An interesting day for so many reasons....
First after the rain (there was more during the night) then add the heat & what follows bees & mosquitos...I am 100% sure I left my bug spray on my dresser at home but fortunately we haven't had too many iin the PACU they are all mostly in the hallway & patient rooms because of the open windows. always something new :)
Before the day started we went up to Pre Op to see some of the patients we will have today and then went down to the post op area to see all the patients we did yesterday...Ramon was dressed up in a blazer & sunglasses all ready for a new life!!!
We again had all lips for our 1st round of patients which can give you a false sense of security. Today was definitely one of those PACU days where there are moments of calm & then times of chaos - the chaos seemed to win today. The 2nd round of patients were all palates - most of them 2-3 years old & wild ones at that - someone walking in may have thought we were having a screamathon. The local nurses prefer not to give as many pain meds & it is not my roll to change their practice & usually the kids do settle down but I am more apt to medicate just a little - so I have altered things a bit when working as a team.
Manuel one of those palate repairs who was 3 had a tough day - some bleeding, some respiratory problems, ...we had to suction him, give a variety of meds, gave 3 respiratory treatments - he really required full on critical care needs. He stabilized out & we sent him to the post op ward about 1:30 but they were uncomfortable with the care he needed so he came back an hour later & we kept him til 6 & in those last 3 hours with alot of work we got him all spiffed up so that he was drinking juice & waved good by as he left us.
By 2 pm we had only finished 12 cases & has 18 to go...things just seemed to stall out then came in steadily. We usually start & end the day with lips & all the palates are in between. One palate William was an add on palate for today - he had a "story". His mom had 7 children from 3 to 14 (he is the youngest) but she left them & went back to Argentina. I heard that the 5 older ones were scattered in homes & a very sweet woman had William & the next older one. William's left arm has been amputated just before the elbow...the "shelter mom" said it was due to an infection that wasn't treated. With tears in her eyes she said he is a "perfect boy" - what a saint of a woman - I was touched by her generous heart.
Near the end of the night we had 2 bilateral cleft lips - so their defect is on both sides of their nose...both 10 months old a boy & a girl. I got photos with them before surgery & posted some on instagram & FB. Mia was a tiny 10 mos old because of all the trouble she has had in eating...I connected with her mom at the shelter on the "party day" & then in pre op this morning & later today just before surgery & told her I would be with Mia right after surgery in the recovery room. as always the transformation for a Bilateral Cleft is the most remarkable - Mias mom came in & was SO HAPPY...she did not get teary but was simply OVERJOYED & kept saying to all of us BLESS YOU, BLESS YOU. I have LOTS of photos of her. The 2nd one was Jordan - he had protruding teeth & was also tiny. His mom was very young & when she came in she was completely overcome with emotion & tears which of course then i get all teary. she gave me a hug & held on so tight...
The later patient were all older....and they always make me think of my own kids & how grateful I would be to people who would help them...
As the final group to leave there were 7 of us who got back to the hotel at 10 - not bad....tomorrow is another day 27 on the schedule!!!
First after the rain (there was more during the night) then add the heat & what follows bees & mosquitos...I am 100% sure I left my bug spray on my dresser at home but fortunately we haven't had too many iin the PACU they are all mostly in the hallway & patient rooms because of the open windows. always something new :)
Before the day started we went up to Pre Op to see some of the patients we will have today and then went down to the post op area to see all the patients we did yesterday...Ramon was dressed up in a blazer & sunglasses all ready for a new life!!!
We again had all lips for our 1st round of patients which can give you a false sense of security. Today was definitely one of those PACU days where there are moments of calm & then times of chaos - the chaos seemed to win today. The 2nd round of patients were all palates - most of them 2-3 years old & wild ones at that - someone walking in may have thought we were having a screamathon. The local nurses prefer not to give as many pain meds & it is not my roll to change their practice & usually the kids do settle down but I am more apt to medicate just a little - so I have altered things a bit when working as a team.
Manuel one of those palate repairs who was 3 had a tough day - some bleeding, some respiratory problems, ...we had to suction him, give a variety of meds, gave 3 respiratory treatments - he really required full on critical care needs. He stabilized out & we sent him to the post op ward about 1:30 but they were uncomfortable with the care he needed so he came back an hour later & we kept him til 6 & in those last 3 hours with alot of work we got him all spiffed up so that he was drinking juice & waved good by as he left us.
By 2 pm we had only finished 12 cases & has 18 to go...things just seemed to stall out then came in steadily. We usually start & end the day with lips & all the palates are in between. One palate William was an add on palate for today - he had a "story". His mom had 7 children from 3 to 14 (he is the youngest) but she left them & went back to Argentina. I heard that the 5 older ones were scattered in homes & a very sweet woman had William & the next older one. William's left arm has been amputated just before the elbow...the "shelter mom" said it was due to an infection that wasn't treated. With tears in her eyes she said he is a "perfect boy" - what a saint of a woman - I was touched by her generous heart.
Near the end of the night we had 2 bilateral cleft lips - so their defect is on both sides of their nose...both 10 months old a boy & a girl. I got photos with them before surgery & posted some on instagram & FB. Mia was a tiny 10 mos old because of all the trouble she has had in eating...I connected with her mom at the shelter on the "party day" & then in pre op this morning & later today just before surgery & told her I would be with Mia right after surgery in the recovery room. as always the transformation for a Bilateral Cleft is the most remarkable - Mias mom came in & was SO HAPPY...she did not get teary but was simply OVERJOYED & kept saying to all of us BLESS YOU, BLESS YOU. I have LOTS of photos of her. The 2nd one was Jordan - he had protruding teeth & was also tiny. His mom was very young & when she came in she was completely overcome with emotion & tears which of course then i get all teary. she gave me a hug & held on so tight...
The later patient were all older....and they always make me think of my own kids & how grateful I would be to people who would help them...
As the final group to leave there were 7 of us who got back to the hotel at 10 - not bad....tomorrow is another day 27 on the schedule!!!
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