Sunday, September 7, 2008

6-Complete in 15 Minutes

Friday was my day to work with my "other" nurse. I think it's been really good for me to have two main nurses that will let me work with them. J teaches me a ton every time I work with her, and then N makes me go out and do it on my own...and I ususally surprise myself with the confidence I come away with.

Friday we had a carryover induction/cervidal from the night before. This was her second baby, and she was bound and determined she didn't need an epidural b/c she hadn't gotten one 18months ago with her first baby 'till she was 9cm, and by that time it didn't really help her. She was about 3 when I came on, and the doc came over and was denying any pain. Then the doc came over and broke her water...and then it started hurting. I figured it was gonna be a long day, especially after we started Pit and they weren't just "natural" contractions anymore. I figured I would be spending the bulk of the day in by her bed helping her through it. All this time and N hadn't even walked into the room was really MY patient! About 0930 I came out to the desk and did my "happy nurse dance" because she had said she wanted an epidrual. Not because I forced her to get one, but I think because I got down on my knees by the bed and told her it was her choice, that we weren't gonna make her do anything, and that this baby was going to be so lucky to have her as a Mom. She was much happier after her epidural. I even set up the pump right...expcept for taking the cap off the tubing...oops!

I checked her after about 45 minutes of epidrual bliss, put in a foley. She was about 5.5-6, but I told her it wouldn't surprise me if she went quick, it being second baby and all. I drained about 500cc from her foley, and was charting beside her bed and she kept saying that the foley hurt and it just didn't feel right. I hate it when they say that, because then I feel like I either totally missed something, or something's gonna happen that I'm not prepared for. But I was so proud of myself, I stuck on a glove and re-checked her...and she felt complete to me, even though I had JUST checked her! The cervix had swung totally around and the head was right there. So I *calmly* went out to the desk...N wasn't there so I grabbed another nurse and had her come recheck. Ya...complete and +1. We had a baby in like 30 minutes, and only that long because we were waiting on the doctor. I was the one who called the doctor, I really did it all! It was an awesome feeling. And when the patient said afterwards "I couldn't have done it without you" I really felt all warm and fuzzy inside. Maybe I can do this...

After we got her all moved out, we got a triage for R/O SROM. Moms: when you think your water broke, and yet you don't wear a pad or anything to the hospital and your pants aren't even damp when you've been sitting in the lobby for 10 minutes before you get to the room...chances are your water isn't broken. We got an order to check her, and I did it...kinda. I really hate checking un-blocked mom's because I don't know what I'm doing, so it's like hiking in a forest blindfolded...I'm just pushing things out of the way trying to figure out where I am. That can't feel good...So I thought I felt the same thing the doctor felt the day before in the office, so I called her unchanged. Then I had to go back and check her an hour later. I've had multiple people tell me "you're so gentle, my doctor just shoves his/her hand on up in there!" So as I'm walking into the room, I told myself "pretend you know what you're doing and just find that cervix!" So I had her sit on her fists and checked her like I knew what I was doing. I thought I had long figers, but I swear, I wish they were two inches longer! I actually did find the cervix, two fingers side-by-side, nothing more. Unchanged. When I went out and told N that I just "shoved my hand on up" she laughed pretty hard, and said that's how you had to do it! No more gentle comments about my cervix exams!

I did a C/S to round out the day...a little bit of everything I guess. I worked with the same S/T I pulled across the table on Wednesday, so we had a good laugh about that. Ah, the joys of working with people you like. I got to see what happens when they knick a bladder during surgery, got to infuse the methaline blue through the foley...neither I nor the nurse I was working with had ever done it, so the CRNA had to show us how. Learning something new everyday!

Babies today: 1M/1F
Babies total: 13M/6F = 19
Vag: 7M/6F = 13
C/S: 6M

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