Rori roars

Yesterday was a looonnnngggg day. I had to meet with a professor about a paper at 8:45, then had class on campus until around noon, met with some other classmates to discuss a project for one of our classes, then ran home, made a tuna sandwich, changed into my uniform and went to clinical for 8 hrs.

This was our first acute care experience in pediatrics. It was also our first experience at this one particular hospital. And it was interesting. It’s located in what was once one of the many booming mill cities in this area. And as with those other cities, it’s struggled over the past century or so as most of those mills packed up and moved to wherever (China?). But it has had less success in that struggle than its counterparts. As a result, this hospital receives most of its funding from federal sources and that fact is obvious from the time you walk in the door. When I first stepped into the lobby I felt as though I had been transported 25 years back. The lobby was clean, but dim, and was probably pretty chic in 1982. The cafeteria had pink and turquoise decor which reminded me of Nurses, that 80s show with Loni Anderson. It was also a ghost town, which seemed odd to me. Granted we were there at an off hour, but in most hospital cafeterias there are still a few people hanging around. Here I thought tumbleweed might start rolling between the tables. The pediatrics ward had colorful images on the walls, a playroom, and kid-friendly wallpaper borders in the rooms, but that dimness remained. I suppose I should admit here that this is my first experience with evening clinicals. My other ones have all taken place during the 7-3 timeframe, so perhaps this facility just seemed dim because it was dark outside. But I’m not so sure. We marvelled at beds that, while not crank beds, looked as though they may have been from the first generation of electrically-powered beds. Our instructor pointed out the scales in the bathrooms used to weigh diapers (to measure baby output you weigh the wet diaper, weigh a dry diaper, and take the difference). She noted that we may find that the scales are missing… there is a fair amount of drug dealing that goes on in the city and the scales work well for weighing whatever illicit substance is being bought/sold. We did get to see a real live working laundry chute, which I thought only existed in myth and legend. We went over to postpartum to see the nurseries. They have a level II nursery at this hospital and if the pedi census is low some of us may get to spend some time over there. But this is no posh post-partum floor or nursery like the one I saw during my maternity rotation.

On the good side, the nurses on our ward were all very nice. I think we’re also at a benefit because our instructor received her diploma from this hospital back in the early 70s, worked there for many years, and has a lot of connections there. But I think that my classmates and our predecesors have helped our cause as well. One of the nurses admitted that when she first heard about our program she thought it was odd, but after seeing the classes roll through she decided that the school must be very selective in who they admit and decided that it’s not such a bad idea after all. Another nurse, knowing that we’re part of this program, asked us to go around and talk about what we did before. They thought that I might have made the biggest change.

It was an interesting evening overall. And despite the slight time warp-y feel, I can’t say that I’d rule out working there, though if I did, I think some Spanish courses would be a must. A classmate of mine and I followed a nurse while she did an intake and the mom spoke very little English. Luckily an aide was able to translate. But I expect you also pick up a lot while you’re there. Just from that interaction I was able to figure out a few words. I think the cultural difference would be the bigger challenge than the language difference. Anyway, I’m excited to find out how our other experiences at this hospital go!

I should totally be studying for my peds exam right now, but it’s been a long day and I’m exhausted. I did want to post about my day though, cause it was awfully fun. My peds prof is a school nurse at an elementary school and I had a one-on-one day with her. I had such a ball… not like I was expecting to hate it or anything, I figured it would be interesting, but I always kinda thought, school nursing, eh.

I got there feeling kinda unsure of myself, kinda sat there and stared. But I went and hung out with the special needs nurse for a bit and helped her with some kindergarten vision and hearing screenings. I did two on my own. The first kid was kinda quiet, but the second one was showing me his new teeth and wiggling a loose one for me and telling me about how he can ride a bike without training wheels and can even do wheelies on it! Nurse Rori (they called me that!) immediately said, “Do you wear a helmet when you ride your bike?” I don’t even know where that came from, it was a knee-jerk response. It’s, of course, the appropriate thing to ask, I was just impressed that I actually said it instead of something like, “Um, that’s cool…” So they were fun. Then I got to meet a little boy who’s part of their preschool program for kids with special needs and observed his speech therapy. After that I went back to the nurse’s office and assessed some of the kids that rolled through. Gosh, they are darned funny. The personalities of some of them! One kid came in with a stinging med patch… he was able to tell me what he was on, why, and helped me look it up in a drug book! Another kid with some chronic issues came in and my prof asked him if it was okay for me to administer his med. His response, “I’m happy to help anyone going into the medical field.” Oh my gosh, that kid was an absolute hoot. We were joking with him about how he’s got a future in medicine and he asked us what field we thought he would go into. I don’t remember what we said, but his response was, “I’m thinking cardiothoracic.” My eyes just about popped out of my head.

My nurse and I also watched a video about allergies in school since she was going to be doing some teacher education about the subject. It was cool to see some of the more administrative parts of school nursing. For any of you who think that it’s handing out band-aids and cold packs… well, it is a fair amount of that, but it’s so much more. There’s a lot of education and a lot of figuring out “the rest of the story” a la Paul Harvey. Very cool.

Boy, you turn me
Inside out
And round and round

A little Diana Ross for you. She sums it up nicely. There are times when I just can’t figure out if I’m coming or going. This week has been one of those times. I felt like I had a ton of stuff to do at the beginning of the week. I still have stuff I need to do now, but it’s not the rush rush rush of the first half of the week. On top of that my schedule changed this week. I don’t have my Thursday clinical anymore, so today is a day off. But tomorrow night (a Friday night!) I have to go to orientation for peds from 3:30-9:00. The things we do. Oh well, that rotation should be interesting. We’ll be spending some time in the hospital (4-5 times) but we’ll also spend a week with VNA (cause we all know I can’t get enough of that) and two weeks in the schools. I’m not quite sure how it will all work out yet, but sounds interesting.

Community health was actually pretty good this week. I got to spend the day with the young family division and I enjoyed that. Went on a total of three visits, one prenatal, one new baby/mom, and one 3-year-old/grandma. I guess that department is constantly in the red. They lose money right and left, in large part because they provide a lot of services despite the fact that insurance will rarely reimburse them. I think it stinks that insurance is so restrictive on new baby visits. You have to get there w/in 48 hours of discharge to get reimbursed, and that’s if the insurer reimburses at all (this organization will go whenever and just take the hit if it’s not reimbursed, though). I think this is a really valuable service that should be offered to ALL moms/babies. There’s just so much to learn and take in with a new baby and the hospital nurses can’t do it all, nor can the parents remember it all. Oh well. There are some fabulous programs that the organization has gotten grants for, like working with low-income moms from pre-natal until their child is 3 years old. It’s partnered with Early Head Start. That was what our prenatal visit was part of. And I think some of these visits they just do out of the goodness of their hearts and chalk it up to charity work. It’s a lot more psychosocial work and education than real physical assessment, but I actually enjoyed that. I wish I could spend the rest of the semester working with them. It was pretty cool.

Time to study for a pediatrics test and read some pathophys (fell asleep reading it this morning and started having really weird dreams!).