Tuesday, March 31, 2009

Should Have Been 2...

I should be happy that I got a delivery last night, and I should be more excited that I survived the night and went the whole night only have 1 patient at a time (for a total of 2) while everyone else was getting slammed!

Walked in and pushed for 45minutes with a patient who was complete and had already been pushing for a while, then took her to the OR and had a baby about 2100. That head was in there all kinds of crooked and all her conehead was off to the side. No wonder she wasn't going anywhere...

Came back out to the madhouse after my recovery and then it snowballed. One by one, everyone under the sun came in, and stayed! One walked in at midnight and was 8cm that another nurse took, we all rushed in and got her started, then 10 minutes later another walked in that I took, she was 6cm and ruptured (leaking anyways), we figured we'd have babies flying out every which way! We got them both blocked and comfy in a good time frame, doctors called, orders written, computer charting done, etc. Then the 1st one delivered and mine didn't...and didn't...and didn't.

She stayed 6cm for a couple hours, then I re-checked her and felt a forebag that was in the way. I turned her to her side and baby took a MASSIVE dump to the 60's for a good 5-6 minutes. It was just a little scary. It was one of those decels that even the monitor can't pick up so nobody knew I was dumping, it just looked like the baby was off the monitor. I was flipping, pulling oxygen, grabbing a scalp, turning again, trying to find a heartbeat, shaking, trying to push my emergency badge just to get a second set of hands. I finally called out from the room phone and asked another nurse to come in. Too many things to do, not enough hands, a blocked patient who can't move on her own and the forever embedded "thump.......thump.......thump....." it makes 2 or 3 minutes seem like a lifetime! We ruptured the forebag and put on the scalp, heart tones came back up and the baby looked beautiful the rest of the night.

I finally started some pit and started pushing at about 0600. I pushed with her 'till about 0710, even though I figured the kid would have flown out after 2 or 3 pushes. No such luck. I gave report and left the room 'cuz I knew I was gonna be back tonight...and the baby delivered at 0715 about 2 pushes after I left. I was NOT a happy nurse. I feel like I totally gave up and should have stayed for 2 more contractions. Now I feel like a bad nurse to the patient and the nurse I gave report to. Bother...back for more tonight!

Babies today: 1f
Babies total: 40M/42F = 82
Vag:29M/32F = 61
C/S: 11M10F = 21
Babies 'caught' = 1f

Monday, March 30, 2009

Night 1 of 3

Ah, my last set of 3 nights before my 8 day stretch off! Hooray! People think I'm crazy for doing 3 in a row, and I do too a lot of times, but I enjoy my 8 days off, and at least I get in a rhythm for those 3 days on! Anyway...

Last night was actually really, really, really good. I had a very fun couple who were totally into having a baby. Her water had broken yesterday afternoon and she was...0.5cm dialated. Not a good place to start when the first thing she had written down was a birth plan with NATURAL all over it. So she'd walked, then we did the tub, then she walked some more, then she was almost 2 after 6 hours, then we started a little pit of pitocin and then she was still only about 2-3. I felt so bad for her. She was trying so hard, her husband was so supportive, she wanted to go natural for all the right reasons and I wanted her to do it so bad.

She finally begged for the epidural, rested and was 5cm in an hour, then complete an hour after that. That's what an epidural will do for an exhausted body! Pushed for about 30 minutes and was holding her baby. I was so proud of her, and I hope in retrospect she's proud of herself too. We had a nice long talk about the whole labor process and the hard things about the water breaking and not being in labor and it being your first baby and being closed when you start out. I know it's possible to go totally natural with the first baby and I think she totally could have done it, but it was a rough starting ground for her I think she just wore herself out. I am 100% convinced that her 2nd baby will be different and I know she'll do it.

She was my only patient all night, another nurse delivered 32 weeks twins who went from 2cm to complete in 20 minutes. That was a little excitement at 0200! i think we're running a special on umbilical cords with "true knots" in them. My baby came out with a nuchal, a true knot and it's feet all wound up in the cord. One of the twins had a true knot and I think a baby had one last week. Parent's don't know how lucky they are when those kids come out ok. It may have explained my two random decels last night though!

I think Joint Comission is coming "to a hospital near us" this week...let's hope they come on day shift and after Tuesday night!

Babies today: 1f
Babies total: 40M/41F = 81
Vag:29M/32F = 61
C/S: 11M9F = 20
Babies 'caught' = 1f

Saturday, March 28, 2009

Custom Words

I was flipping through my phone's "added" words that I've used in text messages and you know you're a L&D nurse when these are the words you've added:

~bleeder
~cerclage
~cervidil
~clonus
~cyst
~dink (as in a "dink" check...time to push!)
~epidural
~forceps
~ICU
~intubate
~keflex
~lidocaine
~NICU
~PIH
~pooped
~scrubs
~SROM
~a number of doctor's/nurses/staff people's names

Talk about a language of our own...Now here's the test...how many of these words do YOU know and/or use on a daily basis?

Friday, March 27, 2009

Done For the Week

I only worked 2-nights this week since I got call on Tuesday, but seriously, I think I'm just as worn out! I feel like I've worked 3-nights...and I guess I technically did work an extra 9hrs on Sunday night, but it still wasn't 3-in-a-row. Convinces me all the more that half the effort is the mental part, and I had to psych myself to get ready to go to work Tuesday anyway before they put me on call.

Anyway, I had a nice delivery last night, well, I guess it was good. The poor girl had been in the hospital all day since about 0800 contracting randomly, but never changing her cervix all day. The day nurse tried 3 or 4 times to send her home but she said "it still hurts" so more stadol, etc, still no cervical change. So the on-call doc when in about 1930 to try to convince her it was just false labor and do go home...surprise surprised, she was 4cm instead of the 2cm! So she got to stay...

I got her blocked, labored, started some pit, put on my very own scalp lead...I was quite impressed with myself :) Then mom spiked a temp right before delivery, then baby came out with a temp, we'll see how that all ends up. Nuchal X1, no wonder I had variables all night!

We're switching our IV catheters over to new ones, and I get a candy bar (or so I'm told) because I started 2 of them last night. They are quite different and I have to stop and think about exactly how they work every time I use them. They're nice 'cuz they have a built in extension tubing and a saline lock on them, but they're just a little different. Does anyone else use these where they work?
Anyways, so I'm done 'till Sunday night, then starts my 8-day stretch again! Hooray!! I'm lying on my bed watching the beginning of our forested 5-9inches of snow start to fall. Seriously, it was like 70 earlier this week. Gotta love midwest weather! Happy weekend everyone!
Babies today: 1m/1f
Babies total: 40M/40F = 80
Vag:29M/31F = 60
C/S: 11M9F = 20
Babies 'caught' = 1f

Thursday, March 26, 2009

C/S Land

Someone write this down...I was acutally "on-call" for 12 whole hours Tuesday night! That has happened ONE other time (back in December) since I've been off orientation. Everyone else is always complaining of how they always get put on call, I guess my days have just lined up right! Good think I picked up those extra 9 hours Sunday night, that made up for the 12-hours that I got all of $2 an hour to sleep! It's ok though, I slept horrible Tuesday afternoon, and yesterday afternoon too. Random phone calls from people with the wrong numbers, realitors trying to show the house, etc. Fun times.

So yesterday afternoon I had just rolled over and turned off my alarm about 1630 after a fitfull nap and my phone rings, it's work. "Can you come in early? Like 1700..." Well, I haven't taken a shower, put my contacts in, let the dog out or even really woke up yet, and it takes me a GOOD 30 minutes to drive, but sure, I'll be there ASAP. I clocked in at 1710. Not bad if I do say so myself...

So I delveged into C/S land last night, I took one section back when I got there so we delivered about 1840 then did a 2hr recovery, came out for about 10 minutes then took a VBAC who had just decided she wanted a section too, so she delivered right before midnight. Another 2 hours in the recovery room that turned into closer to 3 hours because it wasn't "convient" for mom/baby to take her at the moment so they wanted us to "sit" on her for awhile. So next time we have a labor patient walk in, even if they've called and told us they were coming, I think we'll tell them to "sit in the lobby" until it's convient for us to bring them back. I'm sure that would fly...

Then I did a little triage who was scheduled to deliver at a different hospital in 2 days, but they were on diversion and she was contracting, so her doctor sent her to us. Poor girl, she didn't want to be at our hospital, it was 0430, and as soon as she got there her contractions spaced out and she didn't change. She was frusturated that she even came and wanted to go back home. Her husband was funny, he said "who was I to stand in the way of a pregnant woman coming to the hospital?" Ha!!

We're partying for no real reason tonight at work, so I had to go shopping after I got off, then make cookies, finaly I'm heading to bed knowing that I'm gonna have to get up early to finish getting stuff ready for work. So much for my workout today! Bother...

Babies today: 1m/1f
Babies total: 40M/39F = 79
Vag:29M/30F = 59
C/S: 11M9F = 20
Babies 'caught' = 1f

Monday, March 23, 2009

March Madness in Baby Land

So I worked Thursday, Friday, Saturday nights and was planning on enjoying 2 whole nights off before my next set of three. I slept really well yesterday afternoon, got up about 1730, took the dog for a 6mile run then was doing laundry and just relaxing in front of the TV. I love to watch PBR bull riding, so I was just finishing up round two from the weekend about midnight. I took out my contacts and climbed into bed...ah, sweet sleep! And then my phone rang...seriously?!

So into work I went, and left about 9am this morning. It really did get crazy last night, it was a good thing I went in. I thought right at the beginning that they might send me home after my obligated 2 hours, but then the flood gates opened. I took a SROM about 0200 and then I was set for the night, got her blocked, comfy, etc. Meanwhile the madness kept happening. We had a mom walk in with 3 beats of clonus, horrible super reflexive, etc. I swear, we're continuing our PIH special! This was the kind of girl we were all waiting to run down the hall when she seized. Then about 0545 in walks a mom...complete. For being complete shews totally OK, just a little grouchy (I would be too at 0545 when I was hurting!). She made the comment, "I don't want an epidural." That's good hun, because you don't have time for one!

When day shift came on we seriously did not have an empty room, we had 12 labor patients and I think all the day shift nurses were doubled up with inductions or labors. I made the "mistake" of re-checking my girl that I had just started pit on and she was complete at 0655. I didn't have the heart to leave a day nurse with an induction and a complete patient, especially since I really liked my patient! So I hung around, did her FANTASTIC delivery (she pushed 3 times and was intact) and left around 9.

I got all warm and fuzzy this morning when my patient said "My friend delivered here a few months ago and when I told her you were my nurse she said "she was my nurse too! You have a good one!" " Aw...my heart went pitter-pat! She remembered me and liked me enough to tell her friend I was a good nurse! Yea!

I put "no" next to my name for tonight, I can't do 8 in a row, and I still have to work my 3 this week, Tues, Wed, Thurs. I will admit that we had a great crew there last night, so that made it all the better. I love going into work when there's a fun group of nurses!

Babies today: 1m
Babies total: 39M/38F = 77
Vag:29M/30F = 59
C/S: 10M8F = 18
Babies 'caught' = 1f

Sunday, March 22, 2009

1st Set of 3 Down

One of the big plus sides of working 3 nights in a row is that it makes the days go quick! It seems like I just woke up Thursday afternoon and now it's Sunday morning and I'm going to bed! It's gone quick (and I haven't worked out at all during those days...that makes me a little grouchy!)! I have decided a few things after the last 2 nights: I'm ready to have a baby, I've gone lots of days without a baby!!! I'm tired of Mag! I think our hospital is running a special on Mag.

Friday night I sat on my butt the big majority of the night. I had one long-term ante and was triage. I did one trainwreck triage who decided she liked me, and wanted to ask for me by name when she came back for her "real" labor. Hey, a compliment is a compliment! After I sent her home I sat, and sat, and sat, and sat. We got a phone call that a hospital 2hrs away was going to transfer a 33wk PIH patient to us, so we all jumped and got ready for that. That was just before midnight. They called report about 0100 and said they were just starting the mag bolus. Then I called them with a question about 0200 and they were just finishing the mag bolus and hadn't left the hospital yet. The ambulance rolled up around 0500. The PERFECT time for a "busy" patient to come in. She was a sick little gal though, way sick.

I think Friday they had 2 PIH patients whose platelets were dropping and got down into the 50's. That's um...bad news. The transfer that I got had AST/ALT's >200 and a crazy high uric acid. Sick, sick, sick.

Anyway, so I was exhausted when I got home yesterday morning, I think more from sitting and sitting for most of the night, I felt kinda like a waste of a person and would much rather of been sitting (or sleeping!) in my bed at home if I wasn't gonna do anything at work.

Then last night, I ended up with the same patient again who was on mag after her C/S. That lasted 'till about 0100 when other rule out labor's started rolling in. Then we combined a couple post-partum mag patients and I took a couple triage's. My great triage from Friday night came back and I ended up with her again, same problem, same doctor on call, same orders, same routine. She and the FOB asked if I was working on her scheduled induction date. Hmmm...don't know my schedule that far ahead!

My labor patient was 6 when I left this morning, so no babies for me for over a week :( I guess I'm back in a few nights and it'll probably be so busy that I'll be wishing for time to just sit on my butt! Ha!

Friday, March 20, 2009

Back to Work

So my 8-days-off turned into 5-days-off, but that was OK. I was super busy, seems like I had something going on every day while I was off! I was actually a little excited to go back to work last night, we'll see if that excitement can take me through the next 9 shifts!

While I was off a group of us "night-girls" got together and went out to eat. One of the laborist docs came with us too. It was so much fun to get together OUTSIDE of work and not be just gathered around monitor strips, someone having to jump up in the middle of a conversation, etc, etc. Of course work was all we talked about, but it was different. It was great fun, and I'm looking forward to the next time we can all get together.

I had antes last night, I didn't mind, they all behaved themselves. I started out with 3, sent one home after a little hassle and spent some good time chit-chatting with the other ones. The one gal has been there for the last month "growing" her babies. I'd be ready to go home too after being in the hospital for a month! Sheesh! She's so compliant though, she really wants to do whatever she can to help those kiddo's. I wish she could give a pep talk to some of these mom's who are ready to give up at 30wks of being pregnant and who don't want the hassle of being in the hospital or on bedrest, etc. She should write a book!

So this was night #1 out of the first set out of 3 of 3 nights in a row. Let's hope they can all go down like last night did. That would be amazing!

Saturday, March 14, 2009

Last night for a while...I hope!

Ok, 6 days a week at the hospital is a lot. I just got home from another 5+ hrs extra this week. It's been insane! I think they had 13 babies on dayshift today, then another 5 after 7. When I left we had the board cleaned up nicely, one ante and one patient who was deciding what she was going to do. I did a delivery about 2100, moved her over and was out of there. Ah...I told them "no" for the next few nights. I just can't make myself go back for 7 in a row. I think things will calm down over the weekend, at least I sure hope so!

So the last couple days there has been a 19wk PROM staying on our unit. Her history is complicated, and it's made me do a lot of thinking. She came in ruptured, and they did some antibiotics, etc, and after thinking about it and considering her history, she decided that really at 19wks, she didn't want to sit in the hospital for the next 5 or 6 weeks waiting until viable age, and so wanted to go ahead and induce delivery which would basically result in a termination of the pregnancy with the baby not being viable. The baby is still alive and they've been dopplering heart tones, etc, but she and her doctor went ahead with the decision to induce. So yesterday they did cervidil/laminaria to manually dilate the cervix. Then this morning they were going to do cytotec and she told the nurse she had been really feeling the baby move all night and didn't want to continue on the induction route. So the doctor came in and talked to her, and I guess she went ahead with the cytotec this morning. Then tonight, she told the night nurse the same thing, that she'd really been thinking about it and really didn't want to go on with the induction and really wanted to just go home. She said if her body kicked in and delivered on it's own then that was OK with her, but she didn't want to go on with the induction. The doctor said whatever she wanted to do and that she didn't have any further advice for her. I'm not sure what's going to happen, but it really made me think. I don't want to start an abortion/termination debate, but seriously I have no idea what I would do if I was in that situation. I know the risks of infection are super, super high, especially after the cervidil/laminaria, etc, but at the same time, I don't know that I could go ahead with the induction, deliver a live but non-viable baby with a clear conscious. I just pray I'm never faced with that decision...My heart goes way out to this woman.

Babies today: 1f
Babies total: 38M/38F = 76
Vag:28M/30F = 58
C/S: 10M8F = 18
Babies 'caught' = 1f

Friday, March 13, 2009

Any More?

Seriously, we have been a little busy at work. Last night was my second extra partial shift this week. When my phone rang yesterday afternoon and I saw it was work I knew what they wanted and let it go to voicemail. After what the board looked like last night I'm not surprised at all that they needed help. I called back as few hours later and the Charge said that a few people had called back, but one nurse had called in sick, so she wasn't sure if they still could use help or not. I already had plans for the earlier part of the evening so I said I could come from 2300-0700 if they still needed someone...I went in at 2200 and left after 0730. It was crazy.

All I ended up with was a post-partum mag post C/S which was fine. We actually "slowed down" a little for a few hours, then the bus rolled up and we got 3 or 4 walk-ins, then one of the docs called us and told us that one of the other "bigger" hospitals in the city was on diversion, so guess where all the patients were coming! For some reason, any other OB unit can go on diversion, but our hospital never does. Seriously, we've labored patients in the doctors lounge instead of closing. When I left this morning there were no empty rooms, there were 3 inductions sitting in the lobby and there was at least one other ROL on their way. I'm not kidding when I say I was glad to be walking out instead of in! Poor day shift!

So, we'll see if I go back in tonight. J told me today this morning that I need to learn to say "no" and not burn myself out. I agree, but at the same time, I know exactly what it's like to be a scheduled nurse and be there no matter what and have nobody willing to come in and help out when it gets crazy. That's the worst feeling in the world.

Now it's bed time!!

Thursday, March 12, 2009

C/S @ 0200

I worked Sunday, worked Monday, worked Tuesday and had signed up to be "on call" if they needed me last night from 1a-7a, before realizing that I was working Sun/Mon/Tues. Go figure they needed me last night, so I slept from 2200-0000, then went to work, did a C/S and got the 0730 C/S ready for day shift. NOW I can enjoy some time off without feeling too guilty that I haven't been going in extra. It's not my fault that they've been calling only on the nights that I already have plan! Oh well.

I'm house sitting for some friends from church, and I came home yesterday and let the dog out, and went upstairs to bed. Was dead asleep after 3 nights in a row, and all of a sudden I hear this knocking on the front door. I figured it was UPS or someone and they would just go away. No, the door opens and I hear "realtor." Seriously? The people are trying to sell their house but they gave strict instructions to the realtor company that they were supposed to call my cell phone and sent up an appointment before coming. But I guess they gave them the wrong number, and so this guy just came. I stumbled out in my shorts and tee-shirt and poor guy was totally embarrassed. We decided he'd call the reality company back and make another appointment for another time. Needless to say, I'm a little nervous to go to sleep today for fear that someone else is going to come and pay me an unexpected visit!

Babies today: 1f
Babies total: 38M/37F = 75
Vag:28M/29F = 57
C/S: 10M8F = 18
Babies 'caught' = 1f

Wednesday, March 11, 2009

BUSY

For as busy as my night was last night, it was actually pretty good, and I was pretty happy with it. Usually I would have been totally stressed out and grouchy, but even though I was running the entire night I never felt totally behind and hopeless, just constantly busy. I had two cervidils, and when I left they were both blocked and had no cervidils.

One was a gal I had actually sent home a couple times several weeks prior who we kind of knew from the beginning was going to be a little "high maintenance." Every time I walked into her room for something I knew I could count on spending at least half an hour or so doing this and that and fixing that and fixing this, but hey, it's all about patient satisfaction. She wanted a block so bad and I was so glad when she was finally 3cm and could finally get her blocked so she could be happy! She rated her contractions an 11/10 for pain, but if she wasn't watching the monitor and was talking to me instead she would talk right through the contractions without missing a beat. Oh well, to each his own pain scale I guess.

The other gal was a cervidil who was sure she ws coming in to get "platocin" and then cervidil if that didn't work. That made me smile all night, I've never heard it called "platocin" before :) She was a tiny thing (125# 9months pregnant. I want to weigh 125# NOT pregnant!) and took off with the cervidil contracting every 1-2minutes. We pulled the cervidil and she continued contracting that often. She got a couple doses of stadol and then finally changed enough to get a block, so she was happy when I left. We got an IUPC and turns out her contractions that looked so impressive on the monitor were actually these little wimpy things that would never dilate her to a 10, so they were gonna start pit this AM. There was no way that I was going to start pit when she was contracting every minute though!

I learned the value of teamwork tonight. The rest of the crew was great when they knew I was swamped. They all had their own patients but nobody was really going active for them and they all pitched in and helped doing little things for me like flipping one girl while I was with another or watching strips while I was getting blocked. They are the bomb and I love them! Yea teamwork!!!

Tuesday, March 10, 2009

New House

So today starts my month-long house/dog sitting assignment for a couple from our church. Flying to Hawaii for a month to see their daughter...must be rough :) So I get to watch their very lovable/excitable doggy for a month. I'm most excited at the moment to realize that I can get wireless Internet from a sharing neighbor! Hooray!

Last night at work was pretty good, I got the ante assignment which was OK, I haven't done ante's in a while and they were all well behaved tonight, I didn't break any of them. Sent one home by 2000, made friends with the high-maintenance gal who is "growing babies" until she's 32wks with her twins. She's been there a few weeks and has a few left, so she's settling into a routine. Another gal came in post MVA, wks with a positive KlehourBetke (I know that's not spelled right...), so she got to spend the night and was getting a sono today sometime. Another gal who has been working on N/V/D/temp didn't have any of the 4 for me all night, so I'm hoping she's fixed.

It was actually relatively quiet most of the night, our only delivery was a 18wk DIU r/t prolapsed cord. That was really sad, the baby was totally perfect, you could tell it was just the freak SROM and cord prolapse, no anomalies or any suspected reason for it. Ug. That's our 6th DIU for 2009 already. That's way too many. They had 21wk DIU twins last week, no more purple names!

It got crazy about 0430 again, seriously, is there just an alarm that goes off across the city at that time and everyone starts contracting? We had 3 or 4 people come waltzing in during a 45min span. Sheesh! That makes dayshift stress too because it messes up assignments and it looks like night shift has just been slacking all night, when we totally haven't! We can't help it that everyone walks in an hour before shfit change! Oh well, such is the job some mornings :)

I'm back for one more night, then on-call from 1a-7a on Thursday morning. I'm not sure what I was thinking signing up for that on-call shift, but I did it, so hopefully I won't get called in.

Monday, March 9, 2009

100th Post!

My all celebratory post and I'm too tired to really think much about what to say in it...

I survived my 2-day OB-ACLS class last week, it was a fun group of nurses to take it with and the instructors (two of our L&D nurses) made it lots of fun, practical and logical. So it was a fun 2 days. Working only 2 nights last week wasn't bad either, even if it did make it 5 nights in a row. I just keep adding letters after my name: RN, BSN, BCLS, NRP, OB-ACLS, CPR. Sheesh! I sound super smart!

Worked my 1st out of three last night, back for 2 more now. I was acutally "on-call" both Friday night and Saturday night and totally expected phone calls, but didn't get one either night. Speaking of, I should write that down for my hours at work tonight! Note to self... I was kinda expecting to get called last night, but I was there in all my glory, with 2 cervidils who actually behaved themselves. One of them had a "little dip" for about 2 minutes right after I got there but then baby behaved the rest of the night and she got some rest.

Of course it clustered right about 0430 and 3 or 4 walked in ruptured/laboring and then our scheduled 0730 c/s didn't show up 'till 0700 (supposed to show up at 0530) so I stayed and helped get her paperwork done. Of course she had no pre-admit stuff. I seriously think that should be a requirement to have any kind of scheduled procedure induction, C/S or otherwise. If you were scheduled for any other procedure at the hospital they'd have you write a book before you could show up for it, why can't it be the same for us? It saves everyone a TON of time, patient included. Ok, off my soap box now.

It was so nice here over the weekend, in like the upper 70's that my windows were open. Now it's in the low 30's and guess who didn't think to close her windows before work yesterday. It is FREEZING! in my room!

Babies today: 0

Babies total: 38M/36F = 74

Vag:28M/29F = 57

C/S: 10M7F = 17

Babies 'caught' = 1f

Tuesday, March 3, 2009

I Made It!

I made it 5 nights in a row! Last night was so much better than last night, I think a lot of it had to do with the fact that I KNEW that I didn't have to go back tonight! I about floated out the door this morning, I just need a break from being "responsible" for a few nights! I'll be ready to be back Sunday night I think.

I did a fresh recovery, I did a little triage, I did a little C/S for a gal that walked in ruptured and transverse presentation. I felt bad for her, it was her 5th baby, she's never had an epidural, never had a C/S, what a time to have to have to have a section for an upside baby!

Everyone at work was making fun of me because the Bachelor finale was last night. If I work on Monday nights I always go home and watch the Bachelor Tuesday morning, so I really try not to watch it or see snatches of it at work. EVERYONE had it on last night, a bunch of nurses had a chance to go into an empty room and watch the end of it and I refused to go in because I wanted to come home and just watch it without knowing the end. I made it until day shift came in, and then a bunch of day shift nurses came in and were talking about it, I wanted to run away before I found out the end. I didn't hear the exact ending, just that nobody was really happy about how it turned out. So...now I won't be going to bed for a while because I'm only to the beginning of Molly's date! I hope I'm not TOO disappointed...

Babies today: 1f
Babies total: 38M/36F = 74
Vag:28M/29F = 57
C/S: 10M7F = 17
Babies 'caught' = 1f

Monday, March 2, 2009

Blood Donation

On a more entertaining note...I gave blood on Friday. I've always been told I'm not the best vein candidate around, but it takes talent to give someone a bruse like this from an attempted blood donation! I thought I was going to come off the table when they stripped the tubing right next to the needle to see if the vein was really blown. That hurts like I never would have imagined! I ended up donating out of the other arm...and have no bruise!

4 out of 5...almost done!

So I put things into perspective at work tonight when I half jokingly and half not jokingly got told I couldn't work more than 3 nights in a row again because I got grouchy after 3! I think I'm usually seen at work as a pretty happy, optimistic, enjoyable person who likes her job and is a good team player and always ready to help out with things. I didn't feel like that person last night, for the first time I really felt frustrated at some of the other people I was working with and really just couldn't take it anymore. I went in early at 1700 for a nurse so she could go home early and all I heard when I got there was about how busy day shift had been and how day shift is always swamped and they had to call in extra nurses etc, etc. So I took a brand new triage that had just walked in the door, got her all started and came out and my name was next to another patient on the board. Then I noticed it was just a cervidil coming that night. Ok, I can do that. I came back out of my triage room a few minutes later and my name was next to a 3rd patient on the board, it's ok, it's just another cervidil for the night. I jokingly make a comment about everytime I come out to the desk my name's next to another patient. Haha, funny, funny. I sent my triage home, had 5 minutes to run and see my 3 deliveries from the weekend, and come back to find yet another triage with my name on it at the desk. It's now 1900, and I know I have 2 cervidils coming at 2000.

My triage is contracting, multip, post dates, unchanged from her office visit a week ago, I saw the doc on call, she looked at the strip, said it was OK to send her home if she wasn't changed in an hour. An hour comes, her cervix doesn't change, she's still contracting every 5-7", she says she think's she'd be more comfortable at home, I gave her some vistaril and she left. Meanwhile both of my cervidils have shown up, one of the other nurses put them on the monitor for me, etc, etc. These are my 3rd and 4th patients of the night, and I know they're staying for good. So I start getting them both ready, exams, papers filled out the whole 9 yards. I'm on the phone with docs getting orders, cervidils are busy at the beginning.

As I'm walking out of my 2nd cervidil's room there's a big chaos in a room and I find out the 2nd triage I sent home literally an hour before had come back ruptured, 7cm, mec and she spit out a kid in 30 minutes. Nice going, BirthdayNurse. So I feel like the worst labor nurse and it's only 2100.

Meanwhile, 2 cervidils are supposed to be a "full nurse load" and for anyone else they seem to always be that. No, my name managed to get on at least 7 charts last night, people kept walking in, we had 6 patients walk in ruptures last week anywhere from 35wks to 41wks. Somehow my name seemed to pop up as available for every person who walked through the door. I didn't chart one set of heart tones on either of my cervidils until after I gave report to the next nurse this morning.

I was not the only nurse busy, I know that for a fact. I also know that we asked for help multiple times, asked the charge nurse to call in some help, etc, etc, but it wasn't until we had to hand her off a recovery so a labor nurse could take a new SROM'd girl in labor that some phone calls started getting made. I should just learn to keep my mouth shut and remember that I am doing the job that I always wanted to be. I know I'm tired, I know I'm hungry and haven't eaten a real meal since before I started this set of 5 shifts, and I know that this post makes me sound like a whiny wimp! So to everyone that reads this...I really do love my job, I love taking care of patients, I wouldn't trade my job for anything, I just don't like it when I'm trying to take care of too many patients at the same time and don't sit down for 12hrs!

I swear, I don't think there are any pregnant women left in the city at this point! I'm not sure how there can be!

Babies today: 0
Babies total: 38M/35F = 73
Vag:28M/29F = 57
C/S: 10M6F = 16
Babies 'caught' = 1f

Sunday, March 1, 2009

Night #3 out of 5

Ok, so 3 nights down, 2 to go. Seriously, I don't think I'll do this again without really thinking it through! I'm so sleepy!!! Last night was much better than the last couple ones have been. I actually only had ONE patient all night, that is a first in a long time. I wasn't convinced that my sweet little gal was going to make it, but she did it! She was 3cm, 3cm, 3cm, 3cm after SROMing and being closed then being on pit (up to 30mu/min) for hours, and then all of a sudden went from 4cm to complete in like an hour! Yippee for her! Great pusher, great delivery, everything was fantastic! I'm running a streak of amazing patients, and I love it! Very personable, sweet, excited-about-being-parents couples. My favorite!

I told one of the nurses I'd go in for her at 1700 tonight...I'm pooped, it's sleepy time. But that sleepy time isn't gonna last long eough!

Babies today: 1f
Babies total: 38M/35F = 73
Vag:28M/29F = 57
C/S: 10M6F = 16
Babies 'caught' = 1f