Wednesday, October 30, 2013

Day 30 : when a nurse becomes a mom

Being a pediatric nurse can be a great asset in motherhood. Not only for your immediate family, but also for your other friends who are moms.

I love getting calls, texts, and emails from other moms asking questions or for advice on various childhood health and illness issues. 

I love these communications because I love the many acts of the nursing profession! One of my favorite aspects of the job was always the patient education aspect. Followed closely by broadening and deepening my own knowledge base. Helping out my mom friends encourages the continuation of both these interests.

My husband probably doesn't appreciate my skill and knowledge set as much. He is convinced I only have sympathy for illness if you've had your chest cracked open, have drains pouring out at least three orifices, or are currently receiving CPR. While this is not the case, it is true that I have no fear of a sinus infection or a stomach bug bringing any realitivly healthy person anywhere near death.

This pretty much sums up our family's interaction with medical establishments, when I do the decision/appointment making:)

Jared comes from a family with a... shall we say healthy relationship with all establishments medical, while growing up my family was doing good just keeping up to date with immunizations. 

There have been more then a few times he has second guessed my decisions about not contacting a medical practitioner (but to date, its always turned out just fine). Overall he goes with my gut in the end. After lots of repeated explanations on my part. 

While I am very confident in handing out advice to others and helping our friends come up with a plan of action, I am also very comfortable saying I don't know, check with your doc. In the end though, it's their choice what to do - to get checked out, or just treat and watch at home.

Funny thing is that when it comes to my kids I do find i second guess myself. And it's not that I second guess my nursing know-how. I second, triple, and quadruple guess my mothers intuition.

I still have way more confidence in my experience as a nurse then in my experience as a mom

All my life, I have always been far more comfortable with things of the head as opposed to matters of the heart. 

When I would help prepare my patients family's to take home their babies after major open heart surgery, we had  huge list of signs and symptoms to watch for and report, things to do, things to avoid, medications to give, schedules and appointments to keep, CPR to certify, etc… But in the end, I always concluded each discharge teaching session with, "but you are the mom - you know you baby better then anyone. If something seems off to you that is not on this list, do not hesitate to call us about it.

And I still believe a mom does know her child better then anyone. I believe this is true for me and my children.

So why do I triple and quadruple guess myself when making medical decisions for my kids?

Well, first of all, most of my experience comes from giving other moms advice based on what they have told me about their kids and what their gut saying. I use the info they give me and combine it with my nursing knowledge to formulate a plan. My nursing knowledge is way more experienced then my mommy intuition has yet to become.

Second of all, when its my kids its just me, myself, and I giving the advice to my mother's intuition. And let's be honest, that's just way too much Amy for any one person to really handle.

There is probably a little bit of pride mixed in there too. You know, not wanting the be that nurse who can't tell the difference between a common childhood cold and their kid dying.

In her first year of life, Ellie had an ear infection at 4 months of age. Other then a few minor runny noses it was the only time she was sick or on antibiotics. I found out about the ear infection at her 4 month well child exam. Clearly, I had no idea she had an ear infection. She had a cold with a low grade fever a few days prior, but all those symptoms had cleared up. I am fairly convinced the ear infection was viral, not bacterial, but still… I didn't know she was still sick. I apologized profusely to her doctor and to Ellie. The pediatrician looked at me like I was crazy.

About 5 months later, Ellie was either teething, having a really bad 3 days in a row, or she had an ear infection, and I had no clue which it was. And we were getting ready to go out of town. So I did what drove me batty when I worked in a pediatrician's office, I called for a Friday afternoon appointment to make sure my kid wasn't sick before heading out of town. Its pretty much the equivalent of sending your custom ordered plate back at a restaurant because you forgot to mention you wanted the dressing on the side. Except as nurses, we can't spit on anything related to you because we understand germs too well… and you would probably get sick and have to be seen again next Friday afternoon.

Anyway, I had to interrupt Ellie's nap to take her in to be seen, because my pediatricians office is amazing and is always able to somehow work you in. And her ears looked perfect. I just had a fussy, coming into her own attitudinal self, 9 month old, who was now sleep deprived, on my hands.

Again, I apologized to the nurse practitioner profusely about taking up her time when she could have been tending to patients who really needed it. Thankfully, she is a young mom herself. She looked and me and said,"Amy, you are a great nurse, but first and foremost you are a wonderful mom. You can't always been the medical expert for your kids. That's what we are here for. But you are always the expert for your kid. You knew something was wrong, you thought we could help. Unfortunately, and thankfully, there is not we can treat Elliott for, but I have complete confidence you will come up with a perfect plan of care for her when you get home."

Without knowing it, she hit on a deeply seeded mistruth I tend to believe about myself - I need to be practically perfect.

The arrival of Quinn has helped solidify me more deeply into the role of mom. Plus, with two babies under the age of two, I need more help then when I just had Ellie. While I may still have dreams of perfection, I am well aware that it is no where near a viable option.

This past week, Ellie has had strep throat, and through this process I have realized several things - I am a good nurse; I make mistakes; my mommy intuition has gotten better; and even though I am good nurse; I still need medical help.

Here is how the past 7 days have gone. Thursday, Ellie woke up with a low grade fever, but no other symptoms. Odd. Usually childhood fall illness involves congestion at least. That night, I gave her what I thought was ibuprofen to help keep her comfortable as she slept. Unfortunately, since I buy dye free medication, I got confused and grabbed acetaminophen, but dosed her based on ibuprofen. Y'all, I never  made med errors when I worked, and now I can't give the most basic of OTC meds to my kids without over dosing them!!!

Come to find out, I had not overdosed her as I had also hadn't paid attention to the concentration. Miraculously, I had somehow given her the exact right dose. As a result, she was just fine, slept great, and Tylenol and Ibuprofen are now kept in separate places.:)

The next morning, she woke up screaming. And screamed for two hours straight. Her fever was 104. Then she started pull at her ears saying "Ooooowwwweeeee." I am usually a watch for at least 12-72 hours with fever before call the doctor type person, but I listened to my mommy intuition and called.

Raging strep throat.

Quick fix with some amoxicillin. Everything was looking good until Sunday when we noticed Ellie look like she had just woken up from a life long sleep all day long. Her eyes were so puffy.

They were worse the next day, plus her face looked a little swollen. These are the first signs she exhibits when she accidentally comes in contact with eggs, which she is allergic to. When I changed her diaper I noticed a very odd looking rash. It did not look or act like strep-type rash, or an antibiotic reaction rash. But something besides strep was clearly going on with her. So back to the doctor we went.

Atypical reaction to penicillin… most likely. 

Before I could even start my apologies the nurse practitioner stopped me by saying," Don't even think about apologizing, we aren't even sure she is in fact allergic to penicillin, as this isn't a typical reaction type rash."

Just like it took time for me to become confident in my roll as a nurse, it is going to take time in becoming confident in my role as a mom. And I need to be ok with that.

In the meantime, we may just show up to the doc a little unnecessarily, and maybe a tad too late sometimes.

And that's ok.

This is really old picture of Ellie, but one of my favorites


  1. Oh man, poor Elie has been going through the wringer lately!

    I've been writing the dosage on the boxes of Tylenol & iBuprofen and keeping the meds in the boxes - just so I can double check before administering. It's so easy to screw up in the heat of the moment otherwise!

  2. Yep! Apparently when I was a full time nurse, I wasn't mommy-sleep-deprived and it made all the difference in the world!:) I am back to practicing the "5 rights of medications" with my own kids:)