’Twas a bit rough last night. Olivia cried whenever anyone came near her; the first time this has happened consistently. I’m sure the the nurse didn’t feel too great about that.
This morning’s X-rays came back with a bit of swelling from yesterday’s surgery, but seemingly nothing out of the norm. Blood work was drawn again this morning, but they returned some slightly off values. More blood, calcium, and platelets are being given.
She is very sensitive to having the chest tubes emptied. To do this, the flexible tube is held with one hand at the end closest to the body while the other hand pushes the blood away from the body and down into the collection unit. This creates vacuum pressure inside the abdomen and can be painful if done too quickly. Releasing the still hand slowly is the key to not increasing the pressure too fast.
They wanted to move her to a regular room, but I discussed my concerns with moving her too quickly. I’m trying to finagle one more day to have more focused and constant care in Pediatric ICU. Some of the issues that have arisen over the last several days have done so quite quickly. I feel more reassured in a “constant care” type of environment with one-to-one care than I would on a floor with one nurse for four or six patients.
I have fallen into a pattern of discussing two issues with each nurse at the change of shift: (1) Keep pain medications on a steady schedule so her pain doesn’t get overwhelming, and (2) cluster the care whenever possible. If respiratory therapy and radiology are coming soon, and the nursing assessment must be done around the same time, I'm trying to get them to all come in at the same time rather than interrupting several times over several hours. If they can, they are more than willing to work with that request than most people think.
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