My First Child
by Danielle Blood, MSIII
They say it takes about 10 years working in a profession before you feel really proficient and competent at your job, able to tackle most any task that comes your way with expert know-how. I felt this to be true after working as a nurse for that long. I also felt like I had seen a little bit of everything, having worked in many different areas: OB, ED, Surgery, and Medical ICUs of various kinds. But nothing could prepare me for what I would encounter with my first patient at the Burn ICU I had recently been employed at.
I worked the night shift and loved it! Night was the primary time people got burned and that's when most of the admits came, when all the action happened. I was ready and excited for my first shift on my own, having recently come off orientation. I was first up for any admissions that night, so when the unit received a call that a patient was en route by ambulance, I was thrilled. And a little apprehensive when I found out it was a pediatric patient. Having worked with mostly an adult population my whole career, I was wary about how I would adjust to treating a child.
The 2-1/2 year old patient, haphazardly swathed in dry gauze from her armpits down, rolled onto the unit alongside the medics in her car seat on top of a stretcher. She wasn't crying at all, having previously received some good medications from the paramedics. The only thing I knew about her injury at that time was that she had somehow sustained a scald from hot water. My fellow nurses and I busied ourselves transferring her from the car seat, managing her sloppy field dressings, taking her vitals, and preparing for her treatments and wound management.
The question I asked myself at that point was, "Where are her parents?" I then learned that this baby had been intentionally burned by them. And I just shut down at that moment. I forgot how to do all the tasks I had to do to take care of this patient. Everything felt like it was moving in slow motion as I struggled to fully absorb and comprehend this new knowledge. Having four babies of my own, this hit way too close to home for me.
My colleagues were completing their tasks efficiently and quickly and were able to stay focused, like it was no big deal. How could they not be freaking out inside like I was?! For some reason it never occurred to me that I would encounter pediatric patients on this unit who had received burns intentionally from the people who were supposed to protect them the most. I had never seen this sort of injury before in all of my time as a nurse.
With the help of my fellow nurses holding my hand through the whole process, I was able to administer pain medication to my little patient, get her burn dressings applied, get a feeding tube in her, and make her as comfortable as I could.
I sat with that baby the entire night in her room, rocking her in a chair, her moist burn dressings seeping onto my scrubs. And I cried a lot. All I could think was, "Where iss her mother? She should be here comforting her child." I was angry, not about having to hold this sweet girl all night because that was a privilege. I was angry that this had happened to her. Angry that a parent could do this intentionally to their own child.
In the months and years that followed, I took care of many more burned pediatric patients. Some were intentionally burned like that little girl, others were burned from sheer, neglectful ‘parenting.' I eventually became more like my colleagues, able to work through such admissions methodically and robotically, putting my emotions to the side so I could focus on the tasks at hand. These situations became commonplace to me. I became a bit more jaded too and maybe that's what has bothered me the most over the years. I've tried not to let the knowledge that humans can do really horrible things to each other, even to their own children, creep into my future patient interactions. That's often easier said than done as negativity has a way of prying its way into our thoughts sometimes. It's a conscious choice I now make every day to look at each patient situation with a fresh pair of eyes and a softened heart, to not let potential burnout and apathy guide me in the decisions I make or the care I deliver. It's my hope that remembering how I felt that night on the burn unit will help me deliver the same care and compassion I gave that little girl to each of my patients in the future as I continue my journey to becoming a physician. They are all deserving of that.