Birthday Nurse

My 200th baby!! I've been waiting for like a week for that and it took one of the nursery nurses to point out that I had it last night! And check out these stats... Babies today:1m Babies total: 94M/106F = 200 Vag:70M/80F = 150 C/S: 25M25F = 50 Babies 'caught' = 2f1.5m A 3:1 split on the vaginal deliveries vs C/S's... Almost a 50/50 split on the male/female deliveries... An exact 50/50 split on the male/female C/S deliveries... And 3/200 babies I got to catch... :D That one's the best one! Less than 2 years to make 200 babies, that's pretty good I would say!

Does Friday night have an OB curse everywhere?! It's like a full moon...Friday nights have a reputation for being beyond crazy!! Walk in the door @ 1830 and there are no empty rooms...and the board is FULL of labors! Labors are good....it means that they will get delivered and open up a room eventually...but they also can't be stacked up with one nurse, so it takes more nurses to take care of a board of labors over a board of antepartums. Still...I'd rather take labors anyday! Most of the labors were inductions hanging around from 0700, anywhere from 4-8cm. First clue that maybe the night is gonna be full of surprises, in the midst of a pushing marathon a family member passes out, splits their head open and is unresponsive on the floor. It took 3 docs and multiple nurses calling down to ED to have them send a gurney up to get her. "Well...can you put her in a wheelchair and bring her down, we're busy." Um...no. She's unconscious, we can't jus put her i...

I know...it's been over a month since I talked about babies...but trust me, they're still coming! We beat our record for deliveries in January...ever. >330 in 31 days...we thought that was pretty impressive! It's seemed to me that for as many deliveries as we've had I personally haven't done very many :( Lots of cervidils and antes. Maybe my turn is coming soon :) I did have some excitement Sunday morning @ 0600 when a SROM walked in and was in the best abbruption pattern I'd seen in a long time! Right off the bat banging out contractions every 30-60sec. Baby looked like one nice straight line (NOT a good thing). When I went to check her instead of a gush of clear fluid I got a handfull of blood. Of course we didn't have a laborist (in-house OB) that night, so I had to call her doc and get her to come in. I am so thankful for my amazing labor-nurse friends! We had the doc on her way, an IV started and a chart put together in about 15min of her getting the...

And how did we finish the last week of the year?! Like crazy nurses at work! Our "goal" to beat a yearly record of babies was to deliver 315 this month. Because of the holidays we were a few behind, but I think this last week we went crazy and ended up at 300. I worked Christmas night...and the next 3. Christmas night was super slow, we were in the middle of a huge snow storm. I sat for 8hrs without a patient! It was pretty amazing :) We sat around and made no-bake cookies in the lounge and had some good laughs. The next 3 nights...were not so laid-back and relaxed. We had like 19-20 babies every day, there were a bazillion inductions/c-sections scheduled and we kept hoppin'! I had a good delivery each night, did my first c/s with the new (kick me!) charting system and survived :) We all learned a valuable lesson about not opening our mouth about our shift being over and took a crash c/s back at 0643 at change of shift. Craziness!! Ready to see what another year brings! ...

Promise I haven't fallen off the face of the earth! More like into the crater of work! Even though it's the middle of October we're still busting at the seams and somehow managing to survive and laugh about it. Several fun babies lately...all girls, go figure!! There were moments that I felt like and idiot, a bad nurse and almost shed a few tears on the job...but then I look back on that night and think of all the things I learned and all the things I did that I didn't know I new how to do! I learned all about doing a D&C in our OB OR's ...something I'd never done. How to do a sterile vag prep (I've talked to 1 nurse on the floor who'd ever had to do that...). I learned that I could put a scalp lead on someone who was 1/60/posterior when I had heart tones in the 50's (even the doctor was impressed at that!)...and I learned that I could stand up to a doctor and get what I needed for a patient. I also learned that I have some of the BEST co-worke...

No babies this week, but last week I went OOT (out of town) before I got to talk about the 2 nice deliveries I had one of the nights I went in extra. The first was a C/S that was walking to the back as I came on. I almost feel guilty "claiming" that baby because I hardly even got to say "Hi I'm BDay Nurse" to the mom before the drape goes up and the baby comes out. Then in recovery they are usually so out of it, and after laboring all day, all they want to do is sleep. Doesn't leave much time for the "bonding" time. But nice, quick section. We were actually in the OR from in time to out time less than an hour. That's pretty impressive! It was a one of my favorite CRNA's on too, so that always lends some humor to the situation. I was ready to go home after my section recovery was over and I probably could have, but there were 2 patients who were almost complete so I told them I would stay until both of them delivered so that then they wo...

So let's see...I haven't had a baby in a good week! I think I'm failing in the "delivery" part of my job! I can labor them fine apparently...but I have a hard time getting the baby out! I have had 3 nice (well, exciting if nothing else) births the last couple weeks. 1st baby was a super fun couple that I cervidiled one night and then ended up doing the section for the next night because her cervix stopped at 9cm. They were lots of fun and their baby was ADORABLE! Honestly, most new borns aren't that impressive looking...but this little guys was super cute :) I even went back to visit them the next day on my day off to see how they were doing. I love stories like that! Next delivery was one of those "all of a sudden" ones where I had the C/S papers sitting on the desk because she'd been about 4cm for the last 3hrs. We had put in an IUPC and said we'd give her 2hrs and then were going to the back. 2hrs later she was complete! Yay !!! She did...

Only 2 birthdays in the last week :( We've been having babies right and left it seems...I just haven't been involved in them. That makes me sad!!! I want some babies!! It seems like I've had cervidils and antes a lot lately. Boo. Neither of my birthdays have been terrifically outstanding either. Pretty "run-of-the-mill" almost...for lack of a better word...boring! The first one was a close friend of the doctor...so get this...the doc stood in the room and pushed with her for an hour and a half!! Seriously?! I love this doc, she's great, one of our favorites. But come on. I can think of only a handful of things that can make an L&D nurse feel more useless and a waste of space than standing at the perineum and pushing with the patient the entire time. Makes it even worse when the patients husband is there, and so is her sister...who is a pediatrician. So for an hour and a half I stood in the corner, dumping some astroglide everyonce in a while while doc, pat...

I'm still here...don't worry...haven't fallen off the edge of the earth. Even though, after working 6 out of 7 nights in a row...I was pretty sure that it was going to be a good possibility. I had a couple nights of antes, a couple good deliveries, several quite nights...except of course the one night that I asked for "call." That night it was crazy busy. One of my nights included a double-forceps delivery. Mom was a very petite woman, and baby kept turning OP and wasn't very tiny. Finally after pushing for an hour and a half the doctor came in and used one pair of forceps to turn the baby and then another pair to expediate delivery. This particular doc is a pro at forceps, and is one of only a few who I would trust to use them. But still...they always make me a little nervous. Especially since this was the doc who the LAST forceps delivery I saw with him was when he missed the stool he was sitting on and fell and knocked out one of the nursery nurses. This de...

And the craziness at work hasn't slowed down over the holiday weekend at all!! Took my labor patient back for a section @ 2000...what a painful section it was. I had all kinds of pain orders from the doc after the section was over. It was going to be that kind of recovery. Then when the patient slept through most of recovery, I didn't want to keep pushing meds on her. Then got a nice chewing out from the postpartum nurse because the patient (who had no pain tolerance) rated her pain 7/10 when she got over to the other side. "Why didn't you start XYZ pain meds in recovery if she hurt so bad?" Well...because she was sleeping through recovery and couldn't keep her eyes open even when I was checking her fundus . Didn't sound like she needed pain meds to me! Moved that section recovery and took a ROL who walked in 3cm and ruptured. 20 minutes later she was 6cm so I called the doc and said "you better head this way..." and she did. Then as I'...

I was so thankful to have a day off yesterday! I knew how crazy it had been, so I took brownies up to work last night about 2100. The board looked beautiful!! Couple green names and 2 ROL's . Why can't I work on nights like that!?! So I dropped the brownies off and on my way out the door I made a funny comment about "now I don't want my phone to ring tonight because I've already driven over here once tonight!" I should have kept my mouth shut...! Sure enough, about 0245 my phone rings. When I'm in a dead sleep I don't really think about what I'm doing and I just grab the phone and answer it. Sure enough "we need help! People just keep walking in!" Ok ...I'm on my way. I couldn't say no after what I'd said earlier, and after the week we'd had, I know what it's like when nobody will come in to help. Only as I was getting ready to walk out the door did I realize that it was torrentially pouring buckets outside...no wonde...

By Thursday night I was seriously dragging. We had all gotten our butts kicked all week long, and you could tell all us nurses were getting near the end of our strings... I took my patient back for a C/S about 1910 after her being a cervidil the night before and then on pit all day and having made NO change. That and the fact that every time she rolled or changed position baby would have a nice 5-6min decel . A C/S was definitely the best decision for her and her baby. She was a young mom, first baby, and she was giving the baby up for adoption after 24hrs. Got her all ready and back to the section we go. That's where things started spiraling out of control. We had a great anes team on that night, and usually it takes all of about 10 mins to get the spinal in and the patient comfy. So we started working in the back, since we didn't really want to move mom and cause another decel anes tried to put the block in while Mom was laying on her side. This is nothing new for them, ...

Another 2 crazy nights to finish out the week...Wednesday night was another attempt to float me to M/B...that lasted about long enough for me to finish my C/S recovery. Then I took a cervidil , another triage or two, then got a SROM that I got started and ready for dayshift . Pretty good night overall. Loved my cervidil couple, and the SROM couple was pretty hilarious. Thursday night was another night in the zoo. I got to take my cervidil couple back from Wednesday just as she was complete, so we had a baby by about 2000. She did so good, but had had a LONG day on a LOT of pitocin to get the active labor going, so she bled after delivery. Some methergine and 800 mcg of cytotec later and she was OK. I always love to finish those cervidil deliveries, especially if they do it without being cut. I get the start process and the finish process too! An hour into the recovery I claimed the triage crown again and started my 1st of about 4 more triages . One in, one out, one in, one out...

Don't know why, but it seems like I have been working ALOT lately! And the sad thing is...I really haven't been! I haven't done the 6 or 7 IAR thing for a long time, just my 3's with 2 off in the middle. But this is my last set of 3 before my "long stretch" and maybe that's why I'm tired. This week kinda messed me up too with the holiday. I didn't get to work my Sun/Mon/Tues, instead it was Mon/Tues/Wed...so I've been behind a day all week! After my rough week last week I've been a little over anxious/nervous every time I come to work too. I didn't get my first baby 'till Wed, and that was a C/S that wasn't supposed to happen but baby only tolerated the cervidil for about 5 hrs before it got grouchy. I've done cervidils the rest of the week, I guess I had a recovery one night too, but no babies. :( Sadness for me! I'm super glad that I get a few days off now, I need some time to sleep and exercise some, that's f...

Ok ...so Tuesday night I learned that I should stand up to doctors when I want something or think something should be done for my patient. Last night I learned that it's probably better to call the doctors TOO often than not enough...and to go with my gut feeling instead of listening to what other people are "suggesting" even if they may have tons more experience and their opinions make you feel better about the situation at the time. My strip turned to @(#^ last night, and after one run-in with the doc earlier in the evening I wasn't too excited about calling her back and asking for her to come back in to assess it. I had one nurse saying "ya...maybe you should call" and another nurse who has worked there WAY longer than any of the rest of us saying "no...it doesn't look that bad. If it was bad you'd be doing something about it not just sitting here watching it." Ok ...so I didn't call 'till the patient was almost complete, then th...

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 cha...

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. ...

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 ...

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 5 th 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...

Thank goodness I am done for a few (8!) days! Of course I didn't get call last night, and the longer the night went on, the worse it got, and the funnier/more ridiculous it got. We knew ahead of time that we had a @#$% of stuff already scheduled, 5 cervidils , plus all the un -delivered people left over from day shift. So we walk in and the board looks like poop, and it just gets worse. I start out taking the fresh ROL that's sitting in the lobby, and the triage gates open. We had 11 triage patients walk in through the door, I took 7 of them, and the last one ended up being a repeat C/S. Of course our whole computer system was down, so I got to learn how to paper chart. I'm sure I missed SOMETHING, but at this point, all my people were breathing and that's what counts...right? So here's my night in a nut-shell: Pt #1 - rule out labor feeling "pressure". She was 2cm...sent her home in an hour Pt #2 - "I think my water broke" what's your due...