The Baby with Tetralogy of Flow

It is a good day so far—none of the 16 critically ill babies in the neonatal intensive care unit has coded or died. So far, the shrill electronic alarms for dying babies have been silent.

As the neonatologist on call, this gives me the opportunity to talk to Anna and Jake, Baby Milo’s parents. Milo peers up at them with big brown eyes as Anna leans over his crib and whispers to him. A small transparent plastic mask covers Milo’s tiny nose to help him breathe, and a cluster of saliva bubbles percolate between his lips. Despite a sleeve of tape securing his right hand, his tiny fingers tug the orange orogastric tube taped to his cheek.

Milo’s father, a brawny man wearing scuffed brown shoes, ripped blue jeans, a T-shirt, and a tattered Green Bay Packers cap, sits in a chair and nervously taps his knee while he stares with bloodshot eyes at the vital signs on Milo’s bedside monitor.

“Milo is adorable,” I say from the doorway. His parents look over to me as I step into the room.

“We think so,” Anna says with a smile.

“How are you both doing?” I ask. “Being in the NICU can be pretty stressful.”

Milo’s parents glance at each other and nod. Anna takes a seat next to Jake, who touches her shoulder.

I pull up a chair. “Can you tell me Milo’s story? How did you end up in the NICU?” I say.

“We were celebrating my birthday at a steakhouse,” Jake says. “Right after they brought […]

2020-07-15T11:23:21-04:00July 15th, 2020|family, family experience, pediatrics|0 Comments

Does Everything Happen for a Reason? One Oncology Nurse’s Perspective

Does Nature Argue Fate? The Acorn Contains The Tree/
charcoal, pastel, and ink on paper/ Julianna Paradisi 2019

The human need to find meaning.

“Everything happens for a reason” is a saying I hear a lot in my nursing practice, from patients and coworkers alike.

The need to find meaning in the events of our lives, good or bad, appears to be a distinctively human trait. Ancient Greeks believed Clotho, one of the Three Fates, spun the lives of humans. In medieval times, Anglo-Saxons may have believed in wyrd, a concept similar to fate in our modern language. Elsewhere, the idea of karma teaches a cause and effect perspective on this life, and on future lives. These are only a few examples.

Learning to ask ‘why’ as a pediatric ICU nurse.

I began questioning if everything happens for a reason as a pediatric intensive care nurse at the beginning of my career. Asking “why?” is a natural response to watching a child suffer. Why is a baby born without a functional left ventricle? Why does an infant contract leukemia or a brain tumor?

Certainly genetics or environmental factors cause some cases. Regardless, it’s difficult to […]

May Issue: Assessing a Child’s Pain, Handling Work-Related Stress, Stop the Bleed, More

“Nursing takes a steely courage that many people don’t possess. We deal with raw emotions on a daily basis, taking in the grief and loss and pain and hopelessness of patients and families who look to us to make them feel better.”—AJN editor-in-chief Shawn Kennedy in her May editorial

The May issue of AJN is now live. Here are some highlights.

CE: Original Research: Work-Related Stress and Positive Thinking Among Acute Care Nurses: A Cross-Sectional Survey

In the first U.S. study to evaluate acute care nurses’ use of positive thinking in managing work-related stress, the authors found that positive thinking skills are being used to cope with such stress, and that nurses’ use of these skills can be improved through training.

CE: Assessing a Child’s Pain

This article discusses the factors that can influence a child’s report of pain, describes components of a comprehensive pediatric pain assessment, and reviews appropriate pain assessment scales for children of different ages and levels of cognitive development.

Nursing and the Sustainable Development Goals: From Nightingale to Now

The authors explore how nurses can contextualize the United Nations 17 Sustainable Development Goals within their daily practice and create holistic plans of care for patients, families, communities, and nations.

Leading the Effort to Promote Bleeding Control in Our Communities

This […]

2019-04-29T08:16:17-04:00April 29th, 2019|Nursing|1 Comment

Even in an Unimaginable Crisis, Nature Heals

“Eleven-year-old Olivia’s parents were ‘done,’ had reached their limit of bad news, and refused to enter the conference room. They didn’t want more information or what they perceived as pressure to withdraw life support.”

The hardest decision.

by Janet Hamlin for AJN

These words in the opening paragraph of this month’s Reflections column,”Little Sparrow,” describe a situation that will be instantly recognizable to many nurses, especially those who regularly work with people who have suffered severe head injuries or other central nervous system trauma. These two short sentences encapsulate the terrible crisis that develops when a tragic outcome seems inevitable to staff—while family members, in shock, struggle to absorb information and make decisions.

A healing garden.

In the essay, which will be free until February 20, Elaine Meyer, PhD, RN, describes her approach to one such family. While the parents of the seriously injured young girl pray for a miracle, staff are distressed because they feel they are inflicting unnecessary suffering on the child. […]

2019-02-05T08:19:55-05:00February 5th, 2019|family, Nursing, nursing stories|1 Comment

In Pediatrics, What’s the Best Way to Assess for Pressure Injury Risk?

The evolution of a scale.

In children, most hospital-acquired pressure injuries are related to medical devices rather than immobility. A device that can’t be repositioned, such as this cast, presents additional risk. Photo by Rafael Ben-Ari/Alamy Stock Photo.

Pressure injury prevention has always been a top nursing priority. Do you know about the latest tool for early identification of pediatric patients at risk for pressure injury?

The well-known Braden Scale, developed in 1987, was followed in 1996 by the Braden Q Scale for use in kids. Both were developed by nurses and are widely used around the world. However, the Braden Q Scale focused on immobility as a risk factor and wasn’t designed to address device-related pressure injuries, risks to children younger than three weeks of age or older than eight years, or children with congenital heart disease.

An update to include device-related risk in children.

So Sandy Quigley and Martha Curley, the nurses who modified Braden and Bergstrom’s original Braden Scale, set out to validate an updated version of their pediatric tool in order to address medical device use, a broader age range, and children born with heart disease. In “How to Predict Pediatric Pressure Injury Risk with the Braden QD Scale” in this month’s AJN, they explore the use of their Braden QD Scale (the D is for device related).

Quigley, Curley, and colleagues emphasize that while immobility-related pressure injuries in children have decreased significantly, “[in pediatrics] most hospital-acquired pressure injuries are associated […]

2018-11-07T10:32:44-05:00November 7th, 2018|Nursing|0 Comments
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