Sweet Gestures

Every once in a while, NICU families will bring treats or food for the nurses as a thank you. It’s [literally] such a sweet gesture. This past week, a family brought in fancy doughnuts, and they were the prettiest doughnuts I had seen, so I took a picture.

Fancy doughnuts given to the NICU from one of our patient’s families. (Tastes as good as it looks – I had the Nutella cronut on the bottom right and it was amazing)!

However, the sweetest gesture I wanted to remember from this past week was not what we received as nurses but what one family did for another family in the NICU. Due to supply chain shortages, our unit has run short on nursing bottles and caps and can’t give as many away to our patients’ families. Moms use these bottles to pump and store breastmilk for their babies to use while in the NICU. When our supply is limited, we recommend that families purchase and use milk storage bags as an alternative to the storage bottles.

One family overheard another talking about how it’s been hard to find the milk storage bags and how expensive they can be. The parents talked to the other parents and offered to bring them a box of bags. They brought them a box the next day. It was such a sweet thing to witness NICU families supporting other NICU families. Having a baby in the NICU can be challenging, so seeing our patients’ families support one another is reassuring that people can still be kind and thoughtful even when faced with difficult situations.

I have one more thing I want to remember/share from working this past Father’s Day weekend. (I hope everyone had a Happy Father’s Day – I’ll celebrate it late with my father and husband this week). I typically see mothers in the NICU more than I see fathers. Lately, I’ve seen a lot of dads visit with moms. In particular, one father of twin patients has been visiting and caring for his babies more frequently than the mother. The dad lets the twins’ mom continue to rest and recover while he travels to the hospital to bond with his babies. We didn’t make Father’s Day cards for the dads as we did for the moms of our babies for Mother’s Day. However, I hope the dads realize what a difference they are making by being in their child’s life and supporting their child’s mom. I know there are cultures where mothers are primarily responsible for parenting and the domestic duties of diapering or feeding a child. However, it’s been refreshing to see so many fathers involved in caring for their babies in our NICU.

I hope you can draw inspiration from the sweet moments you encounter in your work or training. Did you witness anything that inspired you this past week? Feel free to share in the comments!

Reflection for the Week of 22-May-2022

As a mother of a school-aged child, the mass shooting at a Texas school earlier this week impacted me. I felt a mixture of grief, anger, and helplessness. Like other parents, I dropped off my child at school the next day, holding them tight as we hugged goodbye before the school day. It’s devastating to consider the victim’s families said goodbye to their loved ones the morning before without knowing it would be their last.

On a nursing community page, fellow nurses asked what they could do to support the healthcare workers caring for the mass shooting victims. I’m a neonatal and pediatric nurse and always find it difficult to see children suffering in a hospital due to the brutality or neglect of adults. It’s inevitable to encounter child abuse cases in my line of work, but dealing with the mass murder of children is unfathomable. I became emotional as I imagined trying to care for the victims and facing so many deaths at once.

I’m so tired of mourning, crying, and feeling helpless. I pray but cannot accept that it’s now the responsibility of parents to search for bullet-proof backpacks or for kids to know where to hide or how to play dead to protect themselves from an active shooter. We have to do better for our children. We need to act and demand action from our leaders.

I have always believed that one cannot complain about issues if you’re unwilling to do something about them or propose solutions. One way to start taking action is to consider donating to Everytown for Gun Safety at everytown.org. I have contributed to the organization based on the guidance of other mothers and family members I trust. Other mothers I know have chosen to participate in their Moms Demand Action groups; I hope to join them.

Have a peaceful week – and if you are not at peace, may your internal discord inspire you to act and make positive life-giving changes. Take care and good luck on your journey.

Mother’s Day in the NICU

Mother’s Day coincided with my 3rd consecutive day working in the hospital. I get pretty exhausted after three-in-a-row shifts, even working on dayshift. Knowing how tired I get, my husband thoughtfully ordered food for us to have dinner at home last night. After dinner, I finally opened my daughter’s Mother’s Day card/gift she made at her school. (She’s been eager to have me open it since she brought it home on Friday – I insisted on waiting until Mother’s Day)

A portrait – part of my daughter’s Mother’s Day gift

My shift was hectic yesterday, but I didn’t mind working on Mother’s Day in the NICU. For our babies who have parents that visit them, I get to be there to comfort and support the parents and to celebrate the mothers on their special day. Some parents have difficulty being separated from their babies while their babies heal or recover in the NICU, especially on days like Mothers Day. NICU nurses often provide emotional support and assurance for patients’ caregivers. Some parents don’t yet feel comfortable handling or caring for their babies. As nurses, we educate and guide caregivers in their new roles.

All the NICU nurses made Mother’s Day cards using our babies’ various handprints or footprints on Saturday. I don’t usually have much downtime to craft cards for parents, but I enjoyed making memorable print keepsakes for our patients and their caregivers. Some of our babies have no parents visiting them and are awaiting placement in foster care or adoption. We still made Mother’s Day cards for them – their future families may appreciate their teeny baby prints!

Until this past weekend, I’d never seen these cards or prints on our unit. At my children’s hospital preceptorship in nursing school, I often saw footprint cards made by nurses in the NICU. However, those patients were at higher acuity, so 1) had longer stays and 2) had 1:1 nurse-to-patient ratios. Still, I want to try making more of these cards for our NICU babies in the future. It’s a great souvenir for caregivers, and it allows me to practice my beginner calligraphy skills!

Since I worked on Mother’s Day, my family decided to celebrate Mother’s Day with my parents on Tuesday, May 10, when my Mexican friends celebrate Mother’s Day / Dia de la Madre. (Cultural Awareness Tip: El Salvador and Guatemala also celebrate their Mother’s Day on May 10). We have many patients from immigrant families at work, so I told some nurses to keep displaying their Mother’s Day cards/signs until Tuesday.

Wherever or whenever you happen to celebrate it, I hope you have (or had) a “Happy Mother’s Day”!

Why I Cried At Work

I spent last Friday morning at work crying. I was in my new job at my new hospital and in training. The training I took Friday morning was a mandatory two-hour computer-based session about the Commercial Sexual Exploitation of Children or CSEC. I cried with the testimonials and the trauma described by survivors and experts in the field. I felt a combination of rage and helplessness while I watched and listened to the videos. Luckily, I was in an area where no one else was sitting around me, so I felt I could express my grief and despair without too much concern.

I think this is part of what scares me about being a pediatric nurse. I worry if I can emotionally regulate myself when working with abused or neglected children. I also wonder and hope I can recognize and report abuse should I ever encounter an abuse victim. As difficult as it was, I appreciated completing the training and felt it was valuable. As a nurse, I am a mandatory reporter and must report child abuse when I suspect it. However, I think the general population should also take the introductory training about the Commercial Sexual Exploitation of Children to increase awareness, recognize and reduce risks, and maybe correct misconceptions about victims.

It is unlikely that the public would voluntarily take a two-hour training about the Sexual Exploitation of Children. Despite this, I hope to educate my readers and others who come across my blog or social media posts, because I think it’s important and is something I can easily do to help victims of CSEC. Some of the things I learned from the training are found below:

I can cry and grieve for these children, but I also want to take action. Let me know if you learned anything new from this post or if you found it helpful. I’m also curious to learn and hear from others about ways they support victims of the commercial sexual exploitation of children.

Major Update: I Quit My Job!

I have not posted in a while because I have been busy with some life changes. I recently resigned from my new grad RN job and accepted an offer to work at another hospital. What could have possibly taken me away from my #1 choice hospital and my highly pursued new grad program? A spot in my dream unit, the NICU!

It was tough for me to leave my program since I felt like the people were supportive overall. I truly appreciated the environment, community, and staff. I was learning a lot and growing as a nurse. However, my experience as a new grad RN working in the Float pool with adult patients also affirmed that my ultimate goal is to work with babies in a NICU.

My hospital has a NICU, which was a big reason I applied to their new grad program – I had hopes to move into their NICU eventually, especially after having a NICU preceptorship during nursing school. However, after working as a resident, I learned that the NICU at the hospital where I was employed does not accept inexperienced NICU nurses. The NICU manager recommended I apply to an L&D fellowship after my Float Pool residency, and maybe I could transfer to the NICU afterward. That would mean the earliest I could go to our NICU would be 2023, and that’s with the caveat that I would get accepted into a competitive year-long L&D fellowship. I would be competing with other nurses whose ultimate goal is to be an L&D nurse and other more experienced nurses previously rejected from the L&D fellowship.

After learning all this, I had the opportunity to interview during a mass hiring event for another hospital. The hospital already had my application from earlier in the year, one of the 70+ positions I applied to before starting my new grad program. I shared I only wanted NICU positions – there was no other reason I’d leave my new grad program since it was a great program in a good hospital. I interviewed with the NICU manager at the new hospital via MS Teams in between scheduled night shifts. At the end of the interview, she shared she’d like to hire me. I gave my job three weeks’ notice once I passed the background check and received a target start date. I started orientation for my nightshift NICU position at the new hospital on Oct. 1, last Friday.

I know it’s customary to give two weeks’ notice, but I felt obligated to give my old hospital three weeks. I ended up working four more shifts than if I had only given two weeks’ notice. During those four shifts, I had the most brutal shift I’ve had since coming off preceptorship and working solo. If I had left sooner, I could have saved myself from experiencing the most horrendous shift I’ve had so far. Luckily, my last shift was smooth and helped build my confidence after feeling torn down and broken from the week before – I met my patient’s needs promptly, charted everything on time, gave good shift reports, and my patients had no incidents. At my last job, I ended on a good note and had valuable learning experiences. My horrible shift in the week leading to my final shift taught me that when I’m overwhelmed, not only should I delegate, I should escalate to the charge nurse or nurse leaders. I will remember how awful my experience was on that shift to remind me in my nursing practice: “When Overwhelmed, Delegate + Escalate!”

I will remember this lesson as I start my new job. I am excited to have the opportunity to be in a NICU again. The children’s hospital where I precepted during nursing school opened its new grad program about a month after starting my previous job. Various cohort-mates encouraged me to apply, but I decided I needed to give my program and hospital a fair chance. I passed the opportunity to apply to the children’s hospital NICU new grad program before learning that my hospital would not hire me into their NICU for at least two more years. I don’t regret not applying to that NICU program because I’m grateful for my experience and feel more confident as a nurse because of what I’ve learned working with adults. I gave my program a chance and put forth my best effort, and concluded that I wasn’t willing to wait years to reach my goal to be a NICU nurse.

The earnest pursuit of career goals is somewhat new to me. For years, I didn’t know what I wanted. I knew that I was comfortable but not necessarily excited or passionate about my previous career as an engineer/scientist. During performance reviews, I would dread when my manager would ask what 5-year plan was because I wasn’t inspired by what was around me. I didn’t want my manager’s job, and other than becoming more skilled, building my expertise, and gaining more leadership experience, I wasn’t sure what else to say. Now, it’s nice to have a goal (dayshift NICU nurse) and work towards it.

It’s still a little terrifying:
“What if I don’t like it?”
“What if the staff is mean at the new hospital?”
“What if it’s not what I thought?”
“What if I’m not good at it?”
“What if I can’t handle the long commute?”
“What if I can’t last long enough on nightshift to make it to dayshift?”

Sometimes, you don’t know if you’re going to like something or will be able to handle it until you give it a try. I also have to be open to the possibility of failure or making mistakes with this new job – it’s those moments where real growth occurs, however. That’s how I became a better engineer or scientist. I made a mistake and remembered not to do it again. It’s like doing something wrong a couple of times before you figure out how to do it right, or in the most efficient way.

I think a terrifying part of being a novice nurse is mistakes in healthcare can have a profound and permanent impact on a patient and patient’s family. If I made a mistake as an engineer or scientist, many processes and people were in place that ensured no one would get hurt or injured. Delays or mistakes I made may cost hundreds of thousands of dollars, but they would never hurt someone. As a nurse, I no longer have that sense of security or protection. It’s anxiety-provoking. I’ve met many nurses with high blood pressure, anxiety, or depression due to the stresses of this profession. I don’t want to develop health issues because of my chosen career. I went into this profession to help people, so I try focusing on how I can help or improve care vs. contemplating the many ways I can injure someone or how someone may injure me (a genuine consideration with adult patients).

I’m still a recent grad with less than a year of acute care experience and still developing. Fortunately, my employer views me as a new grad and is willing to train me as a NICU nurse. I consider my new position as an opportunity to learn, grow, and be a better nurse. I’m going to try to focus on that and becoming the best NICU nurse I can be. Wish me luck!