Posted on by jparadisirn

You Can’t Make This Stuff Up (Niki’s easy shift )

Chapter 57

One of my two post-open heart patients has discharge orders. The better part of an hour is spent reviewing the discharge instructions with her parents, and observing them practice drawing up the right amount of each of the liquid home medications using syringes and a cup of water. This demonstrates they understand the difference between dose and volume, because too much digoxin or potassium can stop a child’s heart; not enough won’t do the job. I never get over the fact that we send parents home with newly taught skills that took weeks for me to master in nursing school. Most of them do just fine, but still…

Later, I’m helping Travis gather his things, because he’s discharging home too. When it’s time to remove his IV, I begin by carefully taking down the tape holding it secure.

“Just rip it off, Niki, okay? I want to get out of here sometime today.” He’s laughing at me, and I’m reminded again of how resilient kids are. It makes working with them so rewarding.

“Okay Boss, you got it.” I ripped off the first piece.

“Ouch! Shit! Leave some skin on my arm, would ya?”

“Okay, I’m going to get some adhesive remover. I’ll be right back.”

As I turn to leave the room, I see the animal therapy volunteer standing in the doorway. A medium sized brown rabbit is cradled in his arms.

The kid in the other bed has his little dog in his lap, and I know what will happen an instant before it does: Rocket catapults from the boy’s arms in a perfect arc, his forelegs stretched in front of him, his hind legs straight out behind. He touches down momentarily at the feet of the animal handler, bounces once, and then vertically leaps upwards nipping the rabbit’s backside. The rabbit launches from the arms of his handler, and they’re off. The animal therapist chases after, and Rocket’s boy starts screaming for him from his bed. Travis laughs, and Reege continues to lie placidly on the floor by his bed.

I run to the hallway, where Rocket is chasing the rabbit around and around the nurses’ station, until the rabbit leaps onto the desk before making a break down the hallway with Rocket in pursuit. In the other patient rooms, parents alarmed by the commotion, carry their children to the doorways to find out what’s happening. Several nurses chase the animals down the hallway, trying to catch them.

You can’t make this stuff up. There goes my quiet shift.

 

Posted on by jparadisirn

How to Sabotage a Shift (Niki Meets a Service Dog)

Chapter 56

Never, ever think your shift is easy and you may go home early. It’s the quickest way to sabotage it.

The shift started well enough. I did vitals and passed meds for the two post-open heart patients first. They each have private rooms, and I chatted a bit with their respective parents. Transferring their children from the PICU to the general floor makes some parents uneasy, even though they understand it means their child is getting well. In the PICU, they become used to their child receiving one-on-one nursing care. They become accustomed to the vigilance of a nurse dedicated to the care of only their child. On the pediatric unit, the nurses are assigned three or four patients plus their child. The parents are now required to practice vigilance for their previously critically ill child’s care. Understandably, some are more comfortable than others. My patients’ parents recognize me from the PICU. A familiar face eases their minds. Our rapport encourages my belief it will be an easy shift.

My third patient shares his room with another.

During report the night shift nurse said, “Niki, your patient, Travis, is a delight, you’ll love him. Unfortunately, his roommate is a bit of a handful, so we assigned him to another nurse. He saw Travis’ seeing eye dog, Reege, and insisted his parents bring his dog to stay with him. They brought him in last night, claiming it’s a service dog too. Fortunately, Travis’ dog is a professional, and ignores the little dog’s aggressive behavior towards him.”

“Well, if Travis and Reege can ignore the other dog, I guess I can too.”

 

“Hi Travis, my name’s Niki. Is this beautiful dog is your partner, Reege?”

“Hi Niki, I need to go to the bathroom. Can you put the IV pole where I can reach it please?”

“Sure. Do you need help?”

“Nope.”

I watch Travis handle the IV pole, and grip Reege’s harness with his other hand. Reege, a golden retriever, pads along silently, leading Travis the to the bathroom. Travis seems steady enough, but his fall risk makes me nervous, so I wait for them in the room.

On the return trip I try again, “Is it okay if I take the IV pole for you?”

“Sure.”

After Travis is back in bed and Reege settled at his bedside, I take his vitals.

“Travis, are you hungry or is your stomach still bothering you? The breakfast trays should arrive soon.”

“I’m hungry. Do you guys have bacon?”

“Of course, but if there’s no bacon on your tray, I’ll call down to the kitchen and get you some.”

“Thanks!”

As if on cue, the meal cart arrives, and I find Travis’ tray. Lucky me! There’s bacon.

I place the tray on his table, adjusting the bed and utensils so they’re within reach. Travis tells me he’s right-handed.

“You’ve done this before, I see.”

“Yeah, a few times,” he grins. Would you tell me what’s on the plate, and its place on the face of a clock?”

“Sure. Anything else? Do you want me to butter the toast or cut anything for you?”

“Nope, I got it. Thanks.”

“Hey Nurse. Hey!” It’s the kid in the other bed. He’s got his dog, a nondescript terrier mix, in his lap.

“Hi. Do you need something?’

“Yeah, can you get some bacon for Rocket?”

“Sure. I’ll make a call to the kitchen.”

When I near his bed, Rocket growls at me.

“Do you want to pet him?”

“Does he bite? I thought strangers shouldn’t pet service dogs.”

“People just say that because they think their dog is more special than Rocket.” The kid glares at Travis, who flips him off. I try not to laugh.

“He only bites if he doesn’t like you. If you give him some bacon, I’m pretty sure he won’t bite.”

“Um, okay. I’ll order the bacon and let your nurse know.”

I leave their call lights within reach, bed rails up, and take breakfast trays to my other two patients. After they’re done, I help their mothers with bathing and dressing them.

One of the perks of day shift is the café is open. There’s time to go downstairs and bring a latte back to the unit. I get in line. There are two police officers ahead of me.

One of them is Officer Mike.

“Hey, Nurse Niki. What are you doing, getting a latte before heading home? I thought night shift prefers beer for breakfast.”

How the hell does he know that?

“Well Officer Mike, how nice to run into you again. No more nights for this nurse. I’ve transferred to day shift.”

“Congratulations. Welcome to the land of the living Niki. See you around.”

Mike and his partner take their coffees from the counter.

Did he just look my way again before walking away?