Sunday, September 26, 2010

I am one of them.

Oh dear. I have turned into one of those people that only updates their blog once every 10 days. My goal is every other day or so, or I forget about stuff I've done and it all blends into the background of a million days of the hospital.

So. I'm already done at my first neonatal rotation. I am starting tomorrow at my second neonatal rotation. How has this happened? Where has the time gone?

At first my time at the hospital was quite terrible. I was working with a few people who hated me (for absolutely no reason - which seems to happen a lot to students). It was a completely new world in the land of neonates. Talk about completely incompetent. The only thing I was good at was monitoring every two hours. And even that was kind of iffy. On my second or third day (see what happens when I don't update frequently) a new person came on at 3 pm. A person who seems to hate life itself, or at very least life at the hospital. She does the 4 pm monitoring and then comes personally to yell at me. And I quote, "We are not just supposed to write down numbers, I have titrated infant x's oxygen, and you should have done that earlier." I apologize. It totally ruins my entire day of loveliness that I have had previous to this (I'm not sure what happened earlier that was so lovely.. maybe some cute babies were born and some cute dads cried, and then I cried too). Anyway, the next day I am all proactive, and ask the therapist if I can wean some oxygen but she says no, that the baby is chronic and I shouldn't touch the oxygen. And she also looks at me like I am very slow.

Sigh. Whatever. Update on infant x. One other RT, working the night shift turned down that kid's oxygen. And he totally tanked, and ended up needing the O2 turned waaaay up. The parents totally lost it. So yes, good idea to turn down the oxygen. I'm never touching any baby's oxygen again.

I did have a lot of really good experiences. I am a pro at taping nasal prongs to a baby's face. I am totally not scared to wipe a baby fresh from the womb free of vernix and other associated baby slime. I can suction their mouth, and even suction their little tummy out. Another skill I have is wrapping a baby up and delivering them to mom and dad.

One day we had so many little guy's in need of oxygen therapy that we had to wean one off of high flow prongs, sterilize it, move it to someone who was being weaned off of CPAP, so that we could clean that machine and put it on someone else. Seriously.

The baby was exhibiting signs of RDS, apparently caused by cholestasis in Mom. We intubated and administered BLES (surfactant). I got to bag for 45 minutes. I am still new enough that it is actually a privilege and an excitement to bag a baby for 45 minutes.  The next day she blew a pneumo, and shortly after that was being transported to our more intensive NICU at another hospital.

The most sad baby I saw the whole time was a 32 weeker. Mom and dad were first cousins. This little one was seen repeatedly by genetics. Each humerus was quite short, and the forearms were unnaturally long. It was odd. And sad. Additionally on x-ray it was evident that all of the cartilage in her joints was actually bone. They were all fused. Every time she was moved she cried. It was my only experience with the ventilator the entire time I was at the hospital. They tend not to hold onto them. The other hospital came and got her.

What is interesting is that I start at that other hospital tomorrow, so hopefully I will get to find out exactly which genetic disorder she has, and follow her for a while.

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