A day in the life of a nurse

A day in the life of a nurse

staff staff

JANINE RUNDSTROM WITH A PATIENT

LAUREN HICKS

Janine Rundstrom did not
attend college for four years to
scoop poop out of a diaper, but
that is what she finds herself
doing on at a quarter to 5 p.m.
on a recent spring day. She is
standing in a room, not much
larger than a closet, that reeks
of human waste and is labeled
‘soiled utility.’ Janine weighs
the diaper, uses a tongue
depressor to scrape some of the
poop into a sealable plastic jar,
and bags the jar. From there,
she exits the room, places the
sample in a large plastic tube
that hermetically seals, and
places the tube in the wall
behind the main desk. It will be
collected for testing later. Thus
concludes the most unglamorous
part of Janine’s dream
job.
Janine, 26, who graduated
from Holy Family University
in May of 2007 with her bachelor’s
degree in nursing, began
working at the first place she
interviewed at out of college.
In October 2007, she joined the
staff of over 400 pediatric
(children’s) nurses at St.
Christopher’s Hospital for
Children, located just outside
Center City, Philadelphia.
Opened in 1875, St.
Christopher’s is one of the oldest
children’s hospitals in the
nation. In 2009, the hospital
achieved magnet status from
the American Nurses
Credentialing Center, meaning
the hospital’s nurses go above
and beyond the basic standards
for patient care. The hospital
receives thousands of applications
every year from across
the country from medical students
hoping to be one of the
24 new doctors chosen to serve
their residency at St.
Christopher’s.
Today, Janine’s long, dark
blonde hair is tucked into a
bun, so little children can’t pull
on it. She is wearing standard
nursing scrubs: a dark pink
shirt and black pants. Her nursing
clogs match the pants and
the headband matches the shirt.
Her nails – kept short because
short nails are easier to clean
and less likely to seriously
scratch a child – are a playful
julep green. She looks every
bit the young, fresh-faced
nurse she is, and this may be
one reason why her patients
are comfortable with her.
Janine’s shift began at 7 a.m.
alongside fellow RN Becky
Sandhu. For the most part,
their work takes place in a single
hallway (called a ‘pod’ by
hospital staff) on the fifth floor.
Their area specializes in general
care for babies and toddlers,
but they do see older kids as
well. In fact, today one of
Becky’s patients is a young
teenage girl with allergies.
The station the nurses sit at is
located at the center of the pod,
and is home to a desktop computer,
patient monitors that
constantly beep in irritating
tones, and stacks of medical
files. The hall is sometimes
crowded with blue laundry
bags full of the dirty sheets of
the last patient to be discharged,
making navigation
somewhat difficult. The lighting
is classic hospital florescent
and everything smells like
cleaning chemicals. Hand sanitizer
is mounted on the wall
outside each patient roomhousing
one or two patientsand
nurses must use the sanitizer
both before and after handling
all patients.
The environment these nurses
work in would make most
people very uncomfortable.
For the nurses, however, the
major source of stress comes
not from the environment but
from the doctors. At 1:30 p.m.
Janine is examining a patient
chart. A look of confusion
crosses her face. “Part of my
day is trying to figure out what
the doctors write.” she
explains, only half-joking. In
this case, she is truly stumped.
She passes the file to a nurse
from another pod who came to
see her. Eventually, one of the
nurses will call down and sort
out what the directions are. For
now, Janine will focus on what
she
can do.
Janine currently has five
patients, the maximum for any
one nurse at a single time, but
she is ready to discharge one of
them. Her patient, a pre-teen
girl in for asthma complications,
is being sent home on
medication, which Janine tells
her to take “twice a day for two
days.” She reads a list of contributing
factors to the girl’s
mother, and instructs the mother
on what symptoms should
prompt her to bring her daughter
to the emergency room.
Janine also tells the girl, who is
on regular asthma medication
but forgets to take it – which
probably contributed to her
hospitalization – that it is
important to take her daily
medication and that she should
take it whenever she does
another regular task, like
brushing her teeth before
school in the morning. This
illustrates one of the special
problems nurses face when
caring for children that they
may not face when caring for
adults, as well as the creative
way the staff at St.
Christopher’s seek to solve
such problems.
For example, whenever
something painful has to be
done, such as the insertion of
an IV into a child’s vein, the
child is taken to a ‘treatment
room’ whose sole purpose is
for carrying out such tasks. By
taking children out of the room
they are sleeping in and into
this separate room, it prevents
the child from associating their
patient room with pain. The
hospital staff wants the patients
to feel their rooms are safe
havens.
Janine herself has seen her
fair share of child-unique problems
in the past few days. She
has had several toddlers and
babies who cried when Janine
placed their IVs in them. No
matter how afraid of needles
they may be, it is unlikely the
grown men at regular hospitals
would wail in the same situation.
Likewise, it is unlikely
that they, after watching too
much WWE, would try to
wrestle with her as she tried to
place the needle in their arm,
like one young toddler recently
did. But Janine does not hold a
grudge: when the same boy
was scheduled for an MRI, she
coordinated with the hospital’s
Child Life Specialist to
demonstrate to the tot what
would occur during the procedure.
One of the hospital’s
interns made a small version of
an MRI machine, large enough
for a doll, which the child can
place in the machine. The child
can pretend to be the doctor
performing the MRI, and by
relating the real MRI to a pretend
MRI, some of the child’s
fear can be alleviated.
There are emotional differences
when caring for children
as well. Often, while a nurse is
trying to care for one patient, a
patient in the next room with
be bawling, which can be very
distracting. Many of the
patients who come through the
halls are could be very sick,
like the male toddler Janine is
caring for right now: he was
admitted with a temperature of
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