Thursday, April 30, 2009


For an un-usual 3IAR (Mon/Tues/Weds nights), this week's been pretty good! They called me 2 minutes before my alarm went off yesterday "can you come in early?!" it always scares me when DAY shift is calling for help, because seriously, if they have 10 or 12 nurses there already, how do they expect a night staff of 5 MAYBE 6 to handle it? And yet we always do...anyway, that's besides the point.

So after getting ready and across town in rush hour traffic, I finally clocked in about 1800. As I was walking in, I met the couple I had triaged the night before and ruled OUT of labor, in the lobby. Guess the UC's came back! Nobody was expecting them, so I jumped at the chance to take them again. They were really sweet and I had been sad to send them home yesterday morning anyway.

She was a good change from that morning, and I had her admitted, AROM'd (per doc), comfy with a block and all my paperwork done by 1930! Everyone else on night shift was just getting started!! My girl did AMAZING and we had a baby by 2200. Not bad for being 3/100 when she came in and a first baby! Great delivery too. It was quite the waterfall when the head came out, amniotic fluid was shooting up and over the legs, but nobody got wet! Made a nice puddle on the floor though...ha!

Waited on a patient that was called in for like 5 hours...never came. So I finished my recovery, sat for a while, did a traige, was walking her out the door and met another one coming in. The 2nd one was one of the presentations (crying, huffing/puffing, screaming, out of control) that has all the nurses running into the room to catch a baby. Throw on a glove, lay her down on the bed...can't find a cervix anywhere...oh wait, maybe I can feel it...WAY back there.
"Sit on your fists..."
ALMOST can reach it...just a little further...there it is! MAYBE I can get a finger in it...and it reaches half way down my finger.
"'re a tight one...and maybe 40-50%...yes I know your contractions long have you been contracting?"
"Your first contraction was 15 minutes ago? Well let's see what a few more do, maybe your cervix will change."
2 hrs later, among many inappropriate comments from the 15 people in the room (including a friend who I had taken care of during labor...who abrupted 30minutes after my shift ended...), poor girls cervix was still the same and as long as nobody reminded her she was having a contraction she would talk and laugh through them. But as soon as somebody said "ok, breathe through this one, it looks big!", there were tears and labored breathing. I think sometimes "support people" need to be reminded of the meaning of "support." I really felt bad for the poor girl! She was sweet as could be, and I don't think she was convinced she was in labor, I think everyone else freaked out and convinced her she was dying. There were some not-so-very nice comments as she was leaving...

Not back 'till Sunday! Ready to enjoy a nice, rainy, muggy weekend with grass about 5 inches long that's way too wet to mow...

Babies today: 1f
Babies total: 43M/45F = 88
Vag:32M/35F = 67
C/S: 11M10F = 21
Babies 'caught' = 1f1/2m

Wednesday, April 29, 2009


Seriously, I have had some sick patients lately! My PIH friend from early yesterday morning that I thought we should deliver ASAP...platelets dropped to 50, livers into the 800's, never got past 2cm. :( Section in the afternoon, then I got to take care of her last night. She felt so much better after she got delivered and her baby is ADORABLE!!!

6hrs postpartum I got a couple quarter sized clots out, increased her main line with some pit in it and hoped they'd go away. Then 45min later, I got a fist sized clot out. 800mcg of rectal cytotec fixed more bleeding!!! Glad we got the bleeding stopped while we could, her platelets were 40 at midnight. Sheesh!

She was a tough IV stick b/c of all her swelling, and so they had put in a 2nd IV in before surgery yesterday. We could use it to draw labs off of...oh my goodness. I think all mag patients should have an extra IV to draw labs off of. It was AMAZING! No searching for a vein, no digging, no extra needles...just pulling off blood into a syringe and then transferring to the vac-containers. I'll do that ANY day!

I'm going on a baby dry-streak again. Time to fix that!!

Tuesday, April 28, 2009

Night #1

Night #1 after having 5 wonderful nights off (except one night I went in @ 0300 so a nurse could leave early for her vacation)! Nice little recovery...nice little cervidil who actually slept...I swear mine NEVER sleep!....and a "nice" little PIH gal who came in at 0415. Severe Right Upper Quad rent pain/brisk reflexes/Liver enzymes of 400+ and 300+ ("normal" is <30)/3+ class="blsp-spelling-error" id="SPELLING_ERROR_3">mag'd her and then pitted her. Wonder what time she'll get cut? They were the sweetest couple, I would take them back tonight...

Wednesday, April 22, 2009

Party for 3

Ok, hold the phone...last night...there were THREE nurses on L&D...ALL NIGHT LONG!!! I was a little nervous about it, combined, the 3 of us have about 4 years of experience, two of us are '08 grads, the other an '07 grad. Not that we're not capable nurses...but I know there's lots of stuff I've NEVER done, and if some train wreck walked in we'd be in deep meconium! But...the night was great!

I sent a triage home, there were 3 antes, I took a SROM, there was a cervidil, then after my delivery we had 2 ROL's walk in and then we had the 0730 C/S to get ready, but together we got it done! We were all pretty proud of ourselves. We had 4 nurses at home on call, so that made us feel a lot better, but we didn't' need them! When we were leaving this morning I kept looking around wondering where all the night shift people were...and then remembered that there were only 3 of us!

My delivery last night was a little crazy, she was a multip, SROM, started some pit, got a block, the doc came in when the patient was about 7cm and then hung out in the break room. When the patient was about 9cm and feeling "pushy", the doctor got a call that she'd just had a patient walk in compete and +2 station at a different hospital. What to do? Does she leave my patient and rush and TRY to make the other delivery (that she probably won't make...) and end up probably missing both deliveries, or does she stay with my patient and just tell them to deal with the other patient since she won't make it anyways?

She decided to dash to the other hospital, which ended up being OK. I guess the other patient really wasn't complete, she was only 7cm with a bulging bag, then when her water broke the nurse didn't check her again, thinking she would just be complete. So the doctor made the delivery, which in her words was "poop filled" and then headed back to my hospital. We had our laborist (24-hr in-house OB doc) sitting at the desk ready to catch my baby. I figured it wouldn't take too long, but my gal was 9.5 cm with a lip for a good 45 minutes, with the kid sky high in the pelvis. So we just kinda stood around and waited. She was finally complete about the time her doc got back. So yeah for the doc who made BOTH deliveries, and who told me afterwards that my delivery was 100X smoother than the other one :)

After work I ran from the hospital to the school my mom works at. It's only 5.5 miles, but it has the worst hills EVER!!! I did it in under 44minutes though, after 3 12-hour shifts...

When I woke up this afternoon I was/am exhausted, can't wait to turn out the lights, go to bed and not go back to work 'till Monday!!

Babies today: 1m
Babies total: 43M/44F = 87
Vag:32M/34F = 66
C/S: 11M10F = 21
Babies 'caught' = 1f1/2m

Tuesday, April 21, 2009

Quiet Night

I probably just jinxed myself...but last night was so PEACEFUL!!! We had a nurse on call, and probably could have had more if we had really wanted to. We had 2 deliveries, 2 cervidils, 3 ante's and a few random triages that were in and out...and 5 nurses! I had ONE (1) (uno) cervidil all night...when was the last time that happened! It was WONDERFUL!!! Ah...for once I'm not "scared" about going back tonight!

A bunch of us nurses were all talking about different charity or not-so-charity running events that are going around in the area this year, and I think we're going to try to get a group of us together and do some of them. I don't by any means call myself a "runner" but I go out and try to do 4-6 miles a couple times a week. I used to do 5+ miles 6+ times a week in college, but once "life" started, not so much any more. There are several 5k or 10k runs going on that look fun and I would never have guessed that some many of the nurses run. So who knows, maybe it will inspire me to get up off my lazy butt and start really running again.

After all the talk about it at work last night, I thought maybe I should at least go get a little wind after I got home this morning. I knew if I didn't do it as I walked in the door it wouldn't happen 'till a different day. I was planning on 3 miles, and it turned into 6.2. Oh well, it didn't hurt me any I guess.

Gonna go switch the laundry, go to bed, get up and go to my brother's baseball game, then back to work for the 3rd party in a row! Horray...I think :)

Monday, April 20, 2009

One Party Down...Two To Go

When I walked into work I had a brief moment of celebration as to how nice the board looked! NO MAG!! a couple antes, a couple postpartum's, a couple of early was beautiful. Then when I left this empty rooms. That's what we did last night!

I admitted 5 patients last night, ended up handing a couple of them off because I can't handle 3 active labor patients at the same time all being admitted within an hour of each other. Sorry...

I started off with a post-partum bleeding, family practice delivery who needed suprapubic pressure, but was intact? I don't think so...when we finally got the laborist in and spec'd her they found a bunch of placental fragments and she used 3 sutures to fix labial tears. Reason #283 why I recommend going to an OB for obstetrical cases...

Handed her off when I got 2 ROL's at the same time. Both ended up staying, and of course I balanced them so that I didn't sit down all night. My goodness...I got the one a block, she was comfy, got the other one a block, was 5 and then complete about 10 minutes later and feeling rectal pressure, turned her to her side to wait for the doctor...for 20 minutes. I knew if I turned her we'd have a baby. As I'm holding Mom's legs together listening to my variables down to the 70's with every contraction I hear someone else walk into a room down the hall, then a nurse call out "she's complete and +2". Sorry, I was a little tied up at the moment, so I think some other nurses took care of that one. My doctor walked in and was like "what's going on?" I rolled Mom to her back, he went to check her and you could just see the head crown up. So he's fumbling to get gowned and gloved, thank goodness I had some gloves on, I'm trying to get the foley out, but figure I better at least grab the head while it's sliding on out with a contraction. He's like "it's ok...I got it..." um, not so much, I was holding the head as he's finishing with the gloves. The bed never did get taken apart, nursery made it after the kid was already up on the abdomen with the cord cut...the doc delivered the placenta and walked out in all of 4 minutes...leaving me with a HUGE mess (in the bed of course) to clean up. Oh well, it was quite the smooth delivery I guess. I was a little bummed because if he had waited another 2 or 3 minutes I would have gotten to catch the baby... :(

I start recovery #1 and then go check my other patient...she's 7 with a BBOW, I figured she was going to blow a kid out any second. She was almost complete when I left, thankfully she and her baby behaved during the chaotic night.

About 0530 everything hit the fan, we had 4 or 5 new patients walk in, I took one who was 5cm and then got in the tub and was 7cm, then was almost complete and unblocked as I was leaving. Ah, the craziness of it all.

It doesn't sound so bad, but it was just constant all night, at least for me. Next time, it's someone else's turn! I'm too worn out for it to only have been my 1st night...

Babies today: 1m
Babies total: 42M/44F = 86
Vag:31M/34F = 65
C/S: 11M10F = 21
Babies 'caught' = 1f1/2m

Sunday, April 19, 2009

Thursday Night

So it's technically Sunday morning...and this blog is technically about Thursday night. I've been too busy enjoying my whole TWO NIGHTS off (last) week that it hasn't gotten written 'till now...and the Internet connection has been kinda shaky.

Anyway, the craziness continues at was jus a SMALL cluster on Thursday night, ok, so it was kinda a crummy night all the way around. Walked in and the assignment didn't look too bad other than the fact that there were no empty rooms, not enough nurses...and it stayed that way all night.

The atmosphere was kinda set by the fact that they had just found out that afternoon that one of our extended-stay twin mom's had lost one of her babies. She'd been admitted for several weeks and they kept talking about sending her home but just hadn't ever done it. They'd been doing NST's every 8 hours and after a great NST Wednesday night...the NST on Thursday morning had only one heartbeat. It was really, really sad. This poor mom was a G6P2, had had several stillborns made all of us sick. She was only 33 weeks, so they weren't going to induce her, but she wanted to be in labor so bad. I don't blame her! I'd want my healthy baby outside and with me NOW after something like that. The nurse I talked to yesterday morning said that she went into labor and delivered early yesterday and the alive baby was doing great.

So after that small shock to everyone Thursday night, things went from bad to worse. We had a 31wkr break through mag and deliver, we had a set of vaginal twins who turned into a section after baby B flipped breech, in the middle of the twin section a 29wkr broke through her mag and was 4cm with a cord presentation, the carge nurse went ahead and called in all 3 cervidils who were scheduled even though we had no rooms for them, then they got frustrated when they had to wait in the lobby, our footling breech IUGR twins who were scheduled for a section Friday morning SROM'd...and the doctor decided that they could just wait a couple hours until their section...needless to say we were all ready to go home Friday morning!

This last week has been CRAZY! The poor NICU is overflowing with 23 kids (their usual max is 18), they're starting to have to ship kids to the children's hospital in town just because we don't have room. Labor's overflowing, and it's nothing "normal" it's all crazy stuff that's going on!

I've been counting small the last 2 nights off!

Thursday, April 16, 2009

2 Babies, More Mag, 1 More Night

So after my melt-down post yesterday...I had a mag gal who had been cervidil'd X2, pit all day yesterday and was 5. Then she was complete at 1915 and we had a baby by 2030! Yea! But then again, the baby was only 4#3, so I would HOPE it didn't take too long to push out! Seriously though, more mag? I think at last count (after starting someone else last night) we have 5 patients on mag. That's insane!

Our manager was in helping us 'till 0300 this morning and we had a little chat about an antepartum unit...and those of us from last night NEVER having to work it! Sure, a load of easy ante's is kinda nice every once in a while, but all these pre-terms, mags, etc are too much! I was talking to J on the way home this morning after we called a rapid response on her delivery from last night and she mentioned how nothing was every "low-risk" anymore. Every delivery has some complication or the mom is some kind of sick. Must be something in the water...

So after I got my mag patient all settled down I got a ROL (because I happend to be the only nurse standing at the desk when she walked in) that I got started...and ended up keeping. I've given up waiting for someone to tell me that it's my turn to take a patient. Someone has to take a patient when she walks in, and I seem to be the one standing there most often, so I might as well do it. I feel so bad when these patients walk in and everyone's saying why they shouldn't be the next one up for triage.

So getting her started, still trying to recover my post-partum mag, and trying to beat the computer before it went down for 3 hours for updates...I was scrambling just a little bit. The IA finally said "can someone please help her get her patient started so she can chart?!" Thank goodness for the IA standing up for me! Then everyone was great and helped get an IV, etc, etc.

She delivered unblocked for me at 0630 this morning. G5P4, straight OP, >8#...and intact! Go her! Honestly this is the first un-blocked delivery that I think I've ever done "on my own." I almost caught the kid too, there's not stopping those unblocked mom's from pushing once their complete! The doc just happened to be at the desk watching the strip and walked in just at the right time! Thank goodness...I didn't need that at 0630!

So now it's too bed, then back for yet another playtime in Magland. Sheesh!!

Babies today: 2f
Babies total: 41M/44F = 85
Vag:30M/34F = 64
C/S: 11M10F = 21
Babies 'caught' = 1f

Wednesday, April 15, 2009

More Of The Same

I'm still tired of antes, mag, preemie's, twins, etc. I got another transfer from out of town who was 4cm/100% and 30wks. Their NICU was full so they sent her to us...our NICU is full (after our 29wk PPROM delivered) and if she deliverers we'll have to ship her baby to the children's hospital. So start some mag, listen to her complain about her foley all night. I would have taken out her foley, but not after the 1st hospital gave her 5L of fluid in 6hrs. Not sure that mag was a good idea after 5L of fluid either...but whatever, her lung sounds stayed clear!

I'm ready for a nice, normal, one-on-one labor patient! No more of this "green" mess! And this was only my 1st scheduled night of 3 this week. I'm regretting going in extra on Monday!

Tuesday, April 14, 2009

Preemie Land

Seriously, I think we're running a special on pre-mature deliveries at a special on twins. I think we've had more <37week deliveries and twins (most of the twins being <37weeks) in the last couple weeks than I can remember in a long time! All these 29 week ruptures or pre-term labors or PIH gals. Yikes!

I was just thinking yesterday that I was actually gonna go a whole week without working any extra shifts. That was until my phone rang about 2000 last night. I think my message was something like..."you can have double time, triple time...and free coffee!" There were no empty rooms at one point, a C/S going on, vag twins, 4 extra nurses, 2 or 3 mag patients, my 29week twins contracting and 3cm, and 2 more SROM's on the was a mess!

I wasn't too thrilled on hanging out all night, 'cuz tonight is when my 3IAR (in a row) starts and I'm sure it's gonna be crazy. Miraculously, I think after a couple deliveries, handing over early recoveries, etc they were able to get all the "extra" nurses out of there by about 0200. I left at 0145, made a McDonalds run for everyone still there, and then got home about 0230. Good thing I took a nap yesterday afternoon!

I slept for a couple hours, got stuff cleaned up at my "house sitting house" let the dog out and headed to my OWN BED! I get to enjoy it for a nap today, tomorrow and Thursday, then I'm "babysitting" for the weekend, then work 3 more IRA, then maybe I can relax on my 8-days off. I'd LOVE to get the lawn mowed sometime in the near future before it's 3 feet long, but the way the weather and my days off have lined up, I'm not sure that's gonna happen!

Sunday, April 12, 2009

Half A Shift

So I love the nurses that I work with :) One of the other nurses offered to split the shift with me last night so that I could hang out with my little brother and go to California Pizza Kitchen (AMAZING!) and a quick comedy show (actually pretty funny!), then I headed into work at midnight. Even though it was only half a shift, I still wasn't sure it was ever gonna end...I was tired!

No babies :( but I did get the "gold star" for the LONGEST rule out labor...she came in at 2000 and I walked her out the door at 0635 this morning! She wanted to be in labor, her doctor wanted her to be in labor, but after 10 hours...still no real cervical change and miraculously a little Nubian let her sleep. So after a little nap, she went home.

I got a SROM started and all lined up for day shift and did lots of charting. I was READY to go home at 0700. I felt really bad, we had a 29wk gal come in with PPROM (preterm premature rupture of membranes). Start some steroids and start the clock. She'll be hanging out a while...hopefully! I think NICU is a little tight, they don't want a 29 week baby if they can help it!

It was cold and rained all day, I think it's supposed to supposed to do that every single day that I'm off this week, but you know it's supposed to be nice and sunny Tuesday/Wednesday/Thursday! Go figure!

Saturday, April 11, 2009

Why I Don't Do Mom/Baby

Why don't I do Mom/Baby (postpartum) nursing? Because I can't handle it. I don't know why I can't handle it, but I can't handle it. I don't understand the charting, I don't really, truly understand the correct "assessment" of it...I just don't get it. Hence why I don't do it. Well, why I didn't do it until last night. There were lots of not-so-nice words going on in my head when I saw my assignment was 2 post-partum mag patients, plus one of their babies. I've done postpartum mom's...never the babies. I'm NOT a baby nurse, I'm a MOMMY nurse...once the baby is on the outside, it scares me just a little because I don't know what to do to it or how to fix it if it breaks. I can't roll it on it's side to get it off the cord, I can't put on a scalp lead to hear the heart beat, I can't run to the back for a C/S if all else fails...besides a pacifier in the mouth I don't know how to fix a baby!

Anyway...I was the first night shift nurse there last night and they were just writing assignments on the board when I got there. I said something about my assignment which probably wasn't the most professional or adult thing to say, but I said it anyway. J was sitting there and said "well change it, you're the only one here." So I asked the nurse writing the assignments up to change it and she said "I didn't make the assignments, it's not my fault." So guess who ended up keeping the post-partum mags? It doesn't seem quite fare that day shift can come in, change every single assignment if they don't like it, but nope, the assignments have already been made for night shift, we can't change them now! Sounds a little fishy to me...

But I did survive, actually got the turn the mag off for both mom's at 0330, gave them nice big glasses of water and let them actually sleep for a few hours without the hourly reflex checking, blood pressures, etc.

Thank goodness for the well baby nurse who helped me with "my baby" and drew labs and knew how to make sure it stayed not-broken for my shift. I'll stick to mom's with the babies inside, thank you!

Friday, April 10, 2009

Dang Cord Blood Collection...

The board looked like crap when we came on at 0700...we cleaned it up and actually sent on of the 2 extra nurses home...then we had about 10 patients walk in and there was not ONE EMPTY room when day shift came on. We had put 6 inductions on hold to...oh brother! I wheeled a C/S out of the OR and did about 20minutes of her post-op recovery before they decided they needed me to traige, so I handed my C/S off to a scared-spitless mom/baby nurse who'd never done C/S recoveries before while I went and got N/V chick in a room and an IV started.

Things calmed down for a while, then I took a rupture, then while I was getting her blocked in came another girl who according to her doctor was "dying" over the phone, got her blocked, etc, etc. The rest of the night flew!

I loved my SROM couple, I wish all women went into labor like that! Her water broke, she came in, was feeling "tightening" but not hurting, decided to just be done with it, got a block before she was dying, got some pit started, she labored great, pushed about 15 minutes and we had a baby about 0630! I will take a no-drama delivery like that ANY day of ANY week! The kidd-o came out in some way I haven't seen before, and neither has the doc. You could tell when mom was pushing that this kid was twisting his head all around and it spun every which way. When the head delivered he was looking at mom's L thigh, then when the doc went to deliver the top shoulder like usual, no the kid flipped totally around and the bottom shoulder came out first with the hand way up by the chin. That kid did AT LEAST a 180 degree spin on the way out. We were all just kinda looking down there trying to figure out what was going on, but mom was intact...can't ask for much more than that!

I had the cord blood collection kit all filled out, then totally forgot to throw it on the table for delivery. As the doc's about to walk out of the room it hit me...what a horrible feeling! The poor doc was super good about it, we played with the cord, we played with the placenta and actually got a good 100cc into the bag for collection, that's WAY better than I thought we would...thank goodness! I think nurses should get an extra bonus for a cord blood delivery...just another thing for me to remember after a 12-hour shift!

I'm hoping that last night is not a pre-cursor to what's going to be this weekend, that was just a little too crazy! It's the storm + a full moon...not a good combination!

Babies today: 1m
Babies total: 41M/42F = 83
Vag:30M/32F = 62
C/S: 11M10F = 21
Babies 'caught' = 1f

Wednesday, April 8, 2009

Not So Much Work Related...

So I know at the beginning of this blog I promised it would only be "work related" stories and experiences, but I couldn't pass this one up...

I went to the dentist today. NOT my favorite place to go (but who likes the dentist?). I had the first appointment after lunch and was on my phone when they called me back. As soon as the hygienist opened the door and called me back I had this sneaking suspicion that I knew her from somewhere. I kept thinking to myself "why is she so familiar? Why should I know her? Where have I seen her before!?" I figured I'd seen her at the hospital before, some random place, etc. I just couldn't place her. It was driving me nuts! All I knew is that I've gone to this same dentist since I was 2 and know all the hygienists, and this one had DEFINITELY not cleaned my teeth before!

Anyway, I sat down, we chatted a little bit and got all ready to start the wonderful process of cleaning my teeth. The TV was on some soap opera and she started flipping channels trying to find something slightly entertaining. We chose some Hollywood Inside show and there was a clip of Melissa (from the Bachelor) on Dancing With the Stars. The hygienist asked me if I watched DWtS and I said "no, but I want Melissa to win because I watched the entire season of the Bachelor." She kinda smiled and said "really? Did you know I was on that show?"

As soon as she said that it totally hit me who she was and why she looked so familiar! It was Shannon! And I had watched her every week! How crazy is that? So I sat in the dentist chair for 30 minutes thinking of all these questions that I wanted to ask her but yet I didn't want to sound like this crazy Bachelor fan and go all spastic on was kinda weird!

She was super, super nice, and afterwards we talked a little bit while waiting for the doctor to come in. She wanted to know where I worked and said that several of her friends were expecting babies and I think some of them are coming to my hospital...I told her that I every Monday night that I worked I would try to avoid watching the Bachelor in the patient's rooms so I could watch the whole thing when I got home. All she said about the show was that it was a "crazy experience." I can only imagine...

I called my sister (another Bachelor fan) and told her, I don't think she believed me. Frankly, I don't think anyone I've told has believed me! On the show none of the bacheloretts had listed as a hometown, but Shannon did said that ABC had them give their hometown for the show. brush with a celebrity for the day :) Maybe I can recruit some patients for my dentist! Haha!

Tuesday, April 7, 2009

Not Much Sleep

So I've been impressed that I haven't been into work since I got off after that staff meeting Wednesday night! I had a great weekend in Branson with my brother's baseball team and my favorite Branson show, so that just topped things off! I'm sitting freezing my butt off at my brother's baseball game yesterday afternoon at 1630 and my phone rings...go figure! I felt guilty, 'cuz they had called me Saturday night and I wasn't in town, so sure, I'll come in for time and a half. They called me back an hour later and said "well, we're OK now, but will you be on call?" Sure why not, I've just been up since 0830 this morning. I know nurses do that all the time, but I'm not most nurses and I need my sleep!

Now a smart nurse would have left the baseball game and gone home and slept in case she got called in. No, I sat there for another hour or so, saw my brother blast a 2-run homer over the fence to win the game, and then went and ate, let the dog out and went to bed about 2130 with my alarm set to call at 2345 to see if they would need me at 0100. My phone rang about 2330...and I was at work by 0005. and my 2 antes hung out for the night. My one ante who un-plugged her own monitor to go to the bathroom and didn't need anything all night...and my other ante who was on mag and was refusing another bag of it and was more worried about the TV remote working than probably getting delivered at 29 weeks. Some people just don't get it!

Anyway, I'd love to go to sleep now, but instead I'm going over to the school to help with the hot lunch program, then I'm supposed to teach piano lessons, then I have a mandatory "charting class" this afternoon at the hospital. So maybe I'll get a nap about, oh say, 1900 tonight? Sigh...But extra money is extra money for a new car, so...

Wednesday, April 1, 2009


I don't know if it's because I haven't slept well this week or if I'm just ready to be back at "my" house instead of house sitting, but this week has worn me out! And I haven't really worked any extra shifts! I'm ready for my 8 off...

Last night was really good actually, a good way to end my last 3-in-a-row. It wasn't too terribly crazy, I had a couple antes and then triaged a few. One of the other big hospitals in the city was on diversion (what's new?) and so we were getting all their triages, etc. I feel sorry for everyone when that happens, the patients don't want to be at our hospital, the docs don't want their patients at our hospital when they were planning on going to the other one, it's tougher on us because we don't have any records or pre-admit papers and so it makes the whole admission process take longer which means it takes longer to get anything done for the patient, etc. So that kept us hopping for a while. We had a couple midwife patients which was interesting last night, we only have 1 or 2 midwives that come to our hospital so having the midwife there was a new experience for me. Interesting to see some of the different ways care is handled.

I took a 19 week traige from the ED last night. Our unit's cut off for triage is 20 weeks (I don't know the exact reason, but that's always been our rule). The patient didn't see one of our OB's but her doctor had given her a due date in August per a sono she had had early in pregnancy and her LMP. The ED doc (who is NOT an OB) re-sono'd her and said that his sono said she was 21 weeks and so he had to send her upstairs. We went round and round and round about the fact that you can't just re-sono someone and change their due date, especially at 19 weeks! He said she needed featl monitoring, so I went and dopplered heart tones in the ED. That's all we would have done upstairs, we can't get a strip on at 19 weeks. Was that enough? No, we had to fix her since she was pregnant. So she got discharged from the ED, came up sat on the bed for 25 minutes with a toco on, we dopplered heart tones, the laborist asked her a few questions, we did her mountain of computer/paperwork and by that time she didn't hurt anymore and went home. Seriously? I felt bad for the poor patient!

For some reason several of us were a little slap-happy most of the night so a good time was had by all. It was our traveling nurse's last shift, that was sad. She's an amazing nurse and has been fun to work with. We all wish that she was going to stick around as full time staff!

We all realized it was April Fool's this morning so we filled in all the empty slots on the board with crazy patients for the day shift, then when real patients started coming in about 0500 we had the poor charge nurse so confused that we erased it all. It would have been funny though...

I went in a little early tonight to cover for one of the day nurses to go to the staff meeting, then I went to the staff meeting, then the board looked like "someone puked red and green" and I thought I might have to stay and help out for a while, but when I left they at least were forming a game plan to make it work. It looked worse than our April Fool's prank this morning! I think there were 2 nurses there extra already, so one of the docs told me to leave while I could, so I did :) Now 8 days off, a weekend in Branson, and a little R&R (including a dentist and an eye doctor's appointment)!