Had a great night at work last night. Got to be in Peds. I'm not officially signed off to do anything in PICU but I've run with team leaders up there a few days over the last year so I feel pretty comfortable with most of the treatments out on the floor.
I had some basic pneumonia kids and the like and then caught a toddler from the ER with some respiratory issues. The kid was one of the cutest little boys I've ever seen in my life except I thought he had either a nervous tic or was on the edge of seizures because he kept squinting his eyes together really quick over and over but at the same time he had a beautiful smile flashing. He was sitting on his daddy's lap the whole time I hooked up his sat monitor. He was actually doing really well and sounded very good. Whatever tx's in the ER, the dad said, were making him breathe better but the docs wanted to keep him overnight to make sure he was okay.
I went to put together some humidy and by that time his mommy was there. Really sweet lady. I told her how cute I thought her son was and she said "Yeah and he's already a big flirt. Did he wink at you?" A-HA! I said, relieved, "Yeah, he did." She said, "He does that to every woman he meets.
Kid's gonna be a ladykiller.
I didn't have a full load up there so I'd been asked to check on a couple of the units on my down time so I did. Right as I walked into one unit an RN grabbed me desperately for help. They had a lady crumping. Okay. I yelled into the RT tech room for help as I moved past. We bagged that one for a while and when the second RT showed up and they were calling anesthesia to tube her I walked to the other unit nearby to see how they were doing. Guess what? Another RT was there alone bagging a second crumper and the RN was getting ready to call for anesthesia. Hmmm...so I went back to the first unit and asked the doc to move on down the line when he was done with the first....and grabbed vents for both rooms. Yeehaw! In the middle of the second tubing I got paged to go back up to Peds IMMEDIATELY about my croupy little guy. Okay. Crap! But they were fine in the units at that point and when I got up to Peds...
(By the way in NICU and Peds we have no respiratory protocols like in adults. The docs write all the orders. They'll listen to us but we can't just roll up our sleeves and do what needs to be done like in adults...info you need for the rest of the story. We'd had phone orders for the sat monitor and humidty only so far.)
One of my favorite residents was sitting there and motioned me over to sit next to her at the far side of the nurses' station. O. kay. She had the chart in front of her and whispered, laughing, "I don't work Peds often. I like adults because I can just write 'RT to assess & treat' and you guys write your own orders....so what do you want and what are the doses up here? I'm thinking the kid needs albuterol, maybe some rac eppy here and there, and the humidity...is that what you think?"
I did so I asked her to write everything PRN so I could have a free hand to treat the little cutie pie.
Gawd, I love docs like that. It's such a blessing to be able to do my job and I'm really grateful for being in a department with so many great RT's who inspire that kind of confidence. You know what I mean? I'm also grateful that that little beautiful boy was just a little stinker winker and not a seizer wheezer.
Cruised through the units later and everything was peaceful. Great placid night for everyone except for that one WTF Half Hour.