Birthday Nurse

For as busy as we've been lately...it's been pretty ok! It's so nice having enough night staff to go around, and my phone hasn't been ringing off the hook every night looking for help! So what's the answer going to be? We're sending more nurses to day shift....of course! But, we will survive, because we always do, and we'll laugh our way through it :) I've realized over the last few weeks how much I love the girls I work with. They are 50% (some nights more) of why I love my job so much! I got my first "thank you" from a student that's been working with me. I got so excited! She wasn't even really "my" student, but she needed some more shifts, so she's been working a couple nights with me over the last few weeks when her normal preceptor wasn't working. It's been fun and really an eye-opener for me. I've never really "preceptored" anyone before. It's hard for me to preceptor new nurses to the floo...

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! ...

What an interesting beginning to my week. One that I wasn't too happy about...until after the shift was over and I took time to think about it. We're one of the only hospitals in the city that has a psych unit (and it stays pretty busy!) For the last several weeks they've had a pregnant woman upstairs who came in with suicidal intentions (she wanted to cut her baby out). So they've been doing NST's etc on her and had just done an amnio and schedule her for an induction. Well, lo and behold, the same day she was scheduled for a cervidil, her water broke. So down to our unit she came. Her and her 1:1 status. When I got there she had just gotten admitted and started. She was on pit and planning to go unblocked. So I settled down in my hard wooden chair for a very long night. When the FOB decided to come up to see her (one of many social problems) she decided to get an epidural to make him happy, and proceeded to progress nicely. She was a super pusher and let's jus...

I know, 3 weeks is a long time to go without blogging...but 3 weeks is a long time to go without a baby too!! We've all been running our tails off at work the last several weeks, but I've seen no fruits of my labor. I keep getting antes, cervidils or getting a labor patient started and then leaving them blocked, comfy and well on their way in the morning...just to let someone else get the fun of delivering :( Even worse are the nights I've come in and had 3 recoveries to move...that's just the dirty work!! Oh well...I guess it's all a part of the process, so I'll do it anyway. I did get "fired" for the first time by a patient this week. I was more than a little upset and hurt by it...until I found out that there hadn't been a nurse yet that she'd gotten along with...including the "reverend mother" of the unit (the sweetest, most caring, gentle, knowledgeable nurse on the unit). The first words out this woman's mouth were "ho...

I'd forgotten how hard it is to go back to work after a long stretch off! Maybe that's because it's been so long since I had more than 2 days off in a row! After going in extra for a few hours both last Thursday and Friday I was off 'till last night! Count it...that's 5 whole days off!! It continues to be super, crazy, insane busy at work. We had 7 deliveries just on night shift alone, with a board full of cervidils and antepartums to beat. We were busy, but thank goodness we had 7 nurses there too! I had my first delivery in what's seemed like ages. At least 2 weeks I think. I wasn't all sure that it was going to be vaginal, but she did it!! I was so proud of her! 1st baby and a great support system in her sister, boyfriend and boyfriends' mom (even more impressive that the baby wasn't this boyfriend's but from a previous relationship). It was fantastic! We've had 210 babies as of midnight on the 18 th ...that's a lot. If it weren'...

I set a new record at work last night...3 babies in a shift! I don't think I sat down all shift! And I know I didn't have a chance to pee all night (but that's nothing new anymore) :( I had one delivery right off the bat @ 1845. Sweet little gal I had cervidiled the night before. Getting induced early for low fluid, never really thought she'd deliver vaginally. She did awesome!! Got delivery #1 recovered and moved, then took over another labor patient from another nurse. She was 5, blocked/comfy and went from 5 to complete in about 45minutes! She was a great pusher and had a fantastic soundtrack of "pump-it-up" music that we played while we pushed. It was the best pushing session I've had in a while! It gives the nurses energy too! She had a little bit of a long repair afterwards, but was a trooper about it. Got delivery #2 half way recovered before my next patient got there. She labored pretty well, tried the tub, tried an epidural that didn't really...

One of my favorite things is when I get to deliver someone who has personally asked me to be her nurse. It gives me a warm, fuzzy feeling in my stomach that someone picked ME to be their nurse and I wasn't just the one who got assigned to her! One of my friends asked me months ago to be her L&D nurse and we've just been waiting and waiting. I think the waiting's been worse on her than me...she's been ready for this baby to be here for months I think!! I just finished a stretch of 8 days off and was out of town for part of it and we all knew that's when Little Miss was going to make her appearance. Mom had been contracting for days and days. She'd gone in for a labor check and wasn't doing anything. She was scheduled for an induction a couple days past her due date and wasn't too thrilled about that. Finally, my first day back at work, she came in ruptured and delivered in 3 hrs!! It was so fun! Super delivery and a super sweet baby. Congrats to Mom,...

Just finished up working 12 shifts in 14 nights...not something that I would recommend doing again for a long time to me or anyone else. That's a lot of work in a not-very-long amount of time!! We have been so busy that the norm anymore is to have no empty room and have to put the elective inductions on hold just because we don't have anywhere to put them!! I could have easily worked both of the nights that I didn't if I had wanted to...but I just couldn't knowing that the first time it would have been 9 nights in a row and the second time would have been after I had stayed over from night shift 'till noon the next day and couldn't force myself to go back at 1900 that night. Anyway...is everyone else seeing a big increase in baby #'s for October?! Our thing is too it's not just "babies" it's pre -term stuff and antepartums filling up the board! A complete previa at somewhere around 30 wks ...that's gonna hold a bed for as long as po...

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...

50 Best Blogs for Neonatal Nurses Nursing Schools : LPN RN BSN MSN : Online Nursing Degree This is what I find surfing the blogging world...I had no idea!! Check out #9!! It makes me feel special :) Congrats to all the other bloggers out there who made the "Top 50 List" too!!

Things have been super busy/crazy/insane at work these last several months (welcome results of winter "coziness"!) and it has led us night shift people to think about our staffing situation. I'm asking for your advice/input/ideas!! My question is...how are you staffed on your units? What have you found that works best and what doesn't? How do you handle putting nurses on call? Any suggestions would be MORE than appreciated!! A little bit about our unit... We are a 17-bed L&D unit for both labor/delivery and antepartum . We average between 320-340 deliveries a month during most of the year, closer to 300-320 during the winter. We don't have a separate antepartum unit/rooms nor a triage area. We have 17 rooms that we use for all of the above. We triage/labor/deliver then after 2hr recovery move patients to postpartum. We have 2 OR's and then 4 separate PACU rooms for our 2hr C/S recoveries before we move them to postpartum. Our L&D nurses do both vag...

Wow, I'm been doing this blog in spurts lately...I end up doing it AFTER I've worked for the week ' cuz there's not much energy in between shifts! This month has been crazy busy, we were already pretty close to 300 babies when I left on Thursday morning!! I've had several nice deliveries, 2 of them last night!! Yay for double deliveries! The two last night were 2 within an hour, that's always good for getting the heartrate up! I did one delivery of "my girl" that I'd had since the beginning of the shift, then walked out and there was another girl that was 7-8 and for some reason the nurse that had her wanted me to take her and finish her delivery. I'm not sure why but the girl was unblocked and there wasn't much time to argue!!! By the time I walked down to the room (for the first time) the midwife said that she was 9+ and wanted to get back in the tub. I wouldn't have gotten her up to the tub at that close to delivery, but the midw...

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...

We've had 5 IUFD's ( Intra -Uterine Fetal Demise) in the last week. 21 wks , 33 wks , 32 wks , 35 wks and 36 wks . Come on! That is WAY, WAY, WAY too many. I haven't taken care of a demise in a long time, since that one last Christmas that hit me so hard. I feel like I've helped with almost every one, but last night was the first one that I've actually taken care of since last December. I hate them so much. All these babies who never have a chance, most of the time we never even know what happens. Mine last night was a rare case, he had a chromosome anomaly that the parent's had known about for most of the pregnancy. They were prepared, then were expecting something like this, and they knew exactly what they wanted. That makes it so much easier on us nurses, and in some ways, I think it makes it easier (at the time) for the parents. They had all their family there, they had all the little outfits for him there, they had their cameras, they had a name, they had...

I promise, promise, promise that I still blog once in a while! Somehow, when I'm so exhausted in the morning, blogging's the first thing that gets put off. So I have to wait 'till I have a day off to do it! Those seem to be pretty few and far between anymore... I was scheduled to work Thurs/Fri/Sat last week, and I did. But Wednesday I went in and worked extra at the last minute. I was mowing all day long, and they called looking for help during the day shift that afternoon, and I couldn't do that. But then the 2 nd time they called me @ 1700 looking for help that night I felt too guilty to say no. So I jumped through the shower and went in. I don't think I've caught up on sleep after that... It has been raining antepartums and pre -term patients for the last week! I swear, we'll have 5-9 antes on the board every night...and when there's only 17 rooms total...that doesn't leave room for too much else! I can't wait for our new unit that is supp...

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...