Hello and welcome to PEP Talk. Pediatric Educational Potpourri.  Those dried flower things that smell?  Well, yes.  But also synonyms of potpourri is mixture, assortment, collection, assemblage, medley, miscellany, or variety. And I have a lot of topics I want to talk about. Hence, Pediatric Potpourri. 

I suppose if you've come here for pediatric education I should probably tell you why I'm here teaching pediatric education.  So here comes the awkward intro where I talk about my favorite subject which is me.  Kidding, please admire my attempt at humor to deflect feeling awkward right now. 

I am by no means an expert and still have tons to learn myself.  I'm just someone in a position to share my own experience.  I myself have been taught by many wonderful teachers and its in part because of their roles in my life that I feel even the slightest bit qualified to be able to share the wealth. 

I became a nurse in 2007 and went into pediatrics right away.  I've worked pediatrics since then and went into PICU after a year in Gen Peds.  I spent almost 10 years in PICU where I also got to do CRRT (Continuous Renal Replacement Therapy, aka slow continuous dialysis) and ECMO (Extracorporeal Membrane Oxygenation; aka heart lung machine.)  Extracorporeal= outside the body.  We oxygenated, filtered and circulated the patient's blood on a machine. It was amazing and I was truly fascinated and terrified of it.  I even had looked into perfusion school but realized the jobs were very niche and I would be working mostly in ORs.  I was able to train other ECMO Specialists to help build our team in preparation to starting a cardiac surgery program in our Children's hospital in Arizona and start ECMO programs at NICUs at sister hospitals.  Anyway, if you ever want me to ramble about ECMO feel free to corner me and get me going but I'll move on from here. 

I moved to another state and after just over 2 years in a new PICU, it seemed like it might be time to try something different. From there I transferred to a pediatric Urgent Care (UC) that was affiliated with the Children's hospital.  It was a good test for me to see if I could leave the ICU.  I consider it a good phase in my career because I got to learn a lot about the well-ish kid side and the start of taking care of kids that could walk in with anything, but it made it clear to me I wasn't done with critical care.  I also realized that I would probably need to branch out into adult land. 

I got a fellowship position at the ER near me.  What's the total opposite of Pediatric ICU?  Adult ER.  Whoops and Yikes! Actually my original intention was to go to ICU.  I figured I knew the ICU environment and there would at least be that crossover.  When the recruiter called me she basically said "um, so it seems you don't have a lot of experience." After I politely explained that I've got quite a lot of experience to the non-medical recruiter person, I ended up pulling my application from the ICU.  But it clearly worked out for the better and I'm so glad it did.  In the interview with the ER, the manager said "I've got to address this...usually if someone spends 10 years in one area, that's their area.  Why do you think you want to make such a big change?" I rambled off what was obviously a brilliant answer because she said "I definitely want to take a chance on you." Sucker.  KIDDING!!! I'm so grateful for it because that catches us up to where we are today. 

I work in a Level II Trauma ER that is also a Stroke and Cardiac Center.  It's also the busiest ER in the state and 10th busiest in the nation.  Basically, I'm tired.  During this time I've learned the front end of critical care.  Is the next person to walk in the door going to code?  Is this abdominal pain actually a STEMI?  You never know.  And adults....well, they're actually as worse as I predicted but I'm loving learning a new area and felt like my career got a good revival.  Plus I work with the coolest people and we're all in this together.  Mostly....there's always that one.  We know who I'm talking about (cue all my coworkers trying to figure it out and then wondering if I'm talking about them.  Enjoy the blog!  Mystery! Intrigue!  We offer it all here!).

The challenge of the ER, as already mentioned, is you get everything.  That includes pediatric patients.  And that's why this blog is here.  I have amazing coworkers who want to learn.  Learn how to not be uncomfortable when they get a peds patient.  And learn how to care for these kids including advocating for them when they feel something might not be right. 

So here we are.  I'm hoping for a way to reach people who want to learn. I love teaching and I love even more when someone shares how they used what they've learned to take care of kids.  I'm always so proud and preen when someone tells me their own account of caring for a kid.

As I mentioned, I've had amazing teachers as well.  It's important to me to honor that and pass on what they've taught me.  We create legacies through what we leave in our wake.  Two of my best teachers were Respiratory Therapists I worked with for 8 years in my AZ PICU.  Pediatrics is heavily respiratory and the RTs were worth their weight in gold.  April and Melissa were my greatest teachers.

April and I could be so in synch that we could do care on a difficult airway, brand new trach without even speaking.  We knew how to move our hands and position and who was doing what.  We ended up being on the ECMO team together.  I taught her all about labs and charting (she said she'd never complain about charting after seeing all that one PICU patient needed...and that was just for the ECMO side).  And she taught me the intricate pathophysiology of ventilation as related to ECMO. We tapped each other for all the info we could get.  When she taught she'd tear off a paper towel and write out notes and respiratory patterns. We called it a "paper towel class".  I still have one of them tucked into my old badge.

Melissa was one of the funniest people I've ever met.  The best storyteller.  And boy she had a lot of them.  She'd crack herself telling them to where you weren't sure if you were all cry laughing over the story or the cycle of laughing. But she was so humble too.  I'd known her for 5 years before I found out the time she helped a woman give birth to a baby in the parking lot of our hospital when she was on a break.  She'd been a PICU RT for 20 years.  When we had downtime she would get out the fake lung and hook it up to a vent and have an impromptu vent class.  If a parent was learning about how to take care of their child's fresh trach, she would get out the trach doll and spend as long as she possibly could with them.  She was an amazing and patient teacher.  She's saved thousands of lives in her career.  Both directly and indirectly through teaching baby nurses and RTs.  Melissa died late last year after a very unexpected cancer diagnosis that took her away from us quickly.  She went out on her own terms and made people laugh until the end.  In fact, while she was intubated in the ICU, she was teaching a new RT about her own vent settings.  On her own vent.  I'm not kidding.  This was one of my teachers and friends.  How lucky am I?  I know she'd be so proud to know more people are learning how to take care of peds. 

My professional goals always included learning things that I was uncomfortable with.  Specifically, if it scares me, I need to charge directly into it and learn it until it doesn't scare me anymore. Ironically I do not live my personal life this way so don't marvel at me.  I wanted to learn and do something so that it wouldn't be a roadblock in my ability to take care of a patient.  This is how I went to PICU.  How I got to do CRRT and ECMO.  I still remember the moment when I realized what ECMO really was ("Wait...so you're saying that if this machine that I'm in charge of stops and I don't fix it within 180 seconds, MY PATIENT COULD DIE?!?).  And it's how I ended up in the ER and continues with roles I want to learn within the ER.  I try not to say I'll never do anything because I really don't know where this career will take me.  That said I'm pretty sure I'll never do OR because I hate standing.  ;)

Along the way, I've gotten a few certifications to try and convince myself I know what I'm doing.  Certified Pediatric Nurse (CPN),  CCRN-Peds, Advanced Trauma Care for Nurses (ATCN), Trauma Nursing Core Classes (TNCC), Certified Pediatric Emergency Nurse (CPEN).  I also got my MSN in 2017 with the goal that if I ever wanted to get my NP I would be closer.  I've always been on the fence about it but for now I'm happy with where I am and love having so many options to keep growing and changing what i want.  Plus, who doesn't love being able to just clock out and being done with work.  So the RN side has more draw for me than NP right now.  That might change in 10 years and I'll be closer to that goal (and hopefully will have my student loans paid off by then in time to fund new schooling.  Yuck.)

So that's me and the blog.  I really hope this is a place that provides resources and tools to help you care for the great span of variety within the pediatric population. And hopefully you get to share some of what you learn and gain over time with other colleagues.