Pediatrics

Winter lingered, and I felt the coolness of the air enter my nostrils as I walked, giving my nose a familiar pink hue. I inhaled the clean morning air, noting the snow crusted grass in the distance. I quickly checked my appearance in the window of the approaching building. Things were changing again. Only this time, they were welcomed changes. Changes I had worked towards for quite some time.

I nervously adjusted my turquoise scrub top under my jacket as I entered the building. I wanted to look just right.

Today was the day I would begin my career as a registered nurse.

I was so excited, having completed clinicals in a variety of settings. General medicine. Obstetrics and gynecology. Surgery. Oncology. Geriatrics. There was however, one particular area that peeked my interest above the rest.

Pediatrics.

I loved kids. I had been babysitting since I was eleven years old. And as soon as I began my clinical rotation on the unit, I fell in love. It was an infant toddler unit, meaning birth through five years old. There were kids with tubes in their noses and IVs in their arms. There were children requiring surgeries for a variety of conditions including pyloric stenosis and Hirschsprung’s disease. There were colon resections and hernia repairs. There were babies born addicted to the drugs their mothers consumed who were in need of careful weaning. Their piercing cries were unlike that of any other child.

There were respiratory viruses and asthma attacks where parents and staff alike fought tirelessly to raise oxygen levels in tiny constricted lungs. There were allergic reactions and fevers of unknown origin. There were pinworms and bodies covered in scabies. And there were cases of sexual abuse and neglect, often occurring in children under the age of two. These sweet ones, unable to speak for themselves, were particularly vulnerable to abuse of all kinds.

And it was all I could do not to become attached to each one as I learned how to bathe, dress and feed them during my clinical rotation. Something in me wanted to help. I knew these kids were strong. But I also knew I wanted to, in some small way, be a part of their story.

My instructor had taken a liking to me during my rotation on the unit, and upon graduation I was accepted as a staff nurse. It was a hard adjustment on many levels. Starting my career was certainly intimidating, as I now had people counting on me. Tiny people counting on me. And parents with wide eyes, looking to me to do the right thing. And worse, say the right thing. More, I didn’t know how my body was going to respond. As hard as I had worked to get through school, I had yet to complete a twelve-hour shift, and I knew these would be the bread and butter of my new-found career. I figured I was a hard worker, and I was determined. My body would surely follow suit.

It had to.

I grabbed my list of patients on that first day and nervously punched the code for the med room. I told myself I had done this many times before. I watched anxiously as another nurse drew up her meds, knowing I was next in line. The thing about pediatrics is that you had to be somewhat good at math. There were many calculations, as the majority of the medications to be administered were weight based. And an error in calculation could be fatal.

I swallowed hard, trying not to overthink things, reminding myself I had earned the right to be here. Earned the right to care for these little ones. Just as much as any other nurse. It was a strange dichotomy in those first few weeks, wondering, as I brought an absurd amount of juice boxes to patients and their families, if I had set the bar all too low, while simultaneously hoping and praying that I wouldn’t inadvertently kill someone later while administering medications.

As the weeks passed, my initial fears were assuaged, and any remaining apprehension was quickly replaced by a new-found confidence and sense of routine. I was eager to learn new skills, knowing there would be much on the job training. It seemed with each newly dropped nasal tube and each newly placed dressing, I was in some small way, proud of myself.

And proud how far I had come.

I hadn’t give up yet.

And while this wasn’t the dream I had set out to do from the start,

I was still here.

Those first weeks passed quickly. My shifts, like those of many new nurses, were not ideal. I was placed on a rotating schedule that included working one week of days followed by one week of nights. Weekends and holidays were also included. It was hard on my body. Harder than I wanted to admit. My joints had begun to ache again, and the fatigue was written all over my face. I wasn’t responding well to the change in shift work, and I could feel it.

But what choice did I have?

I told myself I would get used to it. Used to the schedule of it all. I just had to give it a little time.

But the shifts were busy. It was spring time now, and the units were booming with patients. I had been told many nurses become quite ill within the first year of working on the unit, having been exposed to a variety of illnesses. One had to “build up an immunity”.

But what would that look like for someone like me?

Was I going to get very sick?

I swallowed hard as I parked my car that evening. I hated taking the shuttle into work, but it was getting darker, and I knew I had little choice. It felt like an event just getting to the hospital building, often leaving me fatigued before my shift had even begun. As I neared the unit, I quickly pulled my hair up in a ponytail, telling myself I would drink some coffee and that things would be okay. Promising my body that I would feel better. And that it wouldn’t always be this hard.

But for now, I knew I needed to focus. There were children, most of whom were far sicker than I, who needed to be cared for. There were vital signs to be checked and intravenous bags of food and fluids to be hung. There were assessments to be made and oxygen levels to be monitored. There were dressings to be changed and tubes to be placed. More, there were medications to be given and all too much paperwork to complete.

Later that night I sat in the doctor’s lounge under fluorescent lighting with two other nurses dressed in flowery pink and blue scrubs. We sat around a large rectangular wooden table, each with a chart or two open, attempting to complete notes on our patients for the night. I found charting to come fairly easy and without much effort. And as such, I often found myself curiously listening to the doctors from across the room as they discussed cases. Who were they talking about and what diagnoses were being made? I found myself drawn to them, secretly wishing I were a part of their team.

I had hoped as I began my career in nursing that I would be able to more fully let go of my dreams for becoming a doctor. But as time passed, I found a growing part of me ached bitterly, as I recalled the horrid thin envelopes that had been delivered in the mail all those months ago.

“No, it could have been different.” I told myself.

I could have gone out of the United States for medical school. But that was a risk I just wasn’t willing to take. Not with my health history. Even still, as much as I loved being a nurse, there was something in me that, as much as I tried to deny it, wanted more.

A few moments passed, and I watched as my pen rolled off the table. I quickly bent over to pick it up, noting a sharp pain in my right knee. I reflexively braced my leg as I sat up, noting it was swollen to the touch. I exhaled, recalling the exhaustion I had dismissed not a few hours early. My frivolous doctor thoughts were suddenly dispelled, as reality was setting in.

I was sick again.

And getting sicker.

Despite my best efforts, lupus was not going away.

And to my fear and dread, I needed to talk about it.