Wednesday, February 27, 2008

The Nurse as Ogre

I enter the exam room with a tray in hand and a smile on my face. The tray holds four vaccinations, and my smile is a nervous one, since I know that in a few short minutes, the child squirming in her mother's arms will hate me.

"The doctor sent me in to give your daughter her shots," I say.

"Yes, she told me. Can you give her some Tylenol too?" the mother asks.

"Oh, yes, I have some here for her." I give the baby some Tylenol, and already she's eyeing me with suspicion.

"Here's some information on the vaccines. Do you have any questions?" Sometimes I hope the parent will refuse the vaccines, just so I can be spared the trauma of administering them, but my trauma is nothing compared to the child's.

I ask the mother to lay the child on the exam table, and now the baby starts to cry because she knows that something unusual is about to happen. She can also probably pick up on Mom's fear and my tension, and by now the child is gripped with terror.

Giving four or more vaccines at a time is always a drag. First, if the child is already walking, we like to give the shots in the arm so that he or she will not be discouraged from walking due to pain, but those young deltoids are so small. If the child is not yet walking, we go for the large thigh muscles, but I'm no fool, and I know that even if they're given in the leg, these vaccines burn like a really bad bee sting, at best.

When I clean the baby's thigh with alcohol, she begins to scream. And I mean blood-curdling. My stress level is already probably high because we just had an 11-year-old autistic boy pinned down in another room in order to give him a shot and draw some blood. He was strong, and he pulled his mother's hair so hard I thought he would rip it from her scalp. The vaccine was fine, but we couldn't draw his blood since he moved so much.

Anyway, the baby is screaming, and I still hear echoes in my head from the caterwauling autistic boy. I steady my nerves, and I give the baby two painful injections in each thigh, about 1 or 2 inches apart. She screams some more, and I apologize profusely and hope that she won't be deathly afraid of men with goatees forever. Maybe she will.

This ogre business is truly awful, and I leave the room feeling bad. These Tuesday nights at the clinic are no fun, and with two pediatricians working, there's no escaping the old vaccine drill. I make a mental note to ask Mary to remind me not to work Tuesday nights anymore----Thursdays are so much more preferable with the lack of pedi providers.

There are just simply things that some nurses hate to do. For one, it's tracheostomy care. For another, it's wounds. For me, it's vaccines on little kids. I just hate being an ogre, and I'd give anything to lay that mantle down once and for all.


J.D. Long said...

Personally, for me it's disimpaction, or explosive diarrhea. I don't remember reading ANYTHING about those in the Nursing School brochure.


Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

LOL! Yes, nursing schools, by necessity, paint a very rosy picture indeed. They also never mention sputum.....

Anonymous said...

I have sometimes wondered if the widespread fear of needles that kids frequently sport is linked to the fact that very early in our life, we get several muscle shots (the vaccines you mentioned). Our first experience with needles is at an age where we can't understand it all, involves one of the most painful needle sticks, and involves products that just make us feel worse in the short term. It wasn't until high school that I remember getting a shot in a vein and realizing that needles didn't have to hurt.

That said, I'm glad that people like you are willing to suffer through giving shots like these to keep our children healthy.

Keith "Nurse Keith" Carlson, RN, BSN, NC-BC said...

Thanks, Sean. I am actually avoiding working on the nights that a lot of kids are seen since I find administering so many shots is traumatic for me as well as them!