Birthday Nurse

Sunday night kept a 30 wkr with no pre -natal care pregnant one more night on Mag prior to her C/S in the morning, plus a few triages . Since when are Mag's 1-to-1?! Went in extra for a few hours on Monday night from 2300-0200, did a C/S recovery. Then wasn't expecting to get off @ 0200 after the desperate phone call I'd gotten, but since I was there I decided to just go to the gym anyway. That was a little weird working out by myself @ 0300 and 0400...but it felt good when I was done! Last night...got my butt kicked. I took a girl who was 6-7, blocked, on pit. Figured she'd deliver soon. Then another SROM who was 1/80 who had been 1/80 all day. She'd had a leep , so I figured after that band broke she'd start making some change. Planned on MAYBE getting her delivered. Well...things just snowballed from the get go. Assessed both patients, then my 1st girl had heart burn, then my 2 nd girl needed checked and an IUPC , she was 2-3 at that point. Then I couldn...

So after my stint on Mom/Baby on Tuesday...I picked up the back half of someone's shift and went in 2300-0700. 2 great couples (one of them I saw 3 times since she was a cervidil and already tucked in when I got there) and what I thought was a great delivery right before shift change. Then I found out on Sunday that they had just shipped the baby off to the high-end children's hospital in town because she had pulmonary hypertension and was not doing good AT ALL!! She was pretty unstable and they were thinking about maybe a heart/lung bypass machine. Poor girl! Poor parents! I loved them!!! I haven't heard anything else about the baby...but I'm worried. I hate it when anything goes wrong with one of my babies. And I hate it even more when it's a term baby where everything's expected to go perfect! Sigh...I know it was nothing to do with the delivery or anything I did, but it's still tough to swallow. Babies today : 1f Babies total : 56M/62F = 118 Vag :42M/...

Well, I guess this is technically talking about LAST Tuesday... shows what my life has been like! I went in at 1730 for J so she could go to a party, and so I took her c/s recovery. I had admitted the girl the night before...just a little on the high-drama side of the scale. I finished her recovery and the anesthesiologist wanted to keep her on L&D overnight with hourly vital signs re: some panic attack issues on the OR table (we don't ask questions...we just follow orders...). So I was set to take her for the night, then they tell me that actually, I'm going to give report on my post-op and go take a full team on Mom/Baby for the night. Come again? So...wait 'till 1900, give report to ANOTHER labor nurse to take my recovery back out to the floor, then hightail it over to Mom/Baby to get report on my team of postpartums and babies. I'm already flustered b/c I'm running behind schedule and that threw my whole night off. Here's the kicker that made me mad....

And the craziness at work hasn't slowed down over the holiday weekend at all!! Took my labor patient back for a section @ 2000...what a painful section it was. I had all kinds of pain orders from the doc after the section was over. It was going to be that kind of recovery. Then when the patient slept through most of recovery, I didn't want to keep pushing meds on her. Then got a nice chewing out from the postpartum nurse because the patient (who had no pain tolerance) rated her pain 7/10 when she got over to the other side. "Why didn't you start XYZ pain meds in recovery if she hurt so bad?" Well...because she was sleeping through recovery and couldn't keep her eyes open even when I was checking her fundus . Didn't sound like she needed pain meds to me! Moved that section recovery and took a ROL who walked in 3cm and ruptured. 20 minutes later she was 6cm so I called the doc and said "you better head this way..." and she did. Then as I'...

I was so thankful to have a day off yesterday! I knew how crazy it had been, so I took brownies up to work last night about 2100. The board looked beautiful!! Couple green names and 2 ROL's . Why can't I work on nights like that!?! So I dropped the brownies off and on my way out the door I made a funny comment about "now I don't want my phone to ring tonight because I've already driven over here once tonight!" I should have kept my mouth shut...! Sure enough, about 0245 my phone rings. When I'm in a dead sleep I don't really think about what I'm doing and I just grab the phone and answer it. Sure enough "we need help! People just keep walking in!" Ok ...I'm on my way. I couldn't say no after what I'd said earlier, and after the week we'd had, I know what it's like when nobody will come in to help. Only as I was getting ready to walk out the door did I realize that it was torrentially pouring buckets outside...no wonde...

By Thursday night I was seriously dragging. We had all gotten our butts kicked all week long, and you could tell all us nurses were getting near the end of our strings... I took my patient back for a C/S about 1910 after her being a cervidil the night before and then on pit all day and having made NO change. That and the fact that every time she rolled or changed position baby would have a nice 5-6min decel . A C/S was definitely the best decision for her and her baby. She was a young mom, first baby, and she was giving the baby up for adoption after 24hrs. Got her all ready and back to the section we go. That's where things started spiraling out of control. We had a great anes team on that night, and usually it takes all of about 10 mins to get the spinal in and the patient comfy. So we started working in the back, since we didn't really want to move mom and cause another decel anes tried to put the block in while Mom was laying on her side. This is nothing new for them, ...

After Tuesday night I was already tired and it was only my 2 nd shift! The fact that I picked up an extra 6hrs Monday night really threw me off, and I couldn't even tell you what day it was! Wednesday I took a patient that followed me in the door for a rule out labor ( ROL ). I ruled her out after an hour, made her mad that I was sending her home, and tried to explain that I couldn't "force" her to leave but that I really thought she'd be more comfortable not in our beds and not being able to drink, eat or smoke her cigarettes . She finally decided to leave. Then I took another ROL , got her in a bed, then got a page that somehow it was my turn to take ANOTHER patient. Ok ...so I ran for about an hour and a half, the on-call doctor for the 1st patient decided that since she lived an hour away she should stay and would "probably go into labor during the night." I got her settled, gave her 50mg of vistaril to help her sleep (same sleepy effect of benadr...

I could sum up this last week in 1 word: CRAZY!! But...to be fair, I'll post about each day. Since it's Saturday now (and this recaps Monday through Friday) I may be minus a few details...but all my numbers are correct! Monday night started the ball rolling. I took report on a very nice patient from one of the day shift nurses. The patient was a multip already in labor, already had an epidural and was comfortable. So it was the waiting game on her. She labored very nicely. About 1930 I took a triage who came in contracting, it was her 4 th baby. She was in great control, but was ready for an epidural ASAP, so I got her blocked, comfy and then sat down to chart. Meanwhile, my 1st patient was starting to have a few variables, so I went to check her and she was complete. I set her up and we only pushed a few time, called the doc in and had a very nice delivery! I came out of her delivery, stuck my head in to check on my 2 nd patient and she mentioned she was feeling a little bi...

Probably should talk about Friday night before I talk about the craziness of last night! Friday night...I walked into a girl who was unblocked and on pit but who really hadn't changed all day. I walked down with the day shift nurse to check her right before shift change...she was 8. (Still unblocked). Got the room all set up, gave her a few more contractions...checked her again...she was 9.5...few more contractions , complete. Please let the doc get here! I didn't put her in stirrups 'till I had the doc present and accounted for and I was sure I was gonna catch the baby...but I didn't. Nice delivery, she was so proud of herself for going un -blocked, and with good reason! I love it when they think they're only 2 and then realize that they're like 8 or 9 or complete. It's amazing how well they stay in control that way vs. knowing that they're getting closer and closer. I wonder if it really is a mind game!! So I hung out with my postpartum cuplet (since ...