Rocking My Baby

Came back from lunch today to find Isaac's nurse rocking and cooing over him. He'd woken up a little early so she was keeping him busy until I got up to feed him. He is a snuggly baby. I do wish I could request specific nurses. Isaac and I both approved of her. While some nurses are all business, others really seem to enjoy the little ones.

Interesting People at PCMC

I was chit-chatting with one of the few male nurses I've seen, a gentleman probably in his late 50s. He was friendly guy who liked to talk. I asked him how long he'd worked at Primary's and he said 4 years. "Oh, so where did you work before that?" "I was in construction for 25 years before that."
How's that for a career change?

Around noon I saw a woman in the scrubbing up room of the NICU. She had a heplock still in her hand, and I asked if she'd come from the hospital. "Yeah, I just had my baby this morning."
!!!

While parking the car one day, I spotted two women in long dresses. Did a double take, and sure enough, long prairie type dresses and gibson girl hairdos. They were clearly FLDS. I've only seen them in person once before...protesting a bill before the legislature eight years ago. (As I recall, the bill passed.)

Several days ago, when I was in the mother's room pumping, Jonathan recognized a woman passing in the hallway. "Hey, I think you delivered my son nearly 6 years ago at American Fork Hospital."
"Yep, that sounds about right."

Glucometer Saga Part ??

After lunch I came back up to feed Isaac. His nurse swapped with another nurse at 1:00 because the NICU had some new admits and the nurses got shuffled around. I found her with the phlembotomist using the ISTAT reader (lab reader) to test his glucose. I inquired as to why...his sugar was supposed to be read by his glucometer throughout the day, and 1x in the morning compared with the ISTAT. She'd been led to believe that his sugar was supposed to be read with the ISTAT throughout the day and the glucometer used once in the morning.

So she tracked down Isaac's nurse practitioner who clarified things and wrote a clear (I hope!) order in his charts. Isaac's bedside nurse apologized up and down. Really it wasn't her fault, I understood. I sure was glad to be there to correct this, though. The ISTAT requires so much more blood, and to have it done 8 times a day would have Isaac terribly anemic in no time. The ISTAT lab reader ended up erroring out, so it didn't even get a glucose reading. I showed his nurse how to use the glucometer (she'd never used this type before) and got his glucose number. His nurse in turn made a very clear sign in large letters explaining how and when Isaac's sugars were to be tested and hung it on his crib.

I'm hoping that this is the end of the glucometer saga...

And Odds and Ends

Isaac is now dressed in a little onsie since he doesn't have many tubes or wires in the way.

His cord came off yesterday morning. Yay!

There is rumor that they want to transfer him to the children's unit one floor down. On this floor the nurses are trained to handle diabetic children. Also the NICU is getting more sick babies in and want to move the less sick babies out. Currently there are still beds available in the NICU and none on the floor below. Dr. Z and Dr. C are both very much against transferring him, and are fighting to keep him. Dr. Z contends that the doctors on the floor below may not want to continue down the same treatment path using the sulfonylureas (it is new and a there isn't a lot of research on it), they don't know his case history well and have not done the research the docs on the NICU have done and this may delay treatment, plus his blood sugars still are not stable. I think she may want to keep him too, because his case interests her and she would like to see it resolved. I found out that she's read hours of articles each night on his particular condition, and I think she is loathe to not see him through to the end. We'll see what happens. I kind of hope he stays as well.

Since he is doing so much better, he now shares a nurse with another bed and has for the past few days. Just another sign that he is getter more stable, anyways.

His oxygen levels still dip up and down, but not wildly so. He is on a minimal amount of oxygen. They did an echocardiogram yesterday, and the results are a normal looking heart, but one of the fetal shunts hasn't completely closed off yet.

They are still trying to track down a geneticist who would know what labs to draw and where to send them. Either the labs would show what the problem was, or it would eliminate some possibilities...

Some Pretty Special People Work in The Newborn Intensive Care Unit

Take for example Gary, one of the NPs. His son was born premature 24 years ago. From his experience in the hospital and taking care of his son, he decided to become a nurse. So he went back to school and has now been caring for other little people for decades. Not only is he good with little people, but he is great with "big people" too. He says he understands that it can be overwhelming, and to never be afraid to ask questions, even if it's a question you've asked before. He feels it is part of his job to help the parents as well. Really nice guy. The bedside nurses (with just the one exception) have been fantastic as well.

It is so very hard to leave Isaac each night, but at least I know there are good people watching over him.

Isaac gets an incompetent nurse

Isaac's nurse tonight did not project the aura of competence that his other ones have.  In fact, the adjective that comes to mind is "bumbling," like a well-meaning kid who cleans your mirror with sandpaper.  No, our kids have not done that.  Yet.
Rachel and I broke for dinner at 9, and when we came back up Nurse Incompetent was poking about in poor Isaac's wrist with a needle trying to put an IV in.  After two pokes and much subcutaneous probing, she gave up and called for The IV Team.  (Kind of like the A-Team, only, you know, for IVs.  Rachel has never seen the A-Team.  Makes me feel old.)  But as the IV team was about to poke him again, Garry the NP arrived and said, Stop!  I could tell he was pissed.  "I didn't ask for an IV in him!"  What he had done was express regret that the earlier IV had been taken out, in his opinion prematurely, but "you don't put an IV in unless you need to use it.  He doesn't need one right now."
Nurses are only human and as NICU mistakes go this was relatively benign, but we are going to request that Nurse Incompetent not be assigned to Isaac again.  Rachel didn't think it was worth complaining about for tonight's shift but once was more than enough.
(Later, after taking Rachel's expressed milk to the fridge, she got out formula to feed him.  Rachel caught her and reminded her to use the breast milk.  This woman just did not bring her A game tonight.)
[Rachel commentary:  She also kept putting the diaper over the umbilical stump rather than folding it below the navel so that the cord stump doesn't become contaminated with urine or poop.  Twice I fixed the diaper after she changed him.  The next day we talked with the charge nurse and requested that that particular nurse not be Isaac's nurse again.]

What happens when you don't fill your days with make-work

Rachel started a conversation with Rygg's nurse for the day about her son.  We ended up talking about the fantasy novels he (and she) likes.  She pointed me at one in particular, whose author blurb on Amazon reads, "Christopher Paolini’s abiding love of fantasy and science fiction inspired him to begin writing his debut novel, Eragon, when he graduated from high school at 15."
"I bet he was home schooled," I told Rachel.
"Actually, you're right," said the nurse.

"Little Chow Hound"

That's how Isaac's nurse described him after she fed him at 9 pm last night. He downed 3 oz easily and probably would have eaten more if she'd warmed it up. I came in at midnight and he nursed enthusiastically on one side. Probably got about 3 oz then too, judging by how little I was able to pump on that side afterward compared to the other.

His color looks fantastic! Even just 6 hours earlier when I had left him he was pale, pale. He is now a lovely rosy color. They took the oxygen off of him too, because he's able to maintain good levels on his own. An hour after his midnight eating, his sugar level was 195 which for him is pretty good! The results of the pancreas ultrasound came back normal. At least his pancreas looks normal, if only it would act normal!

I'll return in a few hours and hopefully catch his doctors during the morning bedside rounds so I can listen in on their ideas and game plan for him.