Work...

90% of the time I'm really pleased and happy when I leave work. Proud of what I've done. Then there's the other 10% when my heart is heavy because I'm thinking about a patient. Before I had Marie I wasn't as emotionally attached to the kids as I am now (especially the babies). There was a mom today. O.M.G. I would guess she wasn't any older than 25 and has 5 kids, all under the age of 7 (3 who are under the age of 3, one of those is 2 weeks old). Lord help this woman. I know how I felt when I had Marie and I was an educated woman and had a reasonable amount of help. But I could see it in her face that she was having a hard time with her life at that moment in time. Her education level would reflect what someone in Junior High might know, maybe because she was sleep deprived or maybe that's just her. I remind you she has had 5 kids total, she claims to have breastfed them all. She brought the baby in today because she is having lots of BM's. I was reading in the babies chart that she is on formula. So in my head I'm thinking "Oh SHIT! What's wrong with this little baby?" As I start to ask my questions I see that the mom is really frustrated and genuinely worried about her baby. Then I ask what the baby is eating. She replies "Pedialyte." I ask "WHY?!" Her reply "I called the ER and they said give her Pedialyte." Damn. Then she tells us she was breastfeeding before the pedialyte. I bet she didn't even tell the ER she was breastfeeding. That OR she just decided to give the baby Pedialyte (in other words she never called the ER, but just said that so she didn't seem stupid). Either way. The next words out of my mouth were "STOP the pedialyte, this is completely normal for your baby because you are breastfeeding." The baby also had a diaper rash, and while I'm talking to the mom the NP student who's with me (who has YEARS of wonderful pediatric nurse experience) is changing this poor little baby's diaper and putting cream on her tushy. AND THEN all of a sudden the baby has a BM and squirts out pure pedialyte on to the exam room floor. The student and I both look at the floor, then at each other, then the mom. "STOP the pedialyte. The baby is pooping pure pedialyte!" Immediately I decide we need to feed this baby some formula. I'm afraid the baby is going to starve! Honestly though the physical exam looked fairly normal expect for the diaper rash. She was a well hydrated (obviously) 2 week old female. Mom was having some problems with the WIC office (which is a whole other story) and couldn't seem to get any formula through them. So we gave her enough to make it for a while especially if she continues to breastfeed. At some point during all this I actually pick up the baby and just hold her. The setting was so stressful. The older child that was with her was running all over the exam room and the middle child was CRYING NONSTOP at the TOP OF HER LUNGS! As soon as we put a bottle in the baby's mouth she drank all that was in the bottle and went to sleep (pooooor baby). Later this afternoon I had a phone call, it's the mother. Crying she says "Jennifer I just wanted to tell you thanks for giving my baby formula. The WIC office was still taking too long so I just left without getting any formula." DAMN YOU WIC OFFICE! I realize there are plenty of people who take advantage of the system and maybe this woman has in the past but right now she has a 2 week old baby that REALLY REALLY needs this formula. I'm still worried to be honest. She's supposed to come back tomorrow. Like I said at the beginning...most of the time I love my job for really good reasons. Today I had a moment where I almost volunteered to take a baby home. I must learn to be compassionate but also have distance.