Blood Pressure Cuffs and Paintbrushes: Insight Gained from Pediatrics

This post was written by Angelica Recierdo, a third-​​year nursing stu­dent with a minor in Eng­lish. She has worked/​studied at many of the major Boston hos­pi­tals and is also a colum­nist for the Hunt­ington News.

Heart­breaking and funny – two words that could be used in a film review for a romantic comedy, or rather in my case, working in pediatrics.

To me, working with the older adult patient pop­u­la­tion for my first co-​​op as a nursing stu­dent was the boot camp of med­i­cine. You’re caring for people at the end of their lives that may be bitter, con­fused, care­less, or a little bit of each. It can be draining and surely leaves a novice jaded or with the toughest skin by the end of it.

So when I accepted an offer to work at Boston Children’s Hos­pital it was a new and exciting ven­ture, a breath of fresh air. I went from working 40 hour weeks con­sisting of rotating day, evening, and night shifts on a huge 30+ bed inpa­tient car­di­ology unit to a comfy and fun 10-​​bed out­pa­tient infu­sion clinic. The biggest strug­gles my new patients faced were missing a day of school, which stuffed animal to play with, and whether their parent was present to hold their hand when the IV catheter got inserted.

The Center for Ambu­la­tory Treatment/​Clinical Research is the offi­cial name for this infu­sion clinic serving patients of all ages, back­grounds, and med­ical his­to­ries. A lot of our patients are immuno­com­pro­mised meaning that they are so severely prone to infec­tion that they need to be infused reg­u­larly with intra­venous immunoglob­ulin (oth­er­wise known as anti­bodies to help sup­port their immune system.) These are the kids that more often times have Purell on their hands rather than Crayola marker.

Another por­tion of patients have some form of Irri­table Bowel Dis­ease (IBD) like Crohn’s or Ulcer­a­tive Col­itis. I’ll never forget one ten-​​year-​​old boy who so openly shared with me that he could not be a fire­fighter when he grows up because how could he save people if he always had to go to the bath­room? (Kids really say the darn­dest things).

We also see a lot of Cystic Fibrosis and Cere­bral Palsy patients as well. Their bodies pro­tected in high-​​powered wheel­chairs, eyes glossed to one side, with either the most con­tracted or most flaccid limbs you’ve ever felt. I try to joke with them and have learned that any kind of response like the flut­tering of the eyes or a tighter hand grip means they’re lis­tening. Chil­dren are always lis­tening and it’s impor­tant to always give them some­thing novel to think about.

I find myself laughing in a new way at work. It’s not forced or awk­ward the way social sit­u­a­tions tend to be when inter­acting with other adults. It’s a gen­uine chuckle, throwing my head back or slap­ping my thigh. I find my voice rising to the next octave, trying to gain a toddler’s trust with one hand wielding a blood pres­sure cuff and the other a paint­brush. So many won­der­fully amusing things happen at a children’s hospital.

For example, to elec­tron­i­cally doc­u­ment vital signs on a com­puter appli­ca­tion, there is an option that prompts the clin­i­cian to choose what posi­tion the child is in during the vital signs mea­sure­ment. The three options are sit­ting, standing, and supine. But it warms my heart that my biggest worry is fig­uring out how to chart such move­ments as dancing, kneeling, crawling, or squirming.

I have learned that it’s impor­tant to always remember the time when a dec­o­ra­tive Band-​​Aid cov­ered up pain, when animal crackers and apple juice nour­ished us, and when a col­oring book was suf­fi­cient dis­trac­tion. Working with sick chil­dren has taught me ways to cope with pro­found stress and how to truly make the best of given sit­u­a­tions. It’s not normal for a five year old to know where her “good” veins are, but that kind of accep­tance and courage is of a cal­iber that is seen much later in life, or in some, never at all.

Angelica is a third-​​year nursing stu­dent with a minor in Eng­lish hailing from New Jersey. She has studied or worked in all the major Boston hos­pi­tals. Angelica is also a colum­nist for The Hunt­ington News (http://​hunt​newsnu​.com/​?​s​=​a​n​g​e​l​i​c​a​+​r​e​c​i​e​rdo)  and enjoys writing cre­ative non-​​fiction.