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How do you deal with PICU?

Discussion in 'Pediatrics' started by gaslady, Apr 29, 2004.

  1. gaslady

    gaslady Senior Member
    7+ Year Member

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    I find PICU very interesting, but how do you deal with seeing the death of babies on a regular basis? The kids with multiple medical problems that hang on for a long time, are one thing, but what about the healthy kids that go from healthy to dead in short periods of time? Does it get easier to deal with this? How do I know if I could deal with it as a career?
     
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  3. oldbearprofessor

    Administrator Rocket Scientist Physician Faculty SDN Advisor 10+ Year Member

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    Greetings: I do NICU not PICU but the issue of dealing with the death of babies (or any small children) is similar between the two groups. Generally in an NICU our patients who die are those born prematurely or with congentital problems. In a PICU, it's much more likely to be related to trauma/accidents, post-operative complications, acute infections, and some carry-over related to congenital problems.

    In terms of dealing with these deaths, I perhaps can offer two somewhat conflicting answers. First, is that even in large PICU/NICU settings, deaths do not occur daily, and unexpected/sudden deaths that make it to the PICU (as opposed to trauma that does not make it out of the ER) are not that common although they certainly occur. So, although one's career in intensive care is filled with very sick patients, there is respite between deaths and many of the deaths that do occur are not unexpected and you have had time to prepare for them. A lot of your time is also spent helping very sick children recover and that balances out the bad moments.

    The opposite answer though is to tell you that occaisionally, a death will be difficult for staff, including the doctors to deal with. Like any bad event in your life, you may both be very upset for a while and remember it always. In 1990 I was doing some general ER work when a 2 year old came to the ER who had been playing with his sister and gotten his head caught in a cord from a curtain. He strangled and despite his sisters attempts to get him free, could not be gotten out. We "coded" him unsuccessfully in the ER. I had to tell the family he had died. I went home that night and cut the cords off of every curtain in our house (ie. to make sure they couldn't loop around my kids' necks) and still worry about this when I see kids playing around curtains.

    On the whole, compassionate people who go into fields in which children do not survive become more compassionate and learn to accept what they see without it making it too hard for them to continue. If you have a passion for both pediatrics and taking care of very sick patients you will develop the skills to both help families in these situations and deal with them yourself. But you are a person too, and it is legitimate and real that sometimes these things are difficult.

    Regards

    Oldbearprofessor
     

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