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ClaireEBeth
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Name: Claire
Location: Jackson, Mississippi, United States
Interests: Cubs baseball (YESSSS!), cooking, working out (I really do like it, stress relief), music (makes me smile and dance), family, friends, church
Expertise: studying
Occupation: Student
Industry: Medical
Message: message me
Member Since:
12/16/2005
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| Let's see...since I last visited I have moved from NICU to ER. So far it's been pretty good. I was in one of my best friend's wedding...it was the most fun wedding I've been to! The ceremony was quite long but they are married. The reception had dancing (LOVED it!), which I'm not used to being that most weddings I attend have the reception at the Baptist church...and you know how baptists are about dancing...don't know why!? I dance, I'm baptist! After that I had my last day in the NICU and then made the treck to the beach! A very brief trip to the beach. As in brief I mean a total of 2 days away with an entire HOUR spent on the beach. We just ran out of time...had to check out at 11am. Funny thing is, when you don't have much time off, two days seems like eternity! Seriously, I have Fri-Mon off and after Friday I couldn't believe it had only been a day! Anyway, my mom and I went to Foley and shopped. Then we spent an hour on the beach the next morning...I think I could do that some but a whole week seems like a long time just for the beach (no oil balls when we were there!). Then we helped my brother move into his new apt. It was a good break.
Since then I've been working in the ER. We've had some really good days and then some CRAZY days! Seriously, one day there was NOTHING going on all day until around 6pm when all of our transfers decided to show up. I had to try and do a spinal tap on a 6 year old...not easy! Let me just say, I did one on a 7 day old earlier that day and was done in about 45 seconds. This kid...he jumped off the table. We had to sedate him twice and even then he was jumpy! I have done multiple sutures (funniest one was a kid who had cut his toe while pitching a fit about taking the trash out...his mom was laughing, saying it served him right for not obeying. Don't worry, she was GREAT with him while I was doing the sutures helping distract and calm him). I guess the most exciting thing I've done was put in an intraosseous line. This is basically an IV that you put into the bone in an emergency situation. You literally drill the needle in. WOW! After Monday, I start a stint of 12 days with only 2-ish days off between that. Great fun! Maybe I'll have some stories to tell after that!
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| Well, the night after I posted my last post was quite an interesting one...a good experience, but not one I'd like to do again! The delivery pager went off 911 and we weren't expecting anything. I moseyed upstairs because usually that means that they are doing a c-section on a term baby and we just have to be there "just in case." Well....I got up there and the nurse says it is a 36 weeker (almost term) that they are doing an emergency section on because the HR had dipped below 60 (we do chest compressions if a baby has a HR below 60). As I looked through the window to the OR, I saw a friend's mom who is a labor-delivery nurse...she saw me and just said "It doesn't look good, Claire." Ok...come on...aren't we supposed to delivery within 30 seconds in an emergency section?! Let's go! They actually did it in about 90 seconds, so still fast! When that baby got to us, he was gray, limp, not breathing, no heart rate...NOTHING! This baby was dead! The nurse practitioner moved to the head and I moved to the side and started chest compressions. Wow...first time to do chest compressions on a real child. Within one minute, the attending was at the bedside with one of the most experience nurse practitioners. She grabbed a mask tie off a med student, tied the umbilical cord and pushing in an umbilical line without even thinking. Meanwhile, I'm still giving chest compressions. We give a round of epinephrine through the endotracheal tube and a fluid bolus through the line. Finally, after about 10-12 minutes, the baby got a heart rate and had a little bit more color. We took him downstairs and immediately put him on a cooling blanket to keep him core body temperature at 93 degrees F (yes, normal is 98.6!) to help prevent brain injury due to hypoxia (low oxygen). As I was working on lines with the NNP, the attending came by to check for a corneal reflex (a way to check brain activity)...there was none. goodness! Fast forward about 8 hours...that baby extubated himself and was breathing on his own! Fast forward 6 more hours and I was checking on him the next morning (he's not on my side of the NICU) and he was moving his arm, looking around! WOW...I have no other explaination but that God's hand was all over that baby. There were so many if's: if mom hadn't come, if OB hadn't rushed to the OR, if, if, if...
but God isn't a God of if's! He knows! He has everything in control, in His hands. And guess what...He wants YOU to live! He created us to live with Him, to give glory to Him. But a decision was made long ago that changed that. Adam and Eve chose to disobey God and the punishment for that was death. From that point on we were all separated from God by sin and death. But He made a way to bridge that gap...He sent His only Son, Jesus, to take the punishment for our sin...He came willingly to die for us, to be separated from God and face death head on. He died...and then returned back to life! He beat death! And God wants to do that in Your life. What do you have to do...well, only one thing. Being good won't cut it. Going to church doesn't cut it. Getting yourself together and doing the right things, giving to others, not cussing...that doesn't save you from death. The only thing that will save you from death is to trust in Jesus as your Savior, as the only way to live forever with God. We don't deserve it, in fact we deserve death! But God loves us so much that He gives us grace and mercy through Jesus. So, just as God chose to bring that baby back to life, He wants to bring you to life...forever! Choose Him, trust Him...He wants you to be His and to live!
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| I suppose it's time for an update since I'm halfway through my NICU month. At the beginning of the month I was given a pretty sick baby. He is just tiny and on a ventilator. Apparently, my being given this baby was a sign that the practitioners trust me. I guess that's good but it also makes me nervous. He is so fragile and things change SO quickly for him. We had been able to wean him off of several medications and were making progress on his ventilator; however, things slowed down today. We had to restart meds. It just goes to show that you can never trust a preemie! I have been praying for him ALL DAY today! I didn't want to leave him today. I know I'll be trying to check on him all night long, and, though him being sick makes me nervous and almost want to stay away, it also makes me eager to be back so I can take care of him.
I also have a couple of babies who are pretty stable. One will hopefully go home this week and another just needs to stay and grow. Some of my experiences thus far have included having to call a mom and tell her that her baby has Down Syndrome, being called at 5:30 that a baby had extubated herself. I had to immediately go and reintubate her...thankfully it was successful. I also did a spinal tap on her but it was dry. My calls have been somewhat more eventful than normal. The deliveries have been slow, but it's been pretty active inside the NICU. Babies getting sick, having big bellies, and needing bedside sugery!!! yep, we had a baby born so sick that we couldn't get her stable enough to transport to the OR for surgery, so we transformed her bedside into a sterile OR. It was really interesting! I'm on call tomorrow, so we'll see what I have to add after that!
Please keep baby C and his family in your prayers! I know God has a plan and will use all of it for His glory; yet, it's so hard to see his mama sit by him everyday with him getting better and then sick again!
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| December: I was on wards again for December and had offered to work over Christmas since I don't have a family of my own. The month turned out to be a really good month. I had a great upper level and our census was pretty low...meaning I got an extra half day off to prepare for my stint of Q2 (every other night) call! Yep, over Christmas I had call every other day for six days. However, I then got six days off in a row...WONDERFUL! One night on call I had a call to come check on a baby because he was "crying funny." This is usually a frustrating call but I went to see the child...he was asleep. 45 minutes later they called me back asking me to come see the baby again. Well, when I got up there the baby WAS crying strangely. When I went in the room he was obviously uncomfortable, retracting a LOT (when you can see the skin suck in between the ribs when a child breathes in), and his sat probe wouldn't pick up. Well, I got a new sat probe and the baby was at his normal O2 sats (low for a normal child but okay for him)...I ordered a chest x-ray and called my upper level. In the 3 minutes that it took to do this, his O2 sats dropped to 55%! Normal is 95-100%. We immediately went into high gear, increasing his oxygen and getting blood gases. He ended up going down to the PICU and did not do well. So sad. However, it was a good experience for me at dealing with a sick child and making the necessary decisions quickly. During December I was able to still participate in my church's Christmas program, which is always a blessing. I am so thankful that I have been able to stay active in church as that is one of the things that I believe helps make my life as an intern better!
January: Peds ER!! This is a pretty good month (usually) as you get some random days off (about half the month). I had one day at the beginning of the month and then two days off. WELLLLLL, I caught a stomach bug from one of my patients on the FIRST day! Thankfully, it was a very limited illness, I had the next day off, and it was the ONLY time I got sick all month...quite a feat for ER. Honestly, I'd rather have that one day of illness than 2 weeks of a cold. Anyway, I got to sew up several cuts, took care of a friend's baby (who ended up being okay), took care of several kids with fractures, diagnosed a baby with biliary atresia, and saw lots of minor things.
February: Hematology/Oncology. This is a HARD month! First of all, it is a very busy service and, though you don't have call, you are literally running on your feet ALL day taking care of patients, paper work, admitting people, and doing procedures. I got to do several bone marrow biopsies and aspirations (which is pretty neat to do but I am SO glad that we sedate all of our patients! Cannot imagine doing that or having it done without any) and spinal taps. At the beginning of the month I "randomly" was assigned some patients. WELL, I ended up with all of the rocks. I just say that my patients liked me so much they didn't want to leave. One patient was a little kid who came in SO sick and ended up having a stroke so that the left side of the body didn't work well. One of my favorite moments was in March when I was on the same floor and saw this child walking and talking in the hallway...it was this kid doing SOOOO much better! It literally MADE MY DAY!
Even though it was a hard month it is probably one of the most rewarding months. you see, because your patients often stay a long time, you form relationships with them. One child, I admitted 3 times and when I saw her this month she just smiled and started talking to me. Her mom was always asking me questions even though I wasn't on service. Another patient, who had some setbacks and conditions that we couldn't find a source for for the longest time (sometimes even the doctors don't know!), was getting better. One day I walked in her room and she just burst into a huge grin and held her arms out and said "I'm going HOME!" This was huge because at one point she was not talking and couldn't move. I was SO thrilled. THIS is one of the reasons that I LOVE my job! Now, that does not mean that it's all peaches and cream. I did have a patient that was not getting better at all. In fact, it was pretty obvious that she was not going to make it. However, we all hoped and prayed. At that point, you basically just have to keep them comfortable and minister to their family and their needs. I ended up being on call the night she passed away and was able to be with her family.
March: My LAST month on wards as an intern! This means that next year I will no longer take those silly (well, sometimes I will but in general) calls at 2am. Now I'll be the one admitting the kids. Ahhh! Anyway, I was on a team that has a very active subspecialty on it, so I was responsible for the neurology kids all month. I really enjoyed it. This month, since I'll soon be an upper level, I was determined to try and do as much as I could on my own...make my own decisions. Well, we had a kid get admitted one night who was not doing well. He was satting low and just didn't look good. We were up there as a team and called the PICU attending, got chest x-rays and blood gases, etc. Everything that we did, I would have chosen to do on my own. So thankful for that experience because it gives me confidence (but not TOO much...I will ask for help if needed!) going into next year. God really provides what we need!
April: Newborn nursery - I am LOVING this month! Those babies are so precious. I've had several interesting babies. One that I'm pretty sure has hypomelanosis of Ito. Another who ended up having to have surgery. I just admitted a baby today who was preterm and started to have low temperatures. Right before I left, we transferred her to the NICU...not because she's really sick but for closer observation. All of this has been a great lesson in making judgements for care based on multiple factors. Is the baby term? Is the baby breastfeeding? Where does the baby live? How much does the baby weigh? Is the baby eating well or having good output? All of these can help you make one decision versus another. It has also been a great lesson in communication! I have to talk to the moms every day and explain things in terms that a non-medical person can understand. Sometimes this is easy and other times not!
Up next: NICU...I'll try and update more frequently so you don't have any more of these massive posts and they are more current. Helps me remember things that happened as well!
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| Wow...has it really been since July since I've posted!? So sorry for my absence. Let me see if I can do a quick recap for you all...I'll go month by month:
August: Not a very exciting month. I was on infectious disease, which is an elective month where we basically recommend what kind of antibiotics to use in difficult infections. I did get to pray with a mom. Her son is chronically ill and had an infection that was hard to get rid of; she had been at his side in the hospital for over a month and was basically breaking down! From things she said, I knew that she believed in God and prayer, so I offered to pray with her. It's amazing what that offer can do for the relationship you have with parents! I really learned a lot this month about antibiotics and antifungals but really wish I could take this again...it's hard to remember all that information!
September: This was my first month in the NICU and I was scared. Working with all those TINY one pound babies is intimidating. The first day, I had no clue how to turn them over...but by the end of the month, I was so used to the LITTLE babies, that I couldn't figure out how to turn over a normal sized baby!  I did have one rough night. Call in the NICU isn't usually too bad; however, one night we had a baby who was basically dying in front of us and nothing we did was making her better. I had to call her mom and tell her that she needed to come to the hospital that night because her baby was very sick and might not make it (she then told me she'd try to get ride). My attending and I sat (literally, that's all we did) by the bed of that baby ALL NIGHT, watching her heart rate go down and her O2 saturations get low and then she'd bump back up. We had her on all the meds we could but her little body couldn't handle it. Needless to say, I didn't get any sleep that night...and then just as we were starting rounds, the nurse came over and said that she did not have a heart beat (she was already on the ventilator). I was told to go call it (pronounce her dead). I basically lost it on the way over to the warmer but composed myself and was able to make the official call. Before I left that day I had to fill out her death certificate. By the time I got to my car, I was shaking with tears....and I don't even have children. I cannot imagine what that mother was going through. All I know is that my God is bigger than any sadness we know! It's okay to feel sad, but He gives us joy and will use everything that happens for His glory! I really enjoyed that month but by the end was ready for something different...though a big part of me LOVES those babies!
October: This was an interesting month for me. I was on wards again, but this time I had another intern to work with, which meant that we split the overnight call. YAY!!! At least I got some sleep for half the month! This was her first month on wards and she is not from my medical school, so she didn't know how orders were done here, etc. That meant that some of the things took a bit longer for her, which meant that I had more to do. There were other issues but I don't feel like I should discuss them here. We'll just say that they helped me to learn how to make decisions on my own and prepared me to be an upper level next year! We did have a mock Code 13 (a code blue for our hospital) and I was the FIRST person there (not knowing it was mock until I saw the dummy on the table!). I had to run the code for the first five minutes. Thankfully, in our "de-briefing" the attending said that we had done everything correctly and she liked some of my questions!
November: My last elective of the year (boo!)...GI. This was a very relaxed month. I was basically in GI clinic all week learning about how to treat constipation, reflux, Crohn's disease, and ulcerative colitis...but mostly constipation and reflux. The only other things I did was go to procedures on Tuesday and Wednesday. Here we did EGDs and colonoscopies. It was a helpful month for knowing how to treat many condition I will face in primary care (which is one of my options for after residency). I requested to have an elective in November so that I could be assured of going home for Thanksgiving, the big holiday with my dad's family. It was a great break from work and a wonderful time with family. My brother's girlfriend came as they had recently gotten engaged and she wanted to meet family. It made me realize how much I LOVE time off!!!!
...to be continued....
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