Lately it seems I've been taking care of patients with very vigilant families. This is a good thing. I am always happier as a nurse to have families that care about their children and are involved in their health care. The flip side of that is usually cause for heartache and sadness.
Yep. Involved families are a good thing.
Loving, involved families are even better! I have learned in a few years of caring for other people's kids that, no matter how smart I may be, parents know their kids better than I do. I always try to make sure that parents understand that
I know this - that I
believe this - and that I will believe
them when they tell me something doesn't seem right.
This beast called the Pediatric Intensive Care Unit takes involved families and drives them batty. Yep, batty. I don't blame them in the least. We do it to them. We hook their kids up to a big, shiny monitor with flashy colors, blinking lights, and some noisy alarms thrown in to wake them from a dead sleep in a panic just for good measure. We even go so far as to explain the basics of "normal" values that we look for - all in the name of "family-centered care" and with the thought in our minds that maybe we will set their hearts at ease by making them more familiar with the surroundings. The trouble comes when folks get focused on numbers and forget to look at their kid. Usually our monitors are quite necessary, but, parents of hospitalized children, let me set your jumpy hearts at ease for a minute...
[monitors are a means of gathering information for doctors and nurses].
Yep. That's it. They're not meant to be worry-inducing screens designed to suck you in to their never-ending play-by-play and draw you away from your child's bedside. Please, just watch your child. It's my job to keep my eye closely on that worry-screen so you don't have to. We use monitors to gather information. We also use YOU to gather information about your child -- but when you are focused on the monitor and reporting the numbers to me that I am already spending my hours watching, you simply give me the same data twice. I know the ins and outs of those worry-screens better than you do, as I should. I know why they alarm, and I know when those alarms are serious and require immediate attention. But you know the ins and outs of your child better than I do, as you should. And if you are watching the numbers on the monitor more closely than you are watching your child, you cannot offer me the intimate knowledge of your own child that I can only get from you. And while I promise to listen to your intuition about your child, I ask you to listen to my intuition as a nurse. All nurses have it. We have those moments, quite often
before the numbers on the monitor start looking funny, that we simply
know things aren't right.
[And, hear this, we have many
more moments where the numbers on the monitor start looking a little funny, but we know everything is alright, because nursing involves such a much bigger picture than just numbers on a monitor.]
Those numbers are just one piece in a puzzle that often fits together a little differently with each passing hour. Every time I come in to assess your child, I am piecing the puzzle together all over again, seeing where those pesky numbers and beeping alarms fit in with your child's "bigger picture". Sometimes they're significant, sometimes they're not. I'm not placating you when I disregard an alarm and tell you that it's ok. I promise. I like to be honest. If things do take a turn for the worse, honesty prior to that moment sets us all up to deal with it together.
I can never love your child the way you do, parents of hospitalized kids. I won't say something like, "Trust me, I care about your kid too." That just sounds trite. I understand that sometimes the very rise and fall of your breath depends on what is happening to your child with each passing second. I do not have that level of emotion when it comes to your child. If I did, I would be rendered quite ineffective in an emergency. What I
do have is a deep love of caring for kids
and their families. I have a conviction to be honest with you. I am vigilant
as a nurse, so that you can be released to be vigilant
as a parent. I will keep my brain engaged for your child. I will strive for comfort, for healing. I will fight for your child
all night long. I will even fight for the things you wouldn't know to fight for. I often fight for your children, parents of hospitalized kids, and you never know it. Sometimes you even sleep right through it, which I count as a victory, because you have often been up for even more hours than me. I count that as yet another way that I have cared for your child - parents that have been able to sleep just a little bit are much better equipped to be involved in important decisions, to comprehend complicated explanations, and are more able to be a calming presence in stressful moments.
A couple more small pieces of insight...
1) Please, stay off of Google. It's just scary, and reality is often scary enough. Most doctors and nurses are happy to talk. Ask questions! :)
2) Don't let awful news stories about medical professionals screwing up or being mean cloud your view of all of us. Remember that for every news story about a bad nurse or doctor, there are many more of us who truly care, are honest, and are as safe as a human can be. Just as the few nasty criminals [hopefully] don't cloud your view of every person you meet, don't let those news stories set you up for a distrusting, uncomfortable relationship with those of us who care and are working with you to care for your child.
All this to say, don't try to be your child's parent AND nurse. You'll implode. I offer my vigilance to you as a gift. Please accept it, and go back to hugging your kid. That darn monitor is going to beep either way, and I promise to stay up and worry about it for you.
