A new beginning

Should today not have been a national holiday?  Should we as a nation not rest for one day every four years to honor ourselves and our President?

NewFNP did pause today.  She sat on the floor of the standing room only waiting room with a precocious five-year old African-American patient in her lap, her five-year old scrawny arms draped around newFNP's neck so that she and newFNP were watching the oath of office cheek to cheek.

"Do you know what today is?" newFNP asked this little girl, M as Vice President Biden exited the podium.

"No - what?" M replied.

"Today is a very special day.  We are getting a new president - our first black president," newFNP told her.

"Obama?!?" she exclaimed, wide-eyed, although she pronounced his name Obommer.  "I like Obommer!"

"So do I," newFNP said, giving M a big squeeze.  "So do I."

Ahhhhh......

NewFNP hates to repeat herself, but it is tough to deny that the shit that comes out of a kid's mouth can brighten one's day.

A little background. NewFNP is averaging 30.3 patients per day this week. This is a fact that would give her CEO a big boner but makes newFNP want to stab her eye with a used needle, repeatedly. NewFNP is looking in every corner of every room for the silver lining, but newFNP is fed up. One might even say that newFNP is fucking fed up.

So thank goodness for little miracles, right? And it is unusual in newFNP's life that miracles take the form of fat 9-year olds, but it seems as though miracles do indeed work mysteriously.

This chunky guy was midway through his physical when newFNP instructed him to lie down for the old abdominal exam. Reclined comfortably, he closed his eyes, stretched and sighed, "Ahhhhh, I knew this day would finally come......" He was so serene and sincere, as though he had stepped into the day spa. Or did this patient think he had stubled upon the Best Little Whorehouse in Anonymous Urban Center?

As his mom, older sister and newFNP were chuckling, this Hugh Hefner protoge continued. "I knew that one day I would be here and be examined thoroughly." Now, newFNP knows that this little kid did not intend for his comment to sound creepy or weird - let alone pornographic - and he probably didn't even intend for it to be humorous. But he indeed did receive a thorough exam and is off to urology as a result. Did his big genital fat pad eat his testes or were they never descended to begin with? That is for Dr. Penis to decide.

There was a distinct lack of awesome little kid comments today, however. NewFNP could go for one tomorrow. NewFNP could also go for a day with 20 patients, a new Miu Miu handbag and some raspberry-colored Marc Jacob's patent leather wedges. Alas, newFNP thinks that the wedges are a more achievable desire than is a light clinic day.

Pediatricity

NewFNP feels that she is not alone in declaring that, for FNP students, pediatrics can be daunting. Kids have high fevers, they have weird rashes that may be viral or may be frigging measles. Who knows? What new NP has ever seen measles? What parent feels confident in the diagnosis of 'viral exanthem'?

Nonetheless, pediatric visits have turned into the highlights of newFNP's day. Why, just this week, newFNP had a five year old boy laugh and scream, "You're touching my penis!" during a regular old testical exam during a well-child check. You just don't get that kind of enthusiasm during the adult exam. A four year old boy this week told newFNP several times, "You're funny." And, damn it all, that kid is right. NewFNP was having a grand old time chatting up this four year old about school, his cousin, crying, Batman - a little sample of all things important.

For all the students, newFNP thought she would share some secrets to help overcome the fear of pediatrics for you and your patient.

1) This lesson is courtesy of Sunshine, a co-ed with whom newFNP studied. New FNP uses it without fail. Kids hate the ear exam, but looking for Dora or SpongeBob in a kid's ear will greatly facilitate the process. Sometimes newFNP tells the kid that she saw Dora running to the other ear and they graciously turn and offer the ear for examination. This tool is not limited to the ears, no sir. It works on the mouth too!

2) Making an amazed face upon cardiac auscultation is a wonderful tool to get kids interested in what's up. Of course, older kids can listen to their own hearts, but the young kids like to see that you think their body is working well.

3) Knowing when you don't have to do a full exam is important. Not every well child check needs to be a head-to-toe. If kids are scared and crying, newFNP lays off, especially if they are a regular patient. NewFNP explains her lame exam to the parent, letting them know that being scared is normal and that newFNP will provide a more thorough exam when the child is not screaming and kiding under the chair.

4) Tell parents to bring the kid back the next day if you're concerned. In newFNP's experience, parents don't appear too put out when it comes to their kids' health. You can also try obvious things like oral rehydration and fever management in the office. Duh.

"You're touching my penis!" Ah, good times.

Out of the mouths of babes

NewFNP has fallen in love with the well child visit. Yes, it's true that sometimes the 13-year old well child weighs more than newFNP. Thankfully, those visits are rare enough. But for the most part, well child visits afford newFNP a break from diabetes and BMIs of 45. NewFNP likes all kinds of well child visits now, but has always held a soft spot for teenagers. Especially ones that ask funny questions.

So, all in all, an average 14-year old male well exam. Thin, plays field hockey (quite unusual in my inner city area), respectful, has all parts intact and has no inguinal hernia. Testicular torsion education - done. Safer sex/abstinence education - done. Repeated denials of current or prior sexual activity - accepted by newFNP.

As always, when about to exit the room, newFNP asked, "Do you have any questions?"

"Yeah, I have a question," he replied. "Is it bad to masturbate?"

The way he asked was so sincere. I set the chart on the counter, faced him squarely and said, "No, it's not bad. Everybody does it. Just don't get caught."

He was visibly relieved. Whacky kids!