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)!
I have been following your blog for a couple weeks now (for some reason I can't comment unless I'm on Firebox instead of Internet Explorer). I THOROUGHLY enjoy your blog and love that you keep a tally of how many births you've participated in.
ReplyDeleteHope you have a nice relaxing 8 days! I'm curious what the differences you noticed between the midwives & the doctors...
ReplyDeleteJoy...thatnks for following! I'm glad you enjoy my stories :)
ReplyDeleteChristina...I wasn't actually the nurse for the midwife delivery, and it's been a couple years (since I was doing my OB rotation in school) since I've acutally seen a midwife delivery, but I know that Tuesday night I saw lots more walking in the hall, less monitoring (thank goodness the baby looked good!), AROM later in dilitation, etc. Granted, this wasn't Mom's first baby and she had done this before too. It was good! I was impressed that this midwife seemed supportive, I have seen some of the midiwives not be so supportive and I've been surprised by that. This was a good one!