Tuesday, March 13, 2007

Everybody lies (if only by omission)

I could subtitle this "True Confessions of a NICU nurse" or "Things I Never Told my Children's Pediatrician"

Nurses worry about their kids, sometimes more than non-nurses, sometimes less. Some worries I've shared with the pediatrician, others not.

On the not shared list:

1. Pediatrician: "Does he spit up very much?"
Me: (thinking Not for a kid in my family) No, not really.
Truth: The child spewed after every feeding to the point that I carried towels for burp cloths.
Why not tell? He was my first. I didn't know the pediatrician well enough then to know that as long as the child was gaining weight, he wasn't likely to insist on any unnecessary tests.

2. Breastfeeding 2 day old choked and turned blue with letdown when my milk came in. I never bothered to share this with the pediatrician because the baby had stopped choking by our first office visit 5 days later. I had thoroughly assessed him to be sure he didn't have a murmur or any evidence of aspiration, pneumonia, or other respiratory issues. Also, we'd only had well-child issues with the first one at this point and I didn't fully appreciate the pediatrician's ability to diagnose based on a history and physical exam. IOW, I was still leery of unnecessary testing.

3. Calls to poison control. I can't remember, many years later, whether poison control asked for the pediatrician's name. I expect they did and that he got a report. All 3 times should have given him a good chuckle, they certainly amused the folks at poison control. More on those in a separate post.

4. Child with a history of swallowing objects swallows yet another one. Pediatrician hadn't been impressed by previous events and had simply instructed me on what to watch for. This was one time I should have called. When I eventually mentioned the event to him, he was more than a little unhappy with me. Seems wires from orthopedic equipment are in a different class than small buttons or springs from pocket knives, but he didn't see any point in ordering studies by the time I told him.

I'm sure there are more, but you'll have to wait until they pop into my head.

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