Tuesday, August 4, 2009

Still Here!

I'm still here...don't worry...haven't fallen off the edge of the earth. Even though, after working 6 out of 7 nights in a row...I was pretty sure that it was going to be a good possibility. I had a couple nights of antes, a couple good deliveries, several quite nights...except of course the one night that I asked for "call." That night it was crazy busy.

One of my nights included a double-forceps delivery. Mom was a very petite woman, and baby kept turning OP and wasn't very tiny. Finally after pushing for an hour and a half the doctor came in and used one pair of forceps to turn the baby and then another pair to expediate delivery. This particular doc is a pro at forceps, and is one of only a few who I would trust to use them. But still...they always make me a little nervous. Especially since this was the doc who the LAST forceps delivery I saw with him was when he missed the stool he was sitting on and fell and knocked out one of the nursery nurses. This delivery went off without a hitch besides a nasty 4th degree tear for mom...

Another night tested my patience to no end. My patient had some psycho-social issues, plus some mental dissabilities. That was a little difficult for me. I'll be honest, I hated my psych rotation in school, I have always had a hard time with it and accepting it as a real disease just like cancer, diabetes, etc. I know it is a real disease, it's just always been something I've personaly sturggled. The patient was not handeling labor well, she wasn't tolerating any pain, wasn't taking suggestions to help with coping and had limited coping skills all together. Her cervix wasn't changing, and when it finally did start changing and after an IUPC, she started begging for a C/S. I talked to the doctor, and we did end up sectioning her, good thing too because her baby was >9#!! Afterwards, I felt like a horrible nurse for not having more patience, for not pushing for a vag delivery and for giving in to the section so easily. Honestly, I was pulling for the section myself just because I didn't know what to do next! So next time I'll have more patience...

To round out my 6 our of 7 nights...a very fun family came in, 2nd baby, SROM, 4-5cm. Got her a block quick, settled her down...and then something just didn't feel right when I put the foley in. There was a major crease on the baby's head, like major molding. After a very awkward exam, I finally asked someone else to come and check, cuz I wasn't 100% sure it was a head I was feeling. Sure enough... it wasn't! So we headed back for a section.

One of our night nurses delivered during my stretch, so it was cool to get to see her and her baby while they were there. I wonder how perspectives change after being on the "patient" side of our job :)

Babies today: 1m/1f + 2f
Babies total: 57M/67F = 124
Vag:43M/50F = 93
C/S: 14M17F = 31
Babies 'caught' = 2f0.5m

1 comment:

  1. I think the c-section might be a good call in the case of someone with mental disability and other mental illness. They just can't handle it and aren't thinking about natural/vaginal delivery. So don't feel badly!

    I always wonder how nurses feel when they're on the patient end of care. ;-) I'm sure it was fantastic for her and she was spoiled rotten!