Exploring Resilience via Lifes Burning Issues

Category: Thoughts (Page 27 of 46)

Rush hour

Welcome to part two of observations about the things that have been observed during years of coming and going from a children’s hospital, part one was on watching and learning

 

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The corridors and rooms of the children’s hospital are like the highways and byways.
There is peak hour, bottlenecks, tow trucks and everything else you would expect.

When is Peak Hour?

Well that depends… there’s peak hour when you would expect it… that 9am start causes chaos in the car park,the corridors become jammed with people navigating their way to the various clinic appointments in the different parts of the hospital. There is the usual stream of high volume traffic throughout the day and then the afternoon peak and then…… there is the corridors that look like ghost towns in the middle of the night.

Speedsters and bombs

The corridor traffic is just like the road traffic.There are the zippy little speedsters.. able-bodied people who are in a hurry to get where they have to be, and they duck and weave in and out of the other traffic. There are the beaten up bombs… wheelchairs that their owners have outgrown and look like they are held together with tape and wire (WHY kids need to get to this point with their equipment is a WHOLE other issue that I will address sometime later in another post). There are the one’s doing 40 km/hr when everyone is trying to 60… but that is because they are little kids trying to navigate around with a big pole and lots of pumps and lines and wires attached.. so there is no honking at them, or “road rage” to get them to speed up.

Trucks and tow trucks

Then there are the semi-trailers and/or other assorted trucks…. the beds being moved around by the tow trucks (the porters who are always on the go.. and who are generally characters like Joe.. maybe I’ll write a post about him?), as they move kids to or from surgery to wards, or to or from wards to places like x-ray, or as has been the case too often in my families experience to or from the Intensive Care Unit. The other type of trucks are parents coming in with arm loads of bags.. you know these are the families of kids who are coming for a long stay… generally frequent flyers. Or the parents leaving with that same load of bags.. the long stay is over. The other overloaded parents are the ones leaving with a bag loads of stuffed toys, cards, flowers/balloons etc These are generally the parents of kids who are experiencing their first hospital stay. I look at them and hope that this stay hasn’t been the first of many and that they are lucky enough that this is their first and only major stay… but I know for too many of them that is not the case.

The afternoon peak

Peak hour is different in different parts of the hospital. The PM peak hour is a bit like the usual one on the road… a mass exodus of people leaving the clinics, the road outside becomes clogged. At this point the traffic in the hospital shifts as family and friends all come visiting, the corridors and alcoves become quite noisy and all of the traffic is headed into or out of the wards. Like the peak hour on the roads this one lasts for a couple of hours and then fades away.

The fading of this peak, coincides with the start of the peak in the emergency department. The emergency department has a steady stream of kids coming and going throughout the day, but when evening hits the waiting area in the emergency department begins to burst at the seams. As parents have returned home discussed little Johnnies high temp, and cough, etc etc and they make a decision that little johnny is really very sick and needs some attention. Thankfully the vast majority of these little johnny’s have things that are easily treated with bit of panadol and making sure they get fluids in with gastrolite drinks or iceblocks… things that could have been dealt with by a local
GP and avoided the wait of hours in the Emergency Department waiting room…

This burst of activity for little things that could have been dealt with away from the hospital really gets up a lot of people’s noses. I take a different view.. for most of the parents you see there it is probably the first time their child has been sick to the point of creating concern, and like with the “semi-trailer” parents, I hope that it is their first and only experience of the hospital.

Ghost town….

Once you get past a certain time in the hospital.. in my experience generally around midnight / 1 am the hospital becomes eerily quiet.
Quiet except for the hum of breathing machines, feed pumps and other assorted machines keeping kids going. As a parent who is unable to
sleep walking the corridors after this time, like in the picture for this post, the corridors are long, quiet and the place can feel like
a ghost town.

More observations to come in part three….

 

Always watching and learning

Samuel in Intensive Care Unit

This post is being written sitting bedside in the Intensive Care Unit at the Childrens Hospital…. It’s the second time we’ve been here this year and our seventh time overall  (read this if you want to know the background to how we got here).

I’ve spent the past three days watching Samuel, watching the numbers on the monitors, asking questions etc etc etc…..

But I’ve also had plenty of time to sit here and think about the experiences of being in and around this hospital and the things that I’ve seen and heard in five and half years of being back and forth.

The things I’ve observed are things that go on…..

from minute to minute

from hour to hour.

day to day

week to week

month to month

year to year……..  I’ll share them as a series of observations, so here goes with part 1.

The soft shoe shuffle

The soft show shuffle goes on, on. It consists of all those soft soled shoes that the nurses wear, constantly coming and going. The tempo of the shuffle tells you a lot about what is happening at any given period of time.

The hurried heavy foot steps when a child’s monitor goes into particular types of alarm, or an emergency button is pushed.

The calm stop start as they accompany a child on a walk through a ward.

The tip toe shuffle as they quietly move about in the middle of a night shift doing their checks.

The Tribal Dance

This is a unique ritual that occurs within the hallowed halls of a teaching hospital. The alpha doctor patrols his or her turf with a sense of confidence and ownership, followed by a tribe of beta’s (the registrars) and pack (the residents). They perform their own version of unique rituals as they come to see a child, depending on what specialty they represent.

It’s an interesting dance routine to follow, especially when you have a child that has quite a few of these tribes involved in their care.

Negotiating the dance can sometimes feel like needing to be an international diplomat, the different tribes are concerned primarily with their “patch” of your child, and sometimes don’t think (or appear not to think) about the implications of their directions on the other tribes and the treatments they have already planned.

The diplomat part comes by coaxing them to make smoke signals to the other tribes… OK smoke signals might be a bit off, you know what I mean EMAIL the modern equivalent of smoke signals, and sometimes having to do some translation between the tribes. [ to be fair the tribes do a bloody great job ]

There is also another big challenge in this tribal dance….. the tribes are pulled apart and re-assembled every three months….so after spending three months becoming educated in a particular specialty.. the beta’s and the pack get to go back to scratch and begin working up a working knowledge of a new specialty area and then…… every year members of the pack become beta’s, some of the beta’s become alphas (or go off to practice elsewhere).

Parent also play a big part in the education for the tribes. Parents of complex kids help out regularly by doing “case studies” with the pack and beta’s as they prepare for progression with the the tribe. Giving them a chance to practice getting a full history and thinking about how they would come up with an overarching treatment plan for your child. Practice for their exams as Pediatricians.

Getting them to remember that the parent they are dealing with is the EXPERT in the child they are seeing is a big part of the education process.. sure they have a six year medical degree and a certain amount of practical experience and they may be the expert in a particular field of medicine… but the parent (and/or the child depending on the condition and age etc) are the EXPERTS in how the disease, illness, infection etc is affecting THIS child.. and again to give them their dues the vast majority of the doctors have learned this by the time they assume a Beta position within the tribes… those that don’t, soon become a nightmare for parents, but thankfully this experience has been rare.

 

More to come in Part 2…..

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