Not for the Faint of Heart or Weak of Stomach...

It's probably best not to read this unless you're a health professional or have a strong stomach.

Last Saturday night, I worked an inpatient psych shift. This time, I had the teeny kids (5-12); I rarely work on that floor because with little kids, the less change they have, the less angst they feel. Little kids like and need consistency.

Most of the kids were in the 5-8 range, and were LITTLE, about the size of kindergartners. A lot of kids in this age group haven't even gone to sleep-away camp, yet some of these children will be here for weeks or months without going home. It's a small unit, too, so it only requires one nurse and one tech.

The first 10 to 15 minutes of the shift are given over to report -- the outgoing nurse gives a brief overview of each child, so that the incoming staff members know what to expect. Along with all the usual stuff (early risers, potentially violent, potentially difficult if awakened), there was a report of a child who had painted a wall with feces. Unusual (though not unheard of).

The tech I worked with is a big and tough person who mainly works as a security guard, and has a hard time morphing from guarding to guiding. Why this person was assigned to this unit is beyond me, but mine is not to reason why...

The first half of the night was uneventful; we got our paper work done. The tech wanted to watch a movie (which really isn't permitted) and was a little irritated that I said no. Then the fun started.

One kid got up and asked if she could move her mattress out to the hall because her roommate was "stinky"...and since I had been smelling the flatulence from the nurses' station, that was OK by me, so I helped her move her bed. About that time, another kid, a tiny blond touseled hair boy (who weighed maybe 40 pounds), came up and told the tech his stomach hurt. His pants were soiled, and he admitted he'd had an "accident" in his bathroom...then clutched his stomach and ran to another bathroom and had another "accident" on the floor. The tech was irritated, with raised voice and angry face -- probably thinking of the feces painting kid from report.

Of course the kid was terrified. He was wearing the hospital supplied pajamas, which were way too big, and he hadn't been able to get them off, so the poo had just kind of gone done the pant leg and puddled on the floor. The tech didn't realize this and I finally just sent her off so I could help the kid.

I have to say that I have never seen so much poo out of one person in my whole life. The two piles together looked about the size of the kid, not to mention the stuff on the pajamas. Plus it was horribly stinky (worse than the flatulent kid) and yellowy green (see, told you not to read this) and not quite liquid but not really solid either (and yet you decided to continue reading! No lunch for you!).

Between this and the flatulent kid, my guess is there's a viral something or other on the unit. I hope the MD read my note the next day.

Trying to get the kid undressed, get him showered and still preserve some of his modesty was well nigh impossible, but I did the best I could. THEN, the only pajamas I could find to put him in were the adult sized pajamas (why were they even ON this floor??), but they were better than nothing...and he said his stomach felt better (why shouldn't it? There was nothing left in any of his digestive tract!) and he went back to bed.

The tech did not want to clean up either bathroom and I couldn't see waiting for housekeeping because the smell was so intense that the entire unit was already permeated with it. So I put on some gloves, got towels and cleaned both bathrooms.

Oh, it was AWFUL. Worse than anything in or out of nursing school, even the repiratory stuff I hated. I could not keep from gagging, and my eyes were watering. The poor kiddo got out of bed and watched me unnoticed and then tentatively asked, "Are you OK?" I looked at him and he had that bigeyed, scared look on his face that my kids always had when they accidently broke or spilled something and (mistakenly) thought they'd be in trouble. I suppose he thought I was angry with him, but I just said, "Sometimes bad smells make me a little sick." And he thought about that, and then relaxed and nodded. And went back to bed, and slept.

Some parents (and I hope they are the minority) act just like the tech-- things that aren't the child's fault are treated as punishable offenses. Little kids have dignity, too, and are ultra sensitive to the adults around them -- they have to be, because they are dependent on adults for everything -- their food, clothing, emotional needs, shelter...

To be fair, the tech is youngish, has no children or SO, and is well suited to the security guard job. Unless some changes take place, though, I hope that tech doesn't work on that floor again. That attitude may be tolerated by adults or older teens, but it does not work with little kids. They really don't understand the irritation or frustration of adults and are really much better off with firmness and loving kindness.