I'll need a full year to recover.
Sunday after dinner I went to atone for my sins by volunteering on the Pediatric unit as a baby cuddler. I was given a baby who is perfect in every way, except for having spent his whole life (1 month) trying to wean off drugs his mom took while he was in utero. I have rocked him before, but he was having an especially hard day. Despite my lingering hangover, and the million other things I should have been doing for school, I just couldn't put him down. The only time he stopped crying was when he was held, and he had been crying all weekend. His little voice was raw and he was just so tired. So I rocked him for eight hours, until 1:30 a.m. (The floor nurses love an insomniac-volunteer). Together we watched: NCIS, Friends, The Big Bang Theory, and the Downton Abbey marathon. He was just under 9 lbs, but after this long, my arms were frozen.
Drug babies have a number of symptoms besides having a hard time settling down, one of the strangest to observe is hypertonicity -- their little arms and legs are always very rigid and flexed -- even their necks (they can hold up their heads extremely early!) Changing their diapers is very weird because they are so strong, you can't really uncurl their legs to make things easier. It's like changing a plastic baby doll. I imagine this is one of the things that makes them so unhappy and tired. Imagine doing a sit-up...for weeks.
I slept in on Monday morning and awoke to a text that my 5-hour afternoon class was canceled so I had the afternoon free. But my little guy from the night before was on my mind so after lunch I went back, meaning to hold him just until his next feed. Again...I couldn't put him down and delayed going to do my clinical pre-planning until later that evening.
The next day (today) I was in the Neonatal ICU with a little preemie born 7 weeks early and about 4 lbs. Yikes! What a contrast to my little boyfriend from the night before who was so big (comparatively) and strong!! It was quite an adjustment just handling the preemie who was like a little Raggedy Andy doll. No head control to speak of. I felt like apologizing to him all the time...."Whoa there, sorry about that!...I suppose you'll be wanting to take your head with you while we feed you that bottle." Lord, I felt like I was going to break him! (The really tiny ones look just like baby birds.) Then you watch the NICU nurses just flopping them all around (skillfully, mind you) - but still it's a little hard to watch in the beginning. The thing is, these nurses have eagle eyes and keen senses. The conditions change so rapidly and sometimes so subtly! You can hardly hear the babies little kitten meows and the monitor alarms go off all the time. I am in awe.
Today I felt like I haven't had any nurse training at all.
I fumbled all around. Like a newbie I tried to check the placement of my guy's NG tube by pushing the air through the syringe while listening to his abdomen...and it really would have helped if I took the cap off first! It's ok, another student shared that she put both her hands through one of the holes in the isolette, and her nurse reminded her there were two! While feeding, my clinical instructor tried to help me use one hand to pour the rest of his milk into a syringe (while holding baby in the other), which meant I got breast milk all down my arm.
Later, I was feeding my patient and my rocking chair was facing away from his monitor...where I would have noticed his heart rate going down (a bradycardia), but my nurse got to us both in time to correct it. It didn't do anything for my confidence when I inquired more about it and as she tossed over her shoulder rather morbidly, "Oh that just means he was dying a little bit."
My eyes got wide as saucers as I stared at this little 3-pounder napping happily in my hands...and I died a little bit!
I suspect she loves torturing students. (She was actually an amazing teacher and helped me pick up on so many subtle symptoms and time-saving techniques.)
I'll have this patient again tomorrow and I'm really looking forward to it. I intend to fix all the mistakes I made from today...and probably make a bunch of new ones tomorrow.
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