Monday, October 3, 2011

Rants of a Pediatric Nurse

I totally realize that I am just in the very beginning stages of parenthood. Long before we ever conceived Ellie Faith... long before I  thought of being pregnant... even before I ever thought of getting married... I have cared for 100's, if not 1,000's of pediatric patients. I have learned so many valuable lessons from many of the parents of those little patients of mine. I have also learned many lessons of how I don't want to parent.

It will forever amaze me that one of life's most precious and valuable gifts, children, can be obtained by just about anyone, as long as their reproductive systems are all functioning semi-normally. No tests, no pre-requisites, no requirements. Just the universal language that all humans at some point seem to understand, and often abuse - the act of procreation. Plain ol' s.e.x.

I have taken care of patients born to parents where one spoke english, and one spoke another language... neither spoke the language of the other... this has happened on several occasions. Another situation was a precious family (and I mean that in all sincerity) from Africa, where each parent spoke their own tribal dialect, but their "common language" was supposedly english... however, we could only understand one out of every, oh ten words, they would say. HA!:)

I have taken care of several children whose parents had I.Q's that were documented at retardation levels, yet they loved and cared for the children to the absolute best of their ability.

Children are incredibly resilient! It amazes me daily the inner strength I see them portray despite the obstacles life has thrown their way. They haven't asked for it, they don't deserve it, yet they fight, survive, and often times overcome their life's hardships. Just the other day, we had a highschool senior in our office who had been raised in and out of the foster care system her entire life. Her future career goal is to be a nuclear physicist. Her 4.1 GPA and amazing ACT score indicate she is well on her way. Seeing kids in the midst of their struggles makes me want to go all "Abilene" on them with hugs, followed by the words, "you is kind, you is smart, and you is important."

I tell all my employees to be their absolute best for our patients and their families, because we might be the best example that pediatric patients encounters that day, week, or even month.

Moving on to the rant...

I will never understand parents who appear to have no idea what goes on in their children's every day lives - aspects of their nutrition, what medications they are on, how to spell their child's name, etc...

Names. I have ranted on this a bit before. I have some new names and rules to add.
- Shithead, while a very popular muslim name, will not be pronounced "Shat-heed" here in America, especially when your child is clearly not of muslim descent! It will get pronounced phonetically, and I just think that has to set your child up for near failure in life.
- Diarrhea is a condition very few people on the planet enjoy - a name for your child. Few of us will realize  this word, when used as a name, is supposed to be pronounced Dee-ar-e-ah. Again, I can only imagine the injustice this child will experience on the school play ground!
- When you call to make your child's first appointment with their pediatrician, and after your third attempt at spelling your 3 day old's name and have to yell,"Hey Mama, how we decide to spell junior's name again?" this should your last and final sign you have no business attempting to be creative in naming your offspring. I would even recommend considering never procreating again.

How can parents not know what medications they give their children daily? Now, I realize medications are not the easiest names to remember, and switching back and forth from generic to non-generic, based on your insurance's whim of the month, can make remembering exact names difficult. But come on - put some sort of effort into it. I can not tell you how many times we have patients come in for "medication rechecks," primarily for renewal of their ADHD medications, and when asked what medication is being taken, the parent or patient (many of whom are in highschool) have what medication they are being "rechecked" for.  Depending on my mood, how many of these "uh, I don't know, isn't it in the chart" responses I have gotten that day, and how late in the day these responses occur, I might be known to go "Momma" on these unsuspecting individuals. A lecture on the importance of knowing the exact medications you are on, ways to keep track of said meds, and what could happen if incorrect information is given (always in worst case scenario mode) might ensue.

Along the lines of medications, allergies are another piece of info I will never comprehend not remembering. This especially could have life or death consequences! More often then not when I ask "is your child allergic to any medications?" The responses I get are:
- "its in the chart, I don't remember."
- "uh... that white one."
- "whats the pink one called?"
- "Sulphur." This one I can kinda get - most people have not heard of the drug class sulphonamide, which is often shortend in converstation to "Sulpha". But really - would we really give straight up sulphur to anyone, especially a kid?:) This is also kinda like when parents tell us their kids "stats" were in the 80's when they took them to the ER for difficulty of breathing. Now statiscially speaking, stats in the 80's means your kids is doing great - well above average. However, sats, referring the amount of hemoglobin saturated with oxygen, in the 80's in another whole story. This is is a blue lipped, gasping breath, mottled story - not good.

Enough on medications. Now onto nutrition, combined with the inability to answer basic questions. After 4 months of age, if a child is bottle fed, we ask parents how many ounces a day  they feed their child. The answer 75% of the time: 4 oz. Again, my response to this depends on the moment. Sometimes I sweetly say, "Oh you mean you feed your child 4 oz a bottle. How many bottles a day does your child eat?" To which they usually say, "Uh, gosh I don't know... let me think." followed by 30-45 seconds of complete "silent thinking."  However, if I have gotten this answer too many times that day, it can go like this (with a smile of course!)
Me: you feed your child 4 ounces a day?
Parent: yes
Me: so in 24 hours you only make 4 total ounces for your child to eat?
Parent: oh, no. They usually eat 4 oz a bottle.
Me: oh ok, so many times a day do you feed them this 4 oz bottle?
Parent: about every 4 hours
Me: ok so they eat about 6 bottles a day, for a total of 24 oz a day?
Parent: oh no, only about 3-4. They usually sleep through the night.
UUGGHHH! These are also the parents who started feeding their two month old fruits, veggies, and meats three times a day!

Other examples of inability to answer simple questions:
Me: Any known family history of heart disease or high cholesterol in anyone under the age of 55?
Parent: Yes
Me: Yes to both heart disease and high cholesterol?
Parent: No, just cholesterol, diabetes, cancer, and arthritis in my great grandparents.
Me: ok, did the high cholesterol start before they were 55?
Parents: Oh no, they were really old... I think.

Me: do you use city, spring, well or bottled water?
Parent: we have well water.
Me: do you drink the well water?
Parent: no, we drink bottle water.

And finally, if you decide the best thing for your family is to not follow AAP guidelines (and I give every parent this right to choose for themselves what is right for their family!) do the research and educate yourself accordingly.For example,  don't come into the office saying you are not going to follow the vaccine schedule, still want to get vaccines, just slower schedule, but not have a plan for what that schedule is. If you feel educated and well informed enough to make this decision (and again, this is every parent's right!) you need to take that next step in formulating your plan. Trust me - this will elevate you in the eyes of your physician, and most likely make them way more willing to help support you in your decision. If your physician isn't willing to discuss options or alternate plans with you, that is very good sign you are not with the right medical provider for your family.

Ok, so there is one more thing I would like to say, then I really am done... promise!:) I know there is a lot of controversy regarding vaccines these days. There some wonderful resources out there on the CDC's website as well as The Pink Book. As parents, it is your responsibilty to educate yourself appropriately and not just take your doctor's, or the latest vocal celebrity's, opinion on the subject. I have my own very definite views on immunizations, but I am not going to voice them here - they are our personal feelings for our family. I will say this though. Common childhood diseases, mainly pertussis (whooping cough) and measles are back on the rise. And while not extremely detrimental to a large portion of the population, they are highly dangerous to the younger population. The majority of us adults have already received most of the vaccines out there, and have not suffered any major side effects. As adults, it is our responsibility to protect the younger generations. So talk to your doctor about getting your Tdap booster shot and/or having your titers drawn (simple blood work) to make sure you are still immune. Most OB-GYN's now routinely test a pregnant women's MMR titers, and administer a Tdap immunization prior to discharging her home after delivering her baby. So, if you are nervous about immunizing your child, and still feel you need to do more research before committing one way or another, consider immunizing yourself, with immunization you have already received, to provide your chilld with a little extra protection.

Rant officially over... if any of you waited around long enough to finish reading!:)


  1. I'm reading "The Vaccine Book" right now (, and so far it's incredibly informational. If you can't go in and verbalize WHY you don't like something, you don't really have a right to question something like vaccinations (IMO).

    Wow, you definitely see all kinds in your line of work. Frustrating.

  2. Oh wow, although some of those I cannot understand the how you do not know the answer to I am afraid I am part of the group that does not know the exact amount of ounces or number of wet & dirty diapers right off the top of my head. I could quickly figure it out, well the feedings anyway. I know you weren't referring to that type of thing. (Feel free to correct me if wrong.) I cannot imagine the 10 kinds of crazy/stupid you must come in contact with during any given shift. :-)