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    Fatigue is a constant for critical care nurse
Rose Faber is 31 and single, and has no children. Unless you count her patients. She is a pediatric intensive care nurse at Children's Hospital with 10 years of experience in caring for other people's kids. Her work leaves little time for a social life. Sometimes she's so tired that she cries as she drives home to her townhouse in Cranberry. Often she falls asleep on her couch. There's a shortage of pediatric critical care nurses across the country, but still the same number of hours in a day. When many nurses left Children's pediatric intensive care unit in August due to poor pay and long hours, the remaining experienced nurses took up the slack in the form of back-to-back 16-hour shifts. "Everybody's tired of all the overtime, tired of being at work, tired of being tired," Faber says. She couldn't cope without a few jokes, like her mock competition with a co-worker to get a smile from a cute baby. Pay raises have drawn some nurses back, and supervisors are in the process of hiring 16 more nurses. But the newer staff lacks seasoning, and the senior nurses still end up working longer hours to ensure that complicated patients are covered. Even a critical care nurse must have more training to be qualified to care for certain patients, such as those who have heart problems, need dialysis, or are receiving chemotherapy. "They're being trained, but it takes time," says Dr. Michael Whalen, one of the unit's six attending physicians. "It's an enormous step up (from the ward nurse) in skill requirements and the ability to assess sick patients. It's not enough to just call the resident." Senior nurses may be asked to take the role of charge nurse, who completes a thankless list of chores to be sure the day runs smoothly. Most often, she negotiates space in beds, trying to find empty ones because a new patient is always waiting for admission. If the unit gets really busy, she'll take care of patients, too. Faber didn't have much respect for charge nurses until, as part of a rotation, she became one. She far prefers having her hands on the patients. "I like taking care of kids, seeing them get better, watching them go home," she says. "You cannot put me on an adult floor. I wouldn't know what to do." In the open space of the intensive care unit, a nurse treats only one or two patients, unlike those on the general wards. But Faber also makes sure she knows where the sickest kids are, even if she doesn't have to care for them directly. Experience like hers means crises get handled more quickly. "People are very surprised in an emergency how there are 20 people at the bedside," she says. "You need to be that flexible - you need to know that at the drop of a hat, you could be totally somewhere else." She also makes a point of treating children with dignity. "I'm a firm believer in talking to them. I don't care if they're in a coma. You have no idea what the kid is taking in, what they're learning." Occasionally, nurses will hang signs on the curtains telling people that if they're going to talk around the bed, say nice things. Caution is wise around children who are awake. Faber recalls a patient who was terrified to go to an isolation room, used on occasion to give privacy to a terminally ill child. The girl was moved because she needed a restful place to sleep, but she didn't believe that after overhearing a doctor say she might die. "I'm not going to let anything happen to you," Faber consoled her over and over again. The nurse learned to cope with the deaths of patients the hard way. "The hard way is not letting go," she says. "One kid in particular took me three months to get over. Finally my Mom grabbed me and said, `You know what? You're not the same person. You need to just let it out.' "I cried for two days." Now, she grieves with families and moves on. If there's anything Faber understands, it's stress, but she has a hard time reducing it in her own life. She fidgets when she sits, finding it difficult to relax. A few years ago, her doctor ordered her not to do anything for two weeks - not even shop, her favorite stress reliever. She found the prescription impossible to stomach. She'd rather get out of town, as by making an annual trip to the Mall of America in Minneapolis. "(Other nurses) ask, `Why do you travel so much?' " Faber says with a grin. "I say, if I'm not in the state of Pennsylvania, they can't find me."
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