Birthday Nurse

I must say....I've been waiting to catch a baby for a long time now! It's been almost a year since I've caught a baby! Yet another reason I love unblocked multips with no doc in house :) Yay!! I have yet to catch a nice, normal controlled delivery, all my babies just shoot out at me. And once again, one glove on and one glove off. I guess it's my signature :) Shift change, I had just gotten report. Grand multip, unblocked, on pit, ruptured. The doc had just called, she was 5cm and he said to call him when we were ready. I checked her about 20min later and she was 6cm. I stuck a warmer in my room and put a delivery table outside my door just to be ready. Someone else delivered and needed a gelpie , so I went in to help them look for one. I got back to my room and my Mom said "I gotta puke..." I put on a glove, sure enough, there was the head. I grabbed the phone and called the laborist's room.....it rang....the head came out...I put the phone down in the be...

And how did we finish the last week of the year?! Like crazy nurses at work! Our "goal" to beat a yearly record of babies was to deliver 315 this month. Because of the holidays we were a few behind, but I think this last week we went crazy and ended up at 300. I worked Christmas night...and the next 3. Christmas night was super slow, we were in the middle of a huge snow storm. I sat for 8hrs without a patient! It was pretty amazing :) We sat around and made no-bake cookies in the lounge and had some good laughs. The next 3 nights...were not so laid-back and relaxed. We had like 19-20 babies every day, there were a bazillion inductions/c-sections scheduled and we kept hoppin'! I had a good delivery each night, did my first c/s with the new (kick me!) charting system and survived :) We all learned a valuable lesson about not opening our mouth about our shift being over and took a crash c/s back at 0643 at change of shift. Craziness!! Ready to see what another year brings! ...

What an interesting beginning to my week. One that I wasn't too happy about...until after the shift was over and I took time to think about it. We're one of the only hospitals in the city that has a psych unit (and it stays pretty busy!) For the last several weeks they've had a pregnant woman upstairs who came in with suicidal intentions (she wanted to cut her baby out). So they've been doing NST's etc on her and had just done an amnio and schedule her for an induction. Well, lo and behold, the same day she was scheduled for a cervidil, her water broke. So down to our unit she came. Her and her 1:1 status. When I got there she had just gotten admitted and started. She was on pit and planning to go unblocked. So I settled down in my hard wooden chair for a very long night. When the FOB decided to come up to see her (one of many social problems) she decided to get an epidural to make him happy, and proceeded to progress nicely. She was a super pusher and let's jus...

I set a new record at work last night...3 babies in a shift! I don't think I sat down all shift! And I know I didn't have a chance to pee all night (but that's nothing new anymore) :( I had one delivery right off the bat @ 1845. Sweet little gal I had cervidiled the night before. Getting induced early for low fluid, never really thought she'd deliver vaginally. She did awesome!! Got delivery #1 recovered and moved, then took over another labor patient from another nurse. She was 5, blocked/comfy and went from 5 to complete in about 45minutes! She was a great pusher and had a fantastic soundtrack of "pump-it-up" music that we played while we pushed. It was the best pushing session I've had in a while! It gives the nurses energy too! She had a little bit of a long repair afterwards, but was a trooper about it. Got delivery #2 half way recovered before my next patient got there. She labored pretty well, tried the tub, tried an epidural that didn't really...

Just finished up working 12 shifts in 14 nights...not something that I would recommend doing again for a long time to me or anyone else. That's a lot of work in a not-very-long amount of time!! We have been so busy that the norm anymore is to have no empty room and have to put the elective inductions on hold just because we don't have anywhere to put them!! I could have easily worked both of the nights that I didn't if I had wanted to...but I just couldn't knowing that the first time it would have been 9 nights in a row and the second time would have been after I had stayed over from night shift 'till noon the next day and couldn't force myself to go back at 1900 that night. Anyway...is everyone else seeing a big increase in baby #'s for October?! Our thing is too it's not just "babies" it's pre -term stuff and antepartums filling up the board! A complete previa at somewhere around 30 wks ...that's gonna hold a bed for as long as po...

Promise I haven't fallen off the face of the earth! More like into the crater of work! Even though it's the middle of October we're still busting at the seams and somehow managing to survive and laugh about it. Several fun babies lately...all girls, go figure!! There were moments that I felt like and idiot, a bad nurse and almost shed a few tears on the job...but then I look back on that night and think of all the things I learned and all the things I did that I didn't know I new how to do! I learned all about doing a D&C in our OB OR's ...something I'd never done. How to do a sterile vag prep (I've talked to 1 nurse on the floor who'd ever had to do that...). I learned that I could put a scalp lead on someone who was 1/60/posterior when I had heart tones in the 50's (even the doctor was impressed at that!)...and I learned that I could stand up to a doctor and get what I needed for a patient. I also learned that I have some of the BEST co-worke...

So let's see...I haven't had a baby in a good week! I think I'm failing in the "delivery" part of my job! I can labor them fine apparently...but I have a hard time getting the baby out! I have had 3 nice (well, exciting if nothing else) births the last couple weeks. 1st baby was a super fun couple that I cervidiled one night and then ended up doing the section for the next night because her cervix stopped at 9cm. They were lots of fun and their baby was ADORABLE! Honestly, most new borns aren't that impressive looking...but this little guys was super cute :) I even went back to visit them the next day on my day off to see how they were doing. I love stories like that! Next delivery was one of those "all of a sudden" ones where I had the C/S papers sitting on the desk because she'd been about 4cm for the last 3hrs. We had put in an IUPC and said we'd give her 2hrs and then were going to the back. 2hrs later she was complete! Yay !!! She did...

Only 2 birthdays in the last week :( We've been having babies right and left it seems...I just haven't been involved in them. That makes me sad!!! I want some babies!! It seems like I've had cervidils and antes a lot lately. Boo. Neither of my birthdays have been terrifically outstanding either. Pretty "run-of-the-mill" almost...for lack of a better word...boring! The first one was a close friend of the doctor...so get this...the doc stood in the room and pushed with her for an hour and a half!! Seriously?! I love this doc, she's great, one of our favorites. But come on. I can think of only a handful of things that can make an L&D nurse feel more useless and a waste of space than standing at the perineum and pushing with the patient the entire time. Makes it even worse when the patients husband is there, and so is her sister...who is a pediatrician. So for an hour and a half I stood in the corner, dumping some astroglide everyonce in a while while doc, pat...

I promise, promise, promise that I still blog once in a while! Somehow, when I'm so exhausted in the morning, blogging's the first thing that gets put off. So I have to wait 'till I have a day off to do it! Those seem to be pretty few and far between anymore... I was scheduled to work Thurs/Fri/Sat last week, and I did. But Wednesday I went in and worked extra at the last minute. I was mowing all day long, and they called looking for help during the day shift that afternoon, and I couldn't do that. But then the 2 nd time they called me @ 1700 looking for help that night I felt too guilty to say no. So I jumped through the shower and went in. I don't think I've caught up on sleep after that... It has been raining antepartums and pre -term patients for the last week! I swear, we'll have 5-9 antes on the board every night...and when there's only 17 rooms total...that doesn't leave room for too much else! I can't wait for our new unit that is supp...

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/...

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'...

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...

Needless to say, it's been beyond crazy at work. I somehow managed to slip by on-call for part of my shift Friday night, I couldn't believe it! Then the calls started coming... Saturday night...sorry I have a wedding Sunday morning! Sunday... the manager of the entire Women's & Children's department called...twice!...sorry, I've got a bridesmaid dress on and I'm getting ready to march down the aisle! Monday ...just got off a mower after 5 hrs in 100 degree heat. Tuesday... I was scheduled to work, and sure enough it was crazy. Somehow we've only had like 3 or 4 nurses scheduled every night, to cover an completely full board. We had more nurses there on time and a half pay than we did straight pay Tuesday night! I delivered a girl on mag about 2100, and as I walk out of that delivery with pressures of 160's/100's I get a page that there's a cervidil coming that I need to take. Since when is an unstable mag patient not 1-to-1? Whatever wor...

Another 2 crazy nights to finish out the week...Wednesday night was another attempt to float me to M/B...that lasted about long enough for me to finish my C/S recovery. Then I took a cervidil , another triage or two, then got a SROM that I got started and ready for dayshift . Pretty good night overall. Loved my cervidil couple, and the SROM couple was pretty hilarious. Thursday night was another night in the zoo. I got to take my cervidil couple back from Wednesday just as she was complete, so we had a baby by about 2000. She did so good, but had had a LONG day on a LOT of pitocin to get the active labor going, so she bled after delivery. Some methergine and 800 mcg of cytotec later and she was OK. I always love to finish those cervidil deliveries, especially if they do it without being cut. I get the start process and the finish process too! An hour into the recovery I claimed the triage crown again and started my 1st of about 4 more triages . One in, one out, one in, one out...

First of 3, after 1 off...gotta love the extra on the paycheck, right? When I showed up for work, I had 2 recoveries...and then I hear the wonderful news that the new plan to cover all the short staffing is...to float more labor nurses to postpartum!!! Now isn't that just a way to solve all our problems? So all us new nurses get to be the first ones "cross-trained" to mom/baby. I will do it, because I have to, but let me just say this: #1 I became a LABOR nurse #2 The biggest downfall of a delivery is the 2hr recovery period #3 Since I do those 2hr recoveries...isn't that postpartum? #4 Why is it L&D's job to cover the short staffing of Mom/Baby? Ok , I'm done complaining :) So, as I'm walking over to PP after moving my recoveries I'm hard-core praying for a triage. And one shows up! :) ROL who was scheduled for an AM induction, her cervix didn't change in an hr and a half, but then she had 2 nice little variables so I tucked her in for the n...

Don't know why, but it seems like I have been working ALOT lately! And the sad thing is...I really haven't been! I haven't done the 6 or 7 IAR thing for a long time, just my 3's with 2 off in the middle. But this is my last set of 3 before my "long stretch" and maybe that's why I'm tired. This week kinda messed me up too with the holiday. I didn't get to work my Sun/Mon/Tues, instead it was Mon/Tues/Wed...so I've been behind a day all week! After my rough week last week I've been a little over anxious/nervous every time I come to work too. I didn't get my first baby 'till Wed, and that was a C/S that wasn't supposed to happen but baby only tolerated the cervidil for about 5 hrs before it got grouchy. I've done cervidils the rest of the week, I guess I had a recovery one night too, but no babies. :( Sadness for me! I'm super glad that I get a few days off now, I need some time to sleep and exercise some, that's f...

So Monday was my birthday, and I wasn't originally supposed to work. But then I switched a shift with another nurse so she could do something with her daughter...so I ended up working. I know nobody likes to work on their birthday, but I thought it was kinda fun! I had put in the request book that I did want a labor patient, because if I was gonna work my birthday, then I didn't want antes or postpartum! The worst part of the deal was that I only got one night off (Sunday night) between my 2 sets of 3 IAR , so that was kind a bummer. But tonight was good! I did get my birthday twin, a nice couple, a good delivery. She delivered right around 2100 and had a little girl! Yay ! It's kinda weird to think that not-all-that-many years ago that was my mom and dad looking at their first baby and not sure exactly what hit them...then here that baby is helping another mom and dad do the same thing! That's pretty cool :) It turned out that we had 3 back-to-back-to-back deliveries ...