The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Some Nurse…

Posted by isntshelovlei on October 7, 2010

When (medical-ly) things go wrong in my own house, right under my own nose, it really makes me start to question how good a nurse I can/will be. If I don’t even notice when one of my own kids is in respiratory distress then how in the world am I supposed to be able to assess multiple patients?

One of my daughters—the “small girl” as she calls herself, not the much taller one from my strong therapy post—was admitted to the hospital this week (hence very few tweets and status updates from yours truly). I was at work, actually in the middle of taping another Insights in Nursing podcast episode over my lunch break, when I got a call from the daycare saying that she was breathing pretty hard. Of course I hightailed it over there, stopping by the house to grab her barely-used inhaler. Until this admission, the docs refused to label what she had as “asthma.” They said she was too young and her symptoms were just a bad reaction to a virus, so up to this point she had not been on any type of maintenance therapy. Nevertheless, I did still have that trusty rescue inhaler (which had probably not been used for close to a year). I get to the daycare and she looks absolutely horrible. I could see her working to breath through her hoodie. I gave her her “puffs” and put her in the car. By the time we got to the hospital she was tachypneic, with intercostal and suprasternal retractions. How could I have not noticed any of that this morning? Surely, she did not go that downhill that fast and without showing some preliminary signs/symptoms; she didn’t look like that when I dropped her off that morning.

Thinking back, there had been signs—just none that I had readily accepted. She’d been coughing recently. It started out as a dry cough; I now noticed that it had become junky. Just that morning, she complained that her throat hurt, and she looked tired as all hell. I sort of brushed it off thinking (or hoping) she was “just” coming down with a cold and even told her that she’d “be alright.” And of course she was tired. Our lives are hectic as a side effect of all of our various responsibilities; we get up at the crack of dawn after staying up late nights most of the time. I’m sure our entire household could benefit from a few more hours of sleep.

But this was bad. She’d had a similar “episode” (since we weren’t calling it asthma) sometime in 2009, but it wasn’t like this. It took her a lot longer to come around this time. The albuterol and prednisone weren’t even touching her wheeze (which sounded more like an expiratory snore). I felt horrible. I am under such tremendous pressure and stress—between home, work, studying and keeping my grades up in school, trying to stay “involved,” community service, networking…all on very little sleep. But at what cost? I already know I’m stretching myself thin. But everyone keeps telling me that it’ll all be worth it in the end… 

I think my overpacked schedule and subsequent need to have things proceed in an orderly, organized fashion (such as not having kids get sick when I already feel like I’m being pulled in a million different directions) has led me to develop “hyper“chondriasis (sort of the “opposite” of hypochondriasis). Yep, that’s what this was—a case of hyperchondriasis by proxy. My kid was really sick, but I was in some type of manic denial.

Through it all, I did learn something new…retractions seem to work their way UP. As in the patient usually has subcostal retractions first, then intracostal, then supraclavicular or suprasternal ones. My daughter’d had retractions before, but never up at her collarbone area.

In any event, she’s home now, doing much better, and back to jumping off the walls and eating us out of house and home. 🙂

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2 Responses to “Some Nurse…”

  1. Jen said

    I still think you’re going to be a great nurse. I think she took a turn for the worst at day care. You’ve got so many responsibilities that you are juggling. I don’t know how you do it.

    • isntshelovlei said

      Thanks for your support! I know it’s not really my fault she got sick; I just wish I’d picked up on it a little sooner.
      And as a mother I already have a third eye, but now I think I’m growing a fourth! Now I’m really going to be hypervigilant!! :-/

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