Yesterday was my first Peds clinical in the hospital. We had 2 campus lab days already, but yesterday was the first actual day in the hospital. We started off at pre-conference, where we meet, talk about the day ahead and anything else that needs addressing and then get our assignments. Our instructor had us go around the room and say our name and if we had any children of or own or any experience with children. We actually don't know more than half of our class because in specialty classes, we are mixed with different graduating classes. This is my class's first specialty. The class that started the semester before us is on their third specialty. When I start my third specialty in the fall, we will be with the class that started the semester after us. (Then for the last three courses, I will be back with my graduating class again.) After that, she talked a little bit about some things she expected of us. Then she handed out our assignments. I was assigned a 7 month old boy who was having fevers, gastro issues, and of all things, gallstones. Yes, he did in fact have gallstones, confirmed by u/s. How that happened, I have no idea. Anyway, he was a pretty easing going child. We are allowed to do axillary temps (under the arm) in kids under 4 unless you get a reading over 99. At 8am, his temp was fine, but at 12 his temp was taken and it went up to 101.8 axillary. Now I had to take it rectally. But I have never done it rectally. So, I had to enlist the help of the PCA to assist me (the instructor told us that if we have never done it before, have someone help). Yes, after two kids I have never taken a rectal temp. I prefer the mom method of chin to forehead temp checking. I know thats not a reliable method.....I have always done that to see if they felt warm, and then used the ear thermometer (although at first with Grace I did the axillary route for a while). I used the same brand my pediatricians office uses- so I assumed it was fine to check that way, and would always confirm the fever. Eventually, I upgraded to a temporal scanner thermometer, and that was more accurate than my ear thermometer, until it was dropped on the floor by one of the kids and has never worked right since. Now they are old enough to do oral temps, so thats what we do. I have always found that even though the ear was inaccurate, it was always on the lower side and not the higher side. And the only time I've ever dealt with an extremely high temperature was when Grace had strep throat. But she didn't have any symptoms of being sick, was not acting sick at all, and the only way I even knew to take her temp was because we were changing to go to swim class and she was the hottest I had ever felt a person to be. Her ear temp was 104. I didn't even call the pediatrician, I just hopped in the car and took her straight there. Sure enough, the doctor looked in her throat and was amazed that it didn't hurt her because he said it was a mess.
Wow that was a tangent if I ever saw one.
So anyway. I assisted the PCA with the first rectal temp. And man, are babies who are getting rectal temps squirmy. Now I know why I never opted for this route. Once the kids run a fever and get meds for the fever, we have to recheck the temp in about an hour. Which meant I needed to recheck the temp. Rectally. Sigh. I tried my best to hold down the little squirmy baby, but I don't think I did the best job. He squirmed quite a bit, but I could tell he was cooler and the thermometer didn't get nearly as high as it did earlier. Actually earlier, it almost immediately went to 102 within a few seconds, and now it was barely reaching 101 the entire time I was trying. An hour or so later, it was time for 4 pm vital signs and his axillary temp was way down.
It was a pretty uneventful day otherwise. There was one thing though that really bothered me. Actually, it bothered just about all of us, and especially us with kids. There was a 6 month old little girl who was in for an infection in her toe. She was alone. I tried as hard as I could in my head to give the benefit of the doubt, but at the end of the day, I just got mad. And sad. One of my classmates was taking care of her, and fed her around 11:45am and then the parents showed up. Then at 4 or 4:30 they left. They didn't bring her clothes. Or toys. And they didn't feed her the entire time they were there, saying that she was sleeping when other students had seen her awake in their lap in the chair. And then they said they wouldn't be back until tomorrow. Sigh. Seriously? I get that people have jobs or extenuating circumstances or whatever. But you can at least sleep at the hospital, right? And then the mom comes in all done up....her hair, her makeup, her clothes. She obviously had time to take care of that. I will stop there. I can't say more without getting angry. Poor baby. We left the floor at 5 and the unit secretary had the student nurse put the baby in the stroller to keep with her at the nurse's station because otherwise the baby would be alone. The nurse's have about 4 patients each to take care of, so its nearly impossible for someone to just sit with her in her room. The best that could have been done was to check on her often. At least the baby was able to be at the nurse's station for a bit. I couldn't help but think of her today.
So that was my first Peds day. The jury is still out on whether or not Peds is for me. There's still 4 more clinical days to try to figure it out. Stay tuned......first exam is Monday. Oh boy, I am so unprepared........
Wow that was a tangent if I ever saw one.
So anyway. I assisted the PCA with the first rectal temp. And man, are babies who are getting rectal temps squirmy. Now I know why I never opted for this route. Once the kids run a fever and get meds for the fever, we have to recheck the temp in about an hour. Which meant I needed to recheck the temp. Rectally. Sigh. I tried my best to hold down the little squirmy baby, but I don't think I did the best job. He squirmed quite a bit, but I could tell he was cooler and the thermometer didn't get nearly as high as it did earlier. Actually earlier, it almost immediately went to 102 within a few seconds, and now it was barely reaching 101 the entire time I was trying. An hour or so later, it was time for 4 pm vital signs and his axillary temp was way down.
It was a pretty uneventful day otherwise. There was one thing though that really bothered me. Actually, it bothered just about all of us, and especially us with kids. There was a 6 month old little girl who was in for an infection in her toe. She was alone. I tried as hard as I could in my head to give the benefit of the doubt, but at the end of the day, I just got mad. And sad. One of my classmates was taking care of her, and fed her around 11:45am and then the parents showed up. Then at 4 or 4:30 they left. They didn't bring her clothes. Or toys. And they didn't feed her the entire time they were there, saying that she was sleeping when other students had seen her awake in their lap in the chair. And then they said they wouldn't be back until tomorrow. Sigh. Seriously? I get that people have jobs or extenuating circumstances or whatever. But you can at least sleep at the hospital, right? And then the mom comes in all done up....her hair, her makeup, her clothes. She obviously had time to take care of that. I will stop there. I can't say more without getting angry. Poor baby. We left the floor at 5 and the unit secretary had the student nurse put the baby in the stroller to keep with her at the nurse's station because otherwise the baby would be alone. The nurse's have about 4 patients each to take care of, so its nearly impossible for someone to just sit with her in her room. The best that could have been done was to check on her often. At least the baby was able to be at the nurse's station for a bit. I couldn't help but think of her today.
So that was my first Peds day. The jury is still out on whether or not Peds is for me. There's still 4 more clinical days to try to figure it out. Stay tuned......first exam is Monday. Oh boy, I am so unprepared........
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