Pediatric ERs; theory into practice
Tue, 05/02/2006
Even before it happened, I knew that the odds of an eventual emergency room visit for my newborn son were good. I'd done some research recently - 41 visits for every 100 kids each year was one published count. But I really didn't expect it to happen in the wee hours of the fourth morning of his life. My husband had fallen asleep putting our two year old to bed that night, so I didn't bother getting up every two hours when my alarm went off. I'd just switch on a lamp, slide little Zaid from his co-sleeper to our bed, check the diaper, wave him around in the air a bit and by then he would usually be awake enough to latch on and nurse. Of course, this wasn't enough to get my brain into gear, so it took me until the 4 a.m. feeding to realize that I hadn't actually had to change his diaper in quite a while. As in, it'd been since well before bedtime. When the after-hours nurse returned my call about this at 4:30, she informed me that yes, eight hours with no output could be a problem, especially since our son had been born with a bit of jaundice. And yes, we should take him to the emergency room.
My heart sank. It'd been a secret goal of mine that Zaid would make it longer than six days without a trip to the ER - day six was his sister's first trip there, also jaundice related. I tried not to let my voice break as I answered the rest of the nurse's questions. When I said he was born at the UW Medical Center, she told me to take him to the emergency room there - that's where his records would be.
At this, my left brain woke up with a start. When I'd researched pediatric ER's just two months ago and our pediatrician's office made very few specific recommendations. But among them was: don't take them to the UW emergency room - they're only a stone's throw from Children's Hospital so they don't usually deal with kids. "Of course they take kids," was the nurse's curt reply. She allowed that the records could be sent to Children's, eventually. The nurse didn't seem to have any other basis for her advice, so I said we'd go with our pediatrician's recommendations. She ended the conversation with an exasperated-sounding "I'm not going to argue with you."
For a moment this reproach left me shaken, doubting myself. I'd just rejected the specific instructions of a medical professional. But my next emotion was a rush of she-bear adrenaline. It felt like a primal mother-wit, but it had everything to do with my research, completed in the light of day with no emergency at hand.
It probably wouldn't have been dire - this time - not to be at the best pediatric ER in the region. Zaid had let go with the flow three times by the time we got home, including once on the triage nurse. But would there have been an upholstered rocker and footstool in the exam room, or a TV/VCR and a stock of children's movies? Would our toddler have a good-quality teddy bear as a souvenir, presented when the head ER doctor came in for a final check of her baby brother? And would the doctor in charge of an ordinary emergency room say, upon entering an exam room, "Oh, you're nursing him - that's the most important thing, I'll come back in a few minutes."
That was my lesson from this experience: know all you can about your 'most important thing,' and find others who do too.
To read Alouise's February 2006 column on pediatric emergency facilities, search the archives at www.ballardnewstribune.com. Do you have a parenting question or comment for Alouise? Send an email to bnteditor@robinsonnews.com with parenting in the subject line.