Tuesday, April 8, 2008
It's Hard Being a Kid
Stickers are like gold in the pediatric E.D. I don't remember ever being that excited about them when I was growing up. Around 5th or 6th grade, I got into the girly "Hello Kitty" thing with the cute pencils and erasers (mind you this was the first "Hello Kitty" era in the late 1970's.) But, I really don't remember having a thing for stickers. Kids today, though, love them and actively seek out their favorites.
Unfortunately, we can't heal everyone with stickers, but sometimes it's the best gesture you can make after what these kids go through.
#1 - Foreign body in nose: "I wanted an adventure." 4 year old that decided to stick a rock up his nose. A few problems with this:
a) he lost the rock in the nose and couldn't get it out
b) he didn't like the idea of my sticking a tube in his nose to get it out
c) the "rock" turned out to have been made by a rabbit
- Sponge Bob stickers for him and some antibiotic ointment for his nose
#2 - Hand injury: 13 year old that got beaten up in front of her house by the neighborhood female bully. Supposedly. she lives in a very bad neighborhood, and there's a family that moved in that has caused a lot of problems. This is just the latest. The police report showed that after the girls started fighting, a social worker tried to pull them apart and she was struck and injured, and then more family members jumped in and there was a bigger altercation. Not to mention the reason why there was a social worker at the house: the mother is, to quote one of the ED RNs "Dumb as dirt." There are 4 other children in the house, one of which has cancer, and the mother can't be counted on to assist in his treatment (ie: remember to give him his medications and get him to doctor's appointments for chemo.)
- Princess stickers will help this poor girl feel maybe a little like a kid; she's having to grow up very fast.
#3 - chest wall contusion: 16 year old playing basketball got hit with a knee in the chest as he was bending to pick up a basketball during a game. No stickers for him; he's a little too old for them, althoughI might have given him the Spiderman one just cause.
#4 - possible sexual abuse: this was the hardest case of my night. I had to talk to and exam a 2 year old whose family was suspecting sexual abuse. Seems the little girl spends 2 weeks at her father's and 2 weeks at her mother's. Her mother has a boyfriend, and the father's family was concerned that this was the person abusing her. I had to take statements, do an exam, and call in a report to Child Protective Services. I don't know if I can follow-up with a case worker or not, so I will just have to follow her medical records to see if she pops up again.
- No number of Princess or Dora stickers could make up for the fact that I had to do a vaginal exam on a child already suspicious of anyone trying to have anything to do with that area. I can only be comforted by the fact that she's safe... at least for 2 weeks while at her father's.
#5 - #10: The usual montage of diarrhea, constipation, vomiting and diarrhea, etc. I do have to make one comment: if you're going to tell me that your child hasn't been able to eat or drink anything for two day because they throw everything up, do not hand your child a soda bottle and allow them to drink half the contents in front of me while you are telling me this. I might not believe you. And, when I ask if the child seems to be doing better, don't tell me, "No, she spits up everything she drinks down, " while the child is happily swinging her legs in the chair, sucking down her bottle of pop, and play burping along with me. Seriously, I'll wonder why you came, and you'll be left wondering why I am not doing a million dollar work-up on your child.
This was our ED whiteboard at 2030: we didn't clear it until almost 2 in the morning - and this is with 20 rooms, 2 surgical rooms, a trauma room, and an ortho room - all full.
Ok. Enough of being a vampire. Tomorrow is Grand Rounds Wednesday, and I am presenting the chapter on Pediatric Cellulitis to my reading group, so I better go read it. Back to the E.D. fun on Thursday.
Save the Seals!: