboard.
Thanks for the question! I hope I helped!
Trying to convince nurse residents to choose our unit…
"But in a good way! I swear! Hey… why are you running away? Come baaaaccccckkkkkk!"
A good reminder for any of us, but especially nurses. We are our own worst critics. It’s always good to be introspective and learn from our experiences. But when we hold onto every mistake… every skill we didn’t preform quickly enough… every conversation with patients (or their families) where we didn’t convey exactly what we meant to… it can become paralyzing; and frankly… detrimental to the care we provide.
So for you out there… yes, you… you who are doubting yourself and not giving yourself credit where you deserve. Put the glass down today. Shake off the fears and doubts and go be awesome. Because I’ll bet you’re about 10x more awesome than you’ve been giving yourself credit for.
I enjoy this, especially with the “nurses eat their young” theory that has been emerging more and more in my life recently.
If you treat new hires like crap, they will leave and you will continue to be short staffed.
Wow. This sums up what I’ve been trying to say perfectly.
Nursing is nursing, whether you’re a med/surg nurse, a critical care nurse, ER, telemetry, pediatric, psychiatric, L & D, clinic, ambulatory, home-care or any other of the many disciplines. We’ve all gone through the same pre-requisites and the same core subjects in nursing school, the same despair that is the nursing school experience, and we’ve all passed the same stressful licensing examination (NCLEX). It doesn’t matter if you graduated from a community college or elitist school, or whether it’s an Associates, Bachelor or Masters degree - what matters is that you don’t look down or disrespect your coworkers who have struggled the same as you, achieved the same as you, and maybe even fought battles you probably didn’t know existed. Respect nursing by respecting one another.
Nurse X (via idledancer)