Komlan RN...age 8?

We had just started our shift-change report when 8-year-old Komlan walked up to me and grabbed my left arm.  With a few well-timed swishing noises he pretended to wrap something around my bicep, and then started slapping the inside of my elbow hard.   He poked around thoughtfully for a moment with his index finger, then stuck a fingernail into the bulging antecubital vein, tapped my arm, and declared evo (It’s finished).

I, being a good pediatric nurse, egged him on after a good laugh, and he pantomimed several more IVs on our nursing staff before tiring of his new game.  Ironically enough, this started just a day or two before I was called down to B ward to start an IV on Komlan – restarting on IV antibiotics for a swollen ankle and leg after his skin graft surgery.   I showed him how to tie the tourniquet, and he put it back on me, happily poking through the equipment until he understood that I was actually going to put one in HIM.  He wouldn’t look me in the eyes then, and dropped silent tears onto his gown until we carried him to the next room.  The minute the tourniquet went back on he started to scream, and didn’t stop until I finished filling the syringe of blood for labwork, popped off the tourniquet to flush the IV, and declared evo, dodgi…bravo (It’s over now, brave boy…well done).

I tried bribery with stickers and a tourniquet of his own afterwards, but I wasn’t forgiven.  He was set to sulk, and sulk he did…through the next few doses of IV antibiotics, peeking over the bedrail at me when I came to visit.

Shortly after that I brought over a kidney dish, filled with all the usual IV start supplies, and a cannula minus the needle, to announce that it was his turn to put an IV in ME.  He happily tightened the tourniquet, nodded in understanding when I complained that it was too tight, and put a finger over his lips with a whispered shhhh.  He slapped until it looked like my inner elbow had developed some sort of a rash, rubbed thoroughly with alcohol, and chose a promising-looking freckle.    Out came the plastic cannula, and he jammed it into the freckle, then the vein I pointed out, with enough force to buckle the cannula into quarters.  After a few pokes he declared evo and taped on a bit of gauze before taking the tourniquet back off.

Komlan frequently starts IVs on his nurses now, complete with occasionally taking a fingertip off of his glove to feel for a vein. The last time I drew his blood for labwork, instead of screaming, he pointed out all of his veins and freckles and scars for me to choose from.  He nodded in understanding when I indicated my choice, and watched interestedly as the blood spurted into the tubes, pointing and commenting in wonder cesi est sang moi (this is my blood!).

Others of our pediatric patients frequently join in using medical equipment for a variety of things – from practicing with their designed function to other, more creative uses.  In the long run, we hope it makes their time on our big white ship much less of a scary experience and more of an interesting learning experience.  In Komlan’s case, he should be ready to join the IV team well before he starts high school…or maybe once we actually let him use needles.

If it beeps in the armpit, time to take it out and make an important call...

Our young patients-turned-nurses try out the sound quality of the stethoscopes.  Yes, they do make great microphones!