Senior Nurse Mentor

Boys Under Siege

If you’ve wondered what my teen patients looked like, here’s one of them. He was terrific guy whose back surgery was so risky, the surgeons told him he had a 50/50 chance of ending up paralyzed. Needless to say, I was impressed with his courage and upbeat personality.

As you can tell from the picture, all went well. That was in part thanks to that halo traction, which he could use equally well in bed or out. Screws spaced a few inches apart extend inward from that metal ring into holes drilled into his skull. One of my tasks each day was to do his infection control. 

He also illustrates of what I experienced far more rarely than I would have liked on the teen unit, friendship with its teen boys. To explain that requires some background.

Caring for sick children invariably comes with fears attached. My entire time at that children’s hospital, I never let go on what might be called the Great Fear. That was the possibility that I’d do or fail to do something that would result in death or injury to one of my patients. That was a constructive fear. I used it to drive myself to work hard and improve my skills.

But there’s another fear that comes with starting a new job and might be called the First Fear. It’s something that is not necessarily a constructive. It is often best set aside, since it distracts from what matters.

For Hem-Onc, my First Fear was that my young patients would become terrified of me. I’d seen that happen on day shift during my orientation. With my short white tunic, I’d go into a boy’s room and he’d smile. Then a medical technician with her long, white coat would go in, and that same boy would scream. The boy had learned to associate that long, white coat with the pain of a blood draw.

Working nights on Hem-Onc meant that, like that technician, I was closely connected with a child’s painful experiences. Would he or she cry or scream when I came into their room? It wasn’t a pleasant thought. I had to go into each child’s room a dozen or more times each night. I didn’t want to be seen as a monster on the prowl.

Like it or not, I was connected with pain and pokes. Until we began to use central lines almost exclusively, patient care on Hem-Onc often meant a new IV every two or three days, with me holding while the nurse poked. Even after that became less common, my work still included the horrors of chemotherapy. The timing of our 24-hour infusions often meant that the dose reached toxic levels about one or two in the morning, resulting in vomiting. When that happened, I’d be with the child, holding a small bucket and trying to offer what little comfort I could.

As much as I hated, it, I had a reason to hold that bucket. I did it so a child’s parents didn’t have to do it, sparing them from being linked in their child’s mind with all that suffering. “Better me than them,” I thought. Parents agreed. During my entire time on Hem-Onc, I never heard a mother or father say, “No, we’d rather do that.”

But would that bad experience mean that these kids began to fear and even hate me? That bothered me. After about a month, however, I realized that my First Fear was groundless. By some marvelous mental magic, those children didn’t connect their suffering with me. Even babies seemed to put the blame where it belonged—on their sickness.

That was wonderfully freeing. Starting with my first night on Hem-Onc, I’d resolved to like my young charges and do my best for them. But fear and love don’t mix well. Fear of being rejected can keep us from loving as we ought. Now that I knew that I need not fear rejection, I could relax and focus on caring for those kids. They’d smile when I came into their room, and that felt great. I must be doing something right, I thought.

When I began carrying for teens, I faced a different First Fear. I’d transferred to get away from that war between nurses with little thought for what I was plunging into. One of the first things I noticed when I began working with teens was that I had three different patient populations.