This saturday I participated in one of Cross Over Ministries most well known Volunteering programs called the “Cross Over Challenge Race.” I had to be there at 7:30 a.m. and worked until 11:30. Normally this would be problematic and I would of tried to leave early but i was having way too much fun. It wasn’t the run that was necessarily fun but the people that were there helping made it fun. I was at the water stop with these group of elderly women who were so nice and sweet. One woman, Attie, had me in constant laughter with the things she would say. When introducing herself she tole me her name was Attilia but since no one could get it right she just let people call her Attie. Trying to confirm that Attie was appropriate she countered with “call me what you want honey. Just don’t call me late for supper because I love me some supper.” That statement made my day. I wasn’t tired, hungry, or hot anymore thanks to that statement.
After pouring all the water into the cups for the runners, the race began. It was about 6 of us passing out the water. Once we noticed that they would just sip and throw the cups down, me and Attie decided to be on litter control. So we took our plastic bags and walked a few feet fromt the water table. Some runners complied and threw the cups away in the bag while others were trifling and dumbed them about a half a foot from our feet. Me and Attie must of been on the same page because we just looked and commented to ourselves about how nasty they were. After about an hour and a half we both got hungry. The eldest woman there, Mrs. G, had some extra sausage sanwhiches and some of the best Zuchni bread i ever had. Unfortunately Attie couldn’t eat any because she was on dialysis. I didn’t exactly know what this meant but I was determined to find out.
Once the race came to an end, the group went there separate ways and Mrs. G invited me to her church for worship, and to get some more of that zuchni bread. We exchanged numbers and that was that. Unfortunately this was my last act of community service but i plan to make it back there next year to help out with whatever i can.
This was my first time at KEEPs, a kidney screening program run by the National Kidney Foundation of the Virginias. KEEPs runs testing to search for indicators of kidney disease. They take measurements of body fat and also collect both urine and blood samples to undergo testing. What I thought was interesting is that they had nurses that were finishing up nursing school come in and help. I mainly did registration, so I got to be the one telling patients to pee in a cup and logging in their information, but it was really interesting seeing the types of people that came. One family had just moved from Africa and had heard about the screening through the city of Richmond. Another family had gotten up early in the morning and driven all the way from West Virginia with two toddlers. That really impressed me.
Today was my first day at the Children’s Hospital and I loved meeting all of the kids. The main two that I played with were named Alex and Jordan and were roommates, both with trachea tubes and in wheelchairs. For the majority, I was paired with Jordan, who had been stuck watching endless episodes of Hannah Montana all afternoon. Poor kid. I started playing with him and all of a sudden, he started making really aggressive, quick jerking movements with his arms and legs. I thought he was having a seizure. I went and got one of the nurses, who came to check on Jordan. Apparently, this was simply what he did when he was happy. It was his happy dance. I was so relieved that he wasn’t seizing and made sure that he continued to do his happy dance.
Today was another day at the Children’s hospital. There was a new batch of nurses, completing their nursing school at a community college nearby. After talking to one, I realized that this was their last clinical exposure during their time in school. Many were affected by seeing such young children with harsh ailments. However, they found taking care of these kids much more difficult. Many couldn’t read a blood pressure machine or even take one of the children’s temperatures. This astounded me. They were about to be released from school and allowed to work one on one with patients. They should be able to do these things by now, especially if they’re getting ready to be released to a hospital near you. I wouldn’t want any of these nurses taking care of me, but this is their time to learn. Let’s just hope they learn quickly.
4/15/09
I was playing with Amaaya who is the most adorable 1 year old you will ever meet. I have never seen her cry or do anything but play with her toys or whoever will come over to her. She’s new to the unit and has only been there a few weeks. She is only there for short-term care until her lungs are able to function without the help of a ventilator. As I walked into her room I thought it was weird that no one was there to visit Virginia or Amaaya, but there was no indication that I shouldn’t be there so I went in anyways. After I had been playing with the baby for about 30 minutes one of the nurses rushes in and tells me that I need to wash my hands immediately. Apparently Amaaya has c.diff and precautions against this are the same as MRSA. Not only did 5 members of the nursing staff watch me walk into the room, they were right there while I was with the baby and said nothing. There were no signs up and no indication that anything was wrong. The good news is that no one got sick from her, but needless to say I was very mad about the lack of communication.
Since I couldn’t play with Virginia or Amaaya, I decided to go down the hall to see the boys. Both boys were in rare form and very snippity. Alex kept crying and just wanted to get out of his wheelchair and run around, but couldn’t because he was still attached to his feeding tube. The nurses finally came in and put the boys to bed early. Since the nursing students weren’t around for our amusement we went to play with some of the other children on the unit. I didn’t think anything of it until Lindsey came back to school and told me that both boys had fevers of 105. So much for helping the volunteers stay well…
4/8/09
RCH has a very unique environment. While I have not been able to work in all parts of the hospital, the TCU most of the time seems very disorganized. There are three nursing stations staffed at all times with a total of probably 10 nurses. Additional therapists float around the unit and work with their patients 1-on-1.
Today the new nursing students came to start their clinicals. Some of these students could have used a little bit more training. The first run in I had with one was with Austin. Austin is a 2 year old boy who has very few motor skills. He is content to be rocked back and forth in the rocking chair. As I was collecting his toys and putting them back under his bed, nursing student 1 came in and just wanted to watch me interact with him. She kept asking me specifics about his condition which I had no idea the answers to. It was only later that I found out she thought I worked there which explains our awkward interactions. The entire time she was in the room she did not touch Austin once or even get close to his bed. She almost acted afraid of him.
The second group of nursing students were the best. Lindsey and I love to play with Jordan and Alex. While we were with them, two nursing students came into the room. Now Jordan is a very stubborn kid and if you make him do something he doesn’t want to do, he’s going to pitch a fit. Well the nurses had been watching us play with the boys and they decided it didn’t look too hard. I don’t know where these nurses were trained but I’ve never seen someone interact with a kid like that. It was very stiff and Jordan did not take a liking to the male nurse. Lindsey and I couldn’t do anything but laugh. The head nurse came and asked them to do a test on the boys and the shear look of terror on their faces was hilarious. I stayed over my hours just to watch them attempt their feat. After an hour, they still hadn’t accomplished anything and the poor boys were so ready to get away from them.
It successfully took two nurses to get a temperature from under Jordan’s armpit. But it took four nurses to figure out how to pop off the trache input to reattach it underneath the crib bars…
4/1/09
My second day at RCH was a little less stressful. I finally felt comfortable going into the children’s rooms. It’s difficult to stay out of the way of the nurses and the other therapists because they don’t seem to have a set schedule and get a little annoyed if I’m in the room playing with a child when they come in.
One of my patients is a 5 year old girl who is absolutely adorable. Her family lives in Charlottesville so they only get to come see her on the weekends. She loves attention and is very demanding. I was told she was my assignment for the day because she was driving the nurses crazy. Virginia has a unique way of getting the nurses attention. Instead of waiting her turn for someone to come play with her, she will simply pull the trache out of her throat so all of her alarms go off. She only managed to do this successfully twice while I was there. The nurses had to teach me how to trick her so she wouldn’t know I was leaving and she would leave the trache in.
My second task was to play with Jordan and Alex who are roommates. Alex the “hand man” is easily entertained and I had no problem with him at all. Jordan, however, was another story. Lindsey and I were in one of the entertainment rooms with Jordan and Alex. Jordan also loves hands and just loves people touching his hands or being around him. He has no facial muscle control so he can’t smile or give any sign that he understands or is even paying attention to you. As I was getting ready to leave and just talking to Jordan, he began to flail his arms and move his head around in a sporadic manner. I had never seen him do this before and Lindsey and I became worried. I went to grab one of the nurses because we were concerned that he was having a seizure. As I brought the nurse back to him she just began to laugh. Apparently this new movement just meant that he was happy. Could have fooled me.
3/25/09
Richmond Children’s Hospital has a very unique atmosphere. The entire hospital only serves children under the age of 21 and most areas are made to look like a playground. I went on the grand tour of the 5-6 units contained within the hospital and came to an end at the Transitional Care Unit where I will work for the semester. The doors to the unit are locked and only individuals with a badge are allowed inside. All of the rooms face the into the unit and have large windows facing the greens.
I work primarily with the pre-school age children. Most of these children are kept within cribs that look more like cages. It sounds horrible, but it’s the best way to describe them. There are not enough nursing staff for every child to be played with all the time and the only way to keep them from falling is to keep them inside these enclosures that are sort of a playpen that doubles as a bed.
The first patient that I got to play with was Alex. Alex is probably 6 or 7 but functions on a level of about a 4 year old. They call him the “hand man.” He hardly ever plays with toys, but if you sit with him and give him your hands, he is easily amused for hours. It was amazing to me just how much these kids loved to play and were so happy to see me. It was also difficult for me to be there because I received no instruction from anyone working there. No one seemed to know my function or what I could do so I was just allowed to do what I wanted.
Most of kids are gone now from HHH; it is surprising how fast they get better. Today there were only 2 families remaining in HHH, one was a South American family from Honduras. The young girl, named Cindy, a 3 year old girl who had open heart surgery about 2 weeks ago. The family spoke very little English and the girl seems very shy but healthy. She was eating a lot more than usually, and she seemed very active. They have one more appointment on Tuesday and then they are heading home. I brought with me a movie called Bedtime Stories and put it on the kitchen’s TV. It was a bit hard setting the movie in Spanish, but once set they seemed happy to watch. The other family that was there I didn’t get to see much of. They arrived last night, a 17 year old boy and his mother. They were sleeping in their room until another girl who is a senior at Richmond came to take them to their first doctor appointment. He also will be performed an open heart surgery. Open heart surgery is by far the most common operation I have seen in my time in the IHC. It seems still quite amazing to me to find some many young children that look healthy have such a serious problem. The only things that hint me that young Cindy was sick were that she was a little skinnier than normal for a young girl. Apparently she didn’t have that much of an appetite before her surgery, but now she repeatedly asked food from her mother during my visit. I hope to see this young girl before she leaves next week.
Last night was not terribly busy, but we did receive two interesting calls. The first was a three year old boy, whose mother had called the ambulance because of an allergic reaction to peanut butter. When we arrived, the boy had hives on his face and was very itchy. Luckily, he didn’t have any airway problems and all of his vital signs were within normal range. Sometimes with severe allergic reactions, the victim can go into anyphylactic shock where their airways begin to close. A common cure for this is epinephirine, often delivered through an epi-pen and given has an injection in the thigh. Luckily, this boy was fine, but we took him to the hospital just to be safe.
The next call was around midnight, and we were called to a woman with difficulty breathing. When we arrived on scene, the police were hovering over an unconcious woman. After determining that she was alive and breathing, we began getting the story from the police. Apparently, she had been pulled over for not having her headlights on, and was visibly intoxicated when she stepped out of the vehicle. Multiple wine coolers were found in her car, and while speaking to the police, she passed out onto the pavement. We took her into the ambulance, monitering her vitals, and inserted a nasal airway to help open up her nasal passage. We then placed a non-rebreather mask on her with 100% Oxygen because her pulse oximetry measurement was at a 95%. The paramedic also placed an IV into her arm and administered warm fluids. Everything was fine until all of a sudden the woman woke up and began screaming. She started trying to pull off the mask, take out her IV, and even hit us. She wasn’t coherent enough to do anything but scream and say a few words, but the rest of the ambulance ride was spent with each one of us holding down an arm or a leg. The police accompanied her to the hospital, because assuming her BAC was over the legal limit, she was under arrest.
