Birthday Nurse

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'...

So much better night at work last night...I had no nightmares today while I was sleeping! I must say, I love the nurses that I worked with. I guess I was more shaken up about the whole run-in with the doc and the crappy strip from Wednesday night, plus the 30wk SROM from Tuesday night than I thought. I had at least 3 nurses come up to me last night and tell me that I was a great nurse, that it just takes time to get the docs to trust you, and that the particular doctor didn't have a nurse there who hadn't had a run-in with her at least once. The couple nurses that had looked at my strip said they wouldn't have done anything different than I did, and that I did all the right things. That almost made me cry all over again! When I'd left Thursday morning I really felt like the worst nurse ever and that I had totally missed something super important and that I put my patient into real danger. But after all these nurses who have 10+ years of experience were saying the same ...

Ok ...so Tuesday night I learned that I should stand up to doctors when I want something or think something should be done for my patient. Last night I learned that it's probably better to call the doctors TOO often than not enough...and to go with my gut feeling instead of listening to what other people are "suggesting" even if they may have tons more experience and their opinions make you feel better about the situation at the time. My strip turned to @(#^ last night, and after one run-in with the doc earlier in the evening I wasn't too excited about calling her back and asking for her to come back in to assess it. I had one nurse saying "ya...maybe you should call" and another nurse who has worked there WAY longer than any of the rest of us saying "no...it doesn't look that bad. If it was bad you'd be doing something about it not just sitting here watching it." Ok ...so I didn't call 'till the patient was almost complete, then th...

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!" Ok ...here 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. Ok ...so 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 i...

12hrs Monday night, 12 hrs Tuesday night, 13.5hrs Wednesday night, got a call and went in @ 0430 on Friday morning, then got another call last night and went in from 2300 to 0400. Part of 5 shifts in 1 week! I took tonight off before I start my 3 IAR tomorrow. When I got there last night they re-evaluated the board and kinda figured that they hadn't needed me as desperately as they thought they did, several of the patients ended up going home, and they did some re-assignments. If we get called in, we get paid for at least 2 hrs, so I figured I'd sit for 2 hrs and then go home. I helped move a patient or two, did some random stuff and was just about to leave when one of the doctors came down from the lounge and said he had a patient coming in who thought her water broke. He said that her own doctor was coming on call at 0700, so to just tuck her in and wait for the morning. So I said I'd hang out, get her started, then leave. Story short, she delivered an hour and a half ...

I'm hoping this week doesn ' t take the same pattern as last week with each night becoming more busy and crazy than the last! I started out the shift right by going to the gym and doing a good 5 miles, which made me feel better. I was crossing my fingers that work would be slower, and it was VERY slower! I did a 2130 delivery and then took over on a cervidil after I moved my delivery over about midnight. My delivery was a really fun girl who already had 2 little girls and as soon as I walked in the room right before 1900 the little 3 year old came running over and threw her arms around my legs and started talking up a storm and didn't stop 'till I tucked her into bed in the postpartum room with mom! The delivery was super smooth too. The same doctor did it that came and played with us on Thursday during all the drama. Every time I work with her, my level of respect goes up for her. She is a good doc, and she is a lot of fun too. Besides the cervidil that I watched co...

I apologize ahead of time if I miss totally obvious reasoning for why this happened, but to me it just didn't make sense... G1 29weeks presents to L&D sometime Monday afternoon for higher blood pressures and just not "feeling right." Her mom used to be a nurse in an OB's office, so of course Grandma knows "exactly" what is going on...anyway, her pressures weren't pretty (150's/100's consistently) but since it was a busy day in the office, her doc wanted us to just watch her and treat her pressures with labatalol . Her urine was dipping 4+ protein and you could tell there was some swelling going on. Labs came back " ok " not fantastic, so doc ordered a 24-hour urine to check protein, etc. So that buys her at least a 24-hour stay. She got her first dose of steroids for fetal lung development and hung out 'till Tuesday afternoon. Tuesday, her pressures are even worse and her 24-hour urine came back with 6 GRAMS of protein. That...

So yesterday was the first time I really wondered if I'm ever going to be a Labor nurse like the nurses that I look up to. I worked with N yesterday, ' cuz I needed an extra day. The patient I walked into at change of shift was about 1 1/2 hours into pushing, and trust me, that's the worst time to switch patients. The first thing you see of them is them up in stirrups and you're supposed to go over and introduce yourself? Right...I wasn't too convinced that this gal was gonna be a great pusher, and we pushed and pushed in this position and that position for another hour and a half. I wasn't seeing much progress and I think we were both getting a little frustrated and poor girl was getting tired. Then Dr. M walked in and somehow put his hands on the head and made it happen. I love Dr. M, he did the first delivery I ever saw and I've always just thought he was a good doc. N came into the delivery, but she scrubbed in to help Dr. M so I really was kinda doin...