Birthday Nurse

I know I shouldn't post this when I have two more nights left this week...but I can't remember a night being as good as last night. It started out way hectic and I wasn't sure how it was all gonna turn out, but it was busy enough that it kept me going and the night was actually really good! The worst I had of it was chasing babies, but even that was ok, at least the babies were behaving! My cervidil I expected to labor just because that doc has the reputation of delivering people off cervidil's, but she was pretty quiet all night and baby was a perfect angel, best looking strip I've claimed in a long time! She slept most of the night too, so I'm glad she didnt' hurt too bad. I walked in at the same time as a R/O PROM, and was trying to do that and get the cervidil started all at the same time. By the time I got the cervidil situated I caught the on-call doc for the R/O and he proceeded to do the 1-million dollar workup on the PROM and then decided that she w...

So I was thinking last night after I worked an extra 6hr shift that right after times I think I'm really getting this L&D nursing thing, something else happens that shows me I still have SO much to learn that it scares me all over again! What am I still freaked out about as an L&D nurse? The list seems endless... ~ Decels , no matter what kind, still scare the snot out of me, because it only takes one decel to never come back up again... ~Crash C/S- I seem to get flustered at the littlest things, and at the wrong times anyway. If I can't open a scalp electrode at the right end, how am I gonna rush a patient back for a stat section all in one piece without forgetting something important!? I'm sure it's something that after I do it I won't be so terrified of it, but until that happens... ~A REAL shoulder dystocia - I know how to do suprapubic pressure, but what if that doesn't work? ~ That one time there's no heartbeat...heaven help me if that ever...

It seems like I've worked a ton this week, even though I really don't think I have...I worked Christmas night, it was f retty quiet, but got kinda "clinic-y" since the offices were closed. Lot's of "I'm cramping after I've been up and going crazy the last few days" so lots of hydration, vistaril and home. I had one long term ante who's gonna be around for awhile r/t a complete previa . Gave her a colace , took some vitals and visited with her. Other than that...she slept all night. I did one or two triages too but they all ended up going home. Read through some good trivial prusit cards though! Last night was a little busier, but still really, really "clinic-y" I started out with the same ante from the night before, sent another one home about 2000, then got a ROL about 2100 that was in labor (I suspect 8 hours of shopping gave her a pretty good start). She and her very supportive parents and FOB were really fun and nice. Sinc...

Ok ...this not being able to sleep at night is really starting to get to me. It's after 0300...and why am I not tired? It's weird to think that at this time yesterday morning I was still shaking after catching a baby. But I'd do it again (and hopefully will again someday!) in a heartbeat! P.S. Everything but one little tiny spot of meconium came out of my scrubs and my brand new long sleeved shirt I was wearing underneath. That made me VERY happy, even though my mom wanted to know why I was doing laundry at 5am...!

New favorite quote from a patient/family member... New Grandpa : "Did you play baseball in school?" Birthday Nurse : "No...but I watch my brother play and I play softball in the summer. Why?" New Grandpa : "Because you're the best catcher I've seen!" This after I delivered his new granddaughter all by myself :) I've wanted to "catch" a baby forever...seriously! But I really, truly believed that it would come after working as nurse for much longer and with a doctor right behind me guiding me through the process, not with one glove on as the patient is puking after pushing for 7 minutes. But, there is NOTHING like that surge of adrenaline, ask the scrub tech (who came in as I'm suctioning the baby after the friend went down the hallway looking for someone to help me) who was standing behind me watching my knees shake as she's handing me stuff to clamp/cut the cord and draw cord gases! Oh my goodness, I thought I was gonna fal...

~~ Sorry the time/date is wrong on here! It should have been about 2045 on the 22nd...but I got called into work so this got posted after I got home :) ~~ So after I left work this morning I really am not sure that I'm ever going to feel confident in this job! I know there are shifts when nothing seems to go right, and everyone has them...I think I just had one. What a way to top off an already long weekend (even if I was on call Saturday night!). Started off the night with one ante who was in for a PIH eval and a 24-hour urine, 38 weeks, no big deal. Well then at 1855 another gal walks in, and guess who got elected for triage duty? So I took her back and got her started, it took me an hour before I got into my original patient's room. Finally get both of them somewhat settled and my PIH baby starts randomly "dumping." Baby was all around a little 'sleepy' but nothing too overly horrible, mom's uterus had some irregular irritability that she was sleepin...

I've never had a "call date" (being on-call for at least 6hrs on a night your scheduled to work...) and trust me, tonight was the perfect night for it. I kept thinking in my head on the way home from work this morning how I would 100% take the call option if they called and gave it to me tonight! After last night, I needed some time to think and just take some deep breaths. I really didn't think that the whole shift last night effected me that much until I was writing about it this morning and bawling my eyes out...and then when I woke up from my nap this afternoon crying again after dreaming about it. I was feeling so guilty because I didn't shed a tear last night when everyone around me had lost it. I was really wondering why it wasn't getting to me when I knew it was a horrible situation and now I haven't been able to stop myself from tearing up every time I think about it since. So after I decided in my head that I would take call tonight I got to thi...

So I was on call tonight just long enough for me to change out of scrubs and head to a Christmas concert with my parents...then got called and told there had been a scheduling mis -hap and if I could please come to work. Ok , no big deal, that means time and a half for the first 6 hours. I figured (that's the last time I "figure" anything about this job!) that they would want me out of there ASAP since I was a call-back and making extra money. So...what do I walk into? J met me in the lounge as I was putting my stuff under the counter and going to change and said "girl, get ready to cry your eyes out. You're walking into a sad situation." Great...what happened now. So over the next 2 hours as I piece the story together...G1 came in for a cervidil the night before, good pregnancy, no real problems, labored all day on Pit, good strip, got to complete, pushed and wouldn't descend, went to the back for a C/S...baby came out dead. Parents declined an autop...

So when I was at work Monday night I figured I would do my good "nursing duty" and sign up to be on-call from 1900-0100 last night (Wednesday night). There were already 6 nurses scheduled, and I don't remember the last time I heard them calling someone in from "off the door" where we sign up for extra shifts, so I really didn't think they'd use me. I finished teaching piano lessons about 1700 and thought I would just call to see if they had an idea if they would need me or not...and the day charge nurse said "Come in!!" and sounded pretty desperate. So I dashed to the gym, only got in a 40 minute run and then jumped through the shower and went to work, and they really used me the whole 6 hours! I only had a cervidil , but everyone else was either doubled up or in the back doing sections, so I guess they really did need me! I guess the "ante" world hit today and there were 7 or 8 antes who were gonna be longterm or at least until they...

Cervidils...cervidils...cervidils! But I survived my 2 nd night of "unsupervised" nursing...and both my patients were breathing when I left! I was 1/2 expecting to get put on call, but I didn't...until 0315. I was the only person who hadn't had a "call" date yet, and the one person who wanted to go home had left about 2100, so I was the next one up when we only had a recovery and my 2 cervidils . I was on call for 11 1/2 hours Sunday night, but they ended up sending people home that night too so I didn't have to go in. I'm signed up for call tomorrow from 1900-0100 and am crossing my fingers they really don't need 7 nurses! Then I work this weekend and I'm sure I'll be there for the duration of it, but that's ok ...I need Christmas money! Got some pretty snow today that started right after I got home, so I'm glad I got to drive home and miss it instead of driving home in the thick of it at 0700! Babies today : 0 Babies total : 28...

So I went into work last night kinda sad that it was my last night on orientation, I even took brownies! Imagine my surprise when they told me I wasn't on orientation last night...I was just on my own and here's your patient that's 8cm. So, deep breath in, grab a pager and go. And guess what...I survived (and so did my patients!) :) The night went pretty good! Really nice delivery about 2000, first baby, mom and dad were both super excited and fun to talk to and get to know. Everyone showed up on time (nursery included) and it was a fun birthday party! Got the recovery all done and Mom moved over to her postpartum room before my triage showed up, so I was pretty excited! Triaged a R/O pre -term labor who was contracting, but not changing so vistaril'd her and sent her home before 0100. Then sat on my behind until about 0625 when the C/S that was scheduled for 1400 showed up in labor. Now here's what I can't figure out...when I took the traige at midnight, and...

Thank heaven for auto-save! I went to publish my post about my weekend and lost i nternet connection and thought I deleted it. I was about to just update my "baby stats" and leave it at that...but I found the saved completed draft :) Go Blogger!!!

Maybe it's because I hadn't worked for 8 days...but this weekend was an adventure! I loved having 8 days off, but I'm afraid it may have been a little too long, cuz all of a sudden 3 in a row seemed like a LOT! Thursday night we did a cervidil that did nothing and ended up being cut Friday afternoon, and I also had a ROL that was a G7 who came in banging out contractions every 2 minutes that were off the chart. We watched her for the last 4 hours of the shift and she never changed, but was still contracting pretty regularly after fluids, vistaril , terb , and a morphine/ phergan combo IM . But nobody wanted to send a term G7 home still contracting that often. I think they sent her home mid-morning on Friday. Friday night was when it got interesting. I think every L&D unit has "codename patients" who are frequent fliers for a very LONG 9 months and everyone celebrates after they deliver :) It seems like some docs specialize in these kinds of patients too. A...

I really do like work, I was just telling someone last night about how much I love work. But after working 6 out of 8 nights...I'm ready for a few nights of sleeping when it's dark outside! I know it could be a lot worse, it was never more than 3 in a row, but still, that's a definite switch to the night shift! Last night had the potential to be crazy, but turned out not too bad. We started with 3 antes, but one was a set of 35wk twins that everyone thought was going to deliver. We went 2 out of 3 home before 2100, and I had the twins pretty settled down but then another "early labor" patient walked in about 2145 that kept me running. I think ER sent up 4 patients in an hour and a half last night! That is too many... The twin mom had come in early in the afternoon and had been 2, then later on 3, then even after terbX 2, vistaril and fluid she was about 3-4. She was rating her pain and had gotten some nubain right before I got there. The doc said that she real...

So besides a C/S recovery last night, the only thing worth mentioning is the gal that came about midnight...carrying her baby. These are always a little scary just because you never know what to expect! (The last one of these I took from the ER brought her placenta with her and said she's dropped it carrying it down the steps and it was full of sticks and leaves and grossness...) The lady from last night said this was her 5the baby, and she just wanted to make sure it was OK. She said she had left her other 4 kids asleep at home and she didn't want to stay, but she'd already set up adoption stuff and wanted to bring the baby in. Baby was ok , just cold from being outside, so he went to the nursery. The laborest checked out Mom and found a bunch of clots to get out. We asked if Mom wanted some pain meds but she said no, she'd just delivered a baby, it couldn't be that bad...so the laborest did a 45min D&C in the room with NO meds . There were three of us stand...

I'm hoping this week doesn ' t take the same pattern as last week with each night becoming more busy and crazy than the last! I started out the shift right by going to the gym and doing a good 5 miles, which made me feel better. I was crossing my fingers that work would be slower, and it was VERY slower! I did a 2130 delivery and then took over on a cervidil after I moved my delivery over about midnight. My delivery was a really fun girl who already had 2 little girls and as soon as I walked in the room right before 1900 the little 3 year old came running over and threw her arms around my legs and started talking up a storm and didn't stop 'till I tucked her into bed in the postpartum room with mom! The delivery was super smooth too. The same doctor did it that came and played with us on Thursday during all the drama. Every time I work with her, my level of respect goes up for her. She is a good doc, and she is a lot of fun too. Besides the cervidil that I watched co...

I haven't done 3-in-a-row in a while, but it really wasn't as bad as I thought it was going to be. I'm exhausted and going to bed at 1900 tonight, but I'm really OK with that! We were busy enough last night to keep us all on our toes... Story #1: Gotta love those shift-change catastrophes. When I walked in right at 1830 last night, the unit looked slightly deserted but everyone who was there was a little high strung. I guess about 1810 a lady had walked in 33 wks and said that she had severe right upper quadrant pain. She said it may be contractions, but they just felt funny. The nurse got her on the monitor, got about a 5 minute reactive tracing and then it was the crash. Baby didn't look HORRIBLE, but dropped from 150s to 90's. When I got there she was being rushed to the OR, general anesthesia and the doc was yelling "get the NNP , we're going to have a 33 weeker !" They thought her uterus was rupturing, but when they did the C/S her abdomen w...

So I was all set for nights to be lots of sitting around after Tuesday night. Last night, I think I sat down and took a drink about 0200 or so... Chipotle is still pretty tasty about 0245 when you're starving! We did a delivery about 2130. Kid was seriously +1 or +2 when we started and she could have delivered a lot sooner of she had given any effort to pushing. There were 3 of us in her face really trying to get her to do anything. There was no pressure against that kid's head with that first 45 minutes or so of pushing. Then her lower uterine segment oozed and oozed, methergine , still oozed. So she got extra pit, and she's gonna have some bruises on her stomach from our "mashing." I think it's the weirdest thing when you check the fundus and the cervix sticks out like a tongue. Ha!! Our cervidal across the hall came in the same time we started pushing in the other room so another nurse kinda helped us tag team. She came in saying "I've been havi...

So I'm nervous after the first night goes decently well...I actually thought about sitting down and blogging about 0200 this morning since I was doing nothing, but thought it wasn't very good "nursing practice" to do my first shift with a bunch of new people. The night group seems really relaxed though, and it was a good group of nurses to start out with. I wasn't sure what kind of welcome it was when I looked at the schedule sheet when I got there and my name wasn't on the list. I guess the message hadn't gotten relayed that I was beginning orientation last night, and the nurse that I was supposed to orient with was orienting someone else, and it was slightly a mess. But I refused to go home, so after some assignment switching and swapping, I ended up with a different nurse and a different patient, which I was ok with. That nurse ended up leaving about 0100 and so then I got passed around to whoever else was watching over my shoulder. Ha! I felt bad for...

I haven't put a pair of scrubs on since last WEDNESDAY morning! That's only 12hrs shy of a week! I must say, I'm feeling kinda glad to put them back on, simply because I feel like I haven't really done all that much this last week. I'm not married, I don't have kids, I'm still living at home (rent is WAY cheap and I don't have that bad of a family...), and besides several gym workouts, church over the weekend and some stuff with friends Saturday night the busiest I've been is when I cleaned all day on Friday! Maybe it's just me catching up on all the time I spent in college NOT being lazy, but I'm ready for something to do. So now I'll work 3 in a row and we'll see how I feel on Friday morning when I'm crawling into bed! I haven't worked a night shift since the night that I found out I passed my boards. I can't believe that night was almost/only 3 1/2 months ago! I'm sure night shift as a real nurse isn't going to...

So I haven't worked since Wednesday, and don't work 'till Tuesday, and I'm feeling like I'm missing something without blogging! I told myself that this blog wasn't going to be an online "diary" I was going to keep it work-related. So here's my weekend musing re: work. I've talked to several people and after reading lots of other L&D blogs, here's my question: in a delivery in "your" hospital, who all is there for the delivery? Obviously the doc and the L&D nurse, but is there anybody else typically "required" to be there? I know at our hospital all of our nursery nurses work really close to us L&D nurses. Our Well-Baby nursery (where all babies are admitted to at birth) is right next to our nurses station and they can see our "board" with patients and docs and progress, etc. All the nurses that work in Well-Baby are NICU nurses and everyday 2 float out and do "admits" and come to all our d...

I was so excited when I got a text message from J this morning. My 35 week VBAC did it this morning about 0900! I was so pumped for her! I guess she was 1, 1, 1, then got to 4 and stayed at 4 the rest of the night. I think the doc was about to call it when she came over this morning and she checked her and she was complete! I was over at the hospital working-out this afternoon and so I stuck my head in to see how she was doing and both she and baby were doing great. Baby was an automatic NICU admit because he was only 35 weeks, but he was rooming-in with mom and dad and was doing great! He was 6# something so he would have been huge if he had gone full term! I was so proud of her, she was super excited and I think her labor was more like what she wanted then what she had thought it was going to be like. I just really wish I could have been there to help. See if I ever doubt a laboring mom again! From here on on, I'm going into every labor believing that they can push out their b...

So the good news about going to night shift is no more alarms going off at 0515 every morning for work :) That makes me happy! It makes me very, very, very sad that I don't get to work with J anymore though. I actually got a little choked up and teary last night when I was writing her a card. J has been the most amazing preceptor/mentor whatever you want to call it, she's been it and more. She was the one who first every taught me anything on the floor about L&D out of nursing school. I worked with her for 3 months last summer as an student intern, did over 50 deliveries with her last summer and I really think that it was because of her that I got the job offer on L&D after graduation. She was the one who encouraged me through the last year of nursing school and even more this summer after I had to re-take my boards. She's done all of my precepting and has taught me everything that I know about L&D nursing. Everything I can do I have her to thank for it, and ev...

So after my experience on Friday, I walked into work this morning really excited to have at least 2 more inductions to round out my days orientation (I go to nights next week!). Boy should I have never have pre -planned what my day was gonna be like. Walk in, what color is my patent's name? Green. Next to purple names ( DIU's ), green names (ante's) are my least favorite! And this wasn't just an ante, it was stable 27+5 twins who had been on mag since yesterday afternoon. 2 mag patients in a row, give me a break!!!! That means no new patients for 12 hours. Just me and the twin mom. So after that put me in a very sad mood, my day wasn't too bad. I know I should just be happy with what I get and be ready for anything, but two days of sitting on my behind watching mag babies (or answering 24 un -needed call lights) I really am ready for a delivery! This twin mom was really nice though, these are her 3rd and 4 th babies, and we became friends after I let her eat food ...

So this is the blog that relates to Friday at work, and since it's Sunday morning, that should say something! J wanted me to do at least one more day of antes before I'm done with orientation, so we figured there should be some on a Friday after they've had all week to pile up on the board. Sure enough, we got a Mag patient on for PTL ( pre -term labor) and then another one... The mag patient was too fun, she'd come in the end of our shift on Wednesday , so had been there for a while, she was 1cm/100%/-1 and 30-something weeks. She was so sweet, and so scared, and ready for the mag to come off! Poor girl! She was so tiny that the toco was picking up anything little thing so she looked like she was really crampy and irritable, but I think she may had one or two decent contractions every hour or so. Personally I think the vistaril that we gave every 6hrs was doing her more good than the mag was...She hadn't really changed her cervix so I think the plan was to turn...

So after today, I only have 3 shifts left on days! That just kinda hit me today, and it makes me sad! I'm still a little ( ok , a lot) nervous about going to nights, I think just because that means that I'm almost on my own and nobody's watching my back, and I've never worked nights on L&D before. I've worked nights a lot as a CNA , but not on L&D. I love the day nurses, and now I have to learn a whole new group of people, how they tick (or maybe what ticks them off), a different routine to the unit, it's like taking a big step back! And I'm going to miss working with J, she's been my nursing "friend" for a long time, and she's the one that's taught me everything I know about L&D nursing. Shoot, now I'm getting all emotional and depressed about it! Anyway, today was another good delivery on my own. Another multip induction, really nice, young couple. I wasn't sure how it was all going to go at first, I think it ...

It seems like forever since I've actually gotten to do a delivery! I guess I should kinda get used to that, ' cuz I know I'm not gonna get to deliver every shift when I work nights. Speaking of, it looks like it's gonna be in about 2 weeks, but more on the mixed feelings on that in another blog (not tonight!) I knew when I went to bed at 0000 this morning that I was gonna be in for a long day. I went up and visited all my buddies who are still in school in Lincoln this weekend, and so had a great 5 days off, but then of course got back late last night and was all geared up from my long weekend and didn't get to bed when I should have. I don't think I really woke up 'till about 1000 this morning. I had a prime induction, the kardex (our cheat sheet that gets filled out when patients pre -register. It has basic health history on it, G/P, special requests for delivery, etc, etc) said that there was limited English, so that made me a little nervous. It's h...

I've seen several blogs where people say "people found my blog by searching for...X" how do you see how people find your blog? I have something that tells me who's visited my blog, but I can't tell how people find it, like what they search for and then my blog pops up? Is it something I need to add to my blog or am I just not looking in the right place?

I got a really good comment a couple days ago about nursing jargon and abbreviations, and it made me really think and smile and remember back to just a few months ago when I was learning how to "talk like a nurse" and to save my fingers when typing or writing, and since I'm a bad speller, how to save some face and just abbreviate! So I'll make a little list to maybe make reading my ramblings easier. I'm sure I'll forget something, but hopefully it will help a little! Primip /prime - woman who this is her delivery, it is frequently her first pregnancy too. These labors usually take a little bit longer because the woman's body has never done this before. These women usually come in and have lots of questions and are really nervous, as I would be too! I like prime's because I get to really ease their worries and concerns and help them through the labor. Multip - women who have had a baby before. Their labors are "usually" faster because their...