Wednesday, May 20, 2009

Breaking Patients

So after getting sent home @ 0200 on Monday night, I got the dreaded 'you're on call" phone call @ 1745 last night. I was seriously on my way out to my car...bother. So I sat around after having slept all day, kept texting one of the nurses at work who assured me that everything was nice and quiet and under control. So finally about 0115 I sent one more text saying I was going to bed. My phone rang exactly 10 minutes later "we need you!" I come.

I loved my patient that I had, she was 30+1 weeks and had just SROM'd. Absolutely nothing was done for her when I got there other than a sterile spec by the laborist to confirm rupture and that she was closed. IV, antibiotics, one dose of beta, tuck her in. She was "cramping" every 5-10 minutes she said but didn't say they were any more intense than a menstrual cramp. I finally called the doc about 0430 just to let him know that she was still contracting every 5" or so and if he wanted me to do anything about it. He said "no, just watch her and call her primary OB @ 0645 with an update." Ok, wrote those orders and watched.

Her baby looked amazing, and the patient even got a little sleep. Then about 0630 I went in to check on her and she said the last few contractions had gotten worse, she puked on me (that's way too many patients that have puked on me in the last few shifts!) and said she felt some pressure. So I checked her...she was 4/100/-1. So the primary OB got called a little earlier than 0645 and he wasn't too happy that she hadn't been mag'd already. So we got the mag bolus in, I gave report to day shift and she delivered while I was walking out the front door. The doctor got there, and last I heard baby was doing good. My heart was pounding most of the morning though. That was a little intense for the end of shift! The patient was AMAZING and handled everything perfectly.

I can't help but wonder if there was something I should have done differently though, if I should have pushed the Mag issue with the on-call doctor and laborist a little harder or what. All the nurses at work said I did everything I was supposed to do and that it was more between the docs than me. But my heart goes out to the patient who all of a sudden has a 30wk baby she wasn't expecting. Sigh...drama, drama, drama.

1 comment:

  1. Hi, I've been reading your blog for months now, but just commenting now :)

    I gotta say, this post made me go YIKES! I'm expecting my first (33+1 w) and I feel like I would be terrified PLUS pissed at a doctor who just let me deliver at 30 weeks! Holy cow!

    But, mostly I'm writing because you seem like the kind of L&D nurse I'd be really grateful to have taking care of my family.

    Love to read your stories. Pls keep em coming!