Monday, April 20, 2009

One Party Down...Two To Go

When I walked into work I had a brief moment of celebration as to how nice the board looked! NO MAG!! a couple antes, a couple postpartum's, a couple of early was beautiful. Then when I left this empty rooms. That's what we did last night!

I admitted 5 patients last night, ended up handing a couple of them off because I can't handle 3 active labor patients at the same time all being admitted within an hour of each other. Sorry...

I started off with a post-partum bleeding, family practice delivery who needed suprapubic pressure, but was intact? I don't think so...when we finally got the laborist in and spec'd her they found a bunch of placental fragments and she used 3 sutures to fix labial tears. Reason #283 why I recommend going to an OB for obstetrical cases...

Handed her off when I got 2 ROL's at the same time. Both ended up staying, and of course I balanced them so that I didn't sit down all night. My goodness...I got the one a block, she was comfy, got the other one a block, was 5 and then complete about 10 minutes later and feeling rectal pressure, turned her to her side to wait for the doctor...for 20 minutes. I knew if I turned her we'd have a baby. As I'm holding Mom's legs together listening to my variables down to the 70's with every contraction I hear someone else walk into a room down the hall, then a nurse call out "she's complete and +2". Sorry, I was a little tied up at the moment, so I think some other nurses took care of that one. My doctor walked in and was like "what's going on?" I rolled Mom to her back, he went to check her and you could just see the head crown up. So he's fumbling to get gowned and gloved, thank goodness I had some gloves on, I'm trying to get the foley out, but figure I better at least grab the head while it's sliding on out with a contraction. He's like "it's ok...I got it..." um, not so much, I was holding the head as he's finishing with the gloves. The bed never did get taken apart, nursery made it after the kid was already up on the abdomen with the cord cut...the doc delivered the placenta and walked out in all of 4 minutes...leaving me with a HUGE mess (in the bed of course) to clean up. Oh well, it was quite the smooth delivery I guess. I was a little bummed because if he had waited another 2 or 3 minutes I would have gotten to catch the baby... :(

I start recovery #1 and then go check my other patient...she's 7 with a BBOW, I figured she was going to blow a kid out any second. She was almost complete when I left, thankfully she and her baby behaved during the chaotic night.

About 0530 everything hit the fan, we had 4 or 5 new patients walk in, I took one who was 5cm and then got in the tub and was 7cm, then was almost complete and unblocked as I was leaving. Ah, the craziness of it all.

It doesn't sound so bad, but it was just constant all night, at least for me. Next time, it's someone else's turn! I'm too worn out for it to only have been my 1st night...

Babies today: 1m
Babies total: 42M/44F = 86
Vag:31M/34F = 65
C/S: 11M10F = 21
Babies 'caught' = 1f1/2m

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