Birthday Nurse

Every year (all 2 so far..._ that I've been a nurse I've worked on my birthday. Last night it was the night of my birthday, this year it was supposed to be both ends. Everyone thinks I'm nuts for doing it, but I personally think that it's kinda fun! I've gotten birthday twins both times, and that's fun for me!! This year I looked like a slight idiot doing it, but it all worked out OK. I had a triage come in for bleeding and she sure wasn't bleeding, and she was contracting every 7min, SVE unchanged from the office earlier in the week, cervix way posterior and she said she wouldn't have come in except for the "bleeding." I sent her home with some vistaril after I told the doctor "she's not bleeding or laboring." She was back 1hr later, contracting every 2-3min and 3-4cm. Chalk one up to my great triage skills!!! Oh well....she delivered a few hours later, blocked and comfortable, girl #3 with 2 pushes! We almost had extra people at...

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...

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...

For an un -usual 3 IAR (Mon/Tues/Weds nights), this week's been pretty good! They called me 2 minutes before my alarm went off yesterday "can you come in early?!" it always scares me when DAY shift is calling for help, because seriously, if they have 10 or 12 nurses there already, how do they expect a night staff of 5 MAYBE 6 to handle it? And yet we always do...anyway, that's besides the point. So after getting ready and across town in rush hour traffic, I finally clocked in about 1800. As I was walking in, I met the couple I had triaged the night before and ruled OUT of labor, in the lobby. Guess the UC's came back! Nobody was expecting them, so I jumped at the chance to take them again. They were really sweet and I had been sad to send them home yesterday morning anyway. She was a good change from that morning, and I had her admitted, AROM'd (per doc), comfy with a block and all my paperwork done by 1930! Everyone else on night shift was just getting s...

Someone write this down...I was acutally "on-call" for 12 whole hours Tuesday night! That has happened ONE other time (back in December) since I've been off orientation. Everyone else is always complaining of how they always get put on call, I guess my days have just lined up right! Good think I picked up those extra 9 hours Sunday night, that made up for the 12-hours that I got all of $2 an hour to sleep! It's ok though, I slept horrible Tuesday afternoon, and yesterday afternoon too. Random phone calls from people with the wrong numbers, realitors trying to show the house, etc. Fun times. So yesterday afternoon I had just rolled over and turned off my alarm about 1630 after a fitfull nap and my phone rings, it's work. "Can you come in early? Like 1700..." Well, I haven't taken a shower, put my contacts in, let the dog out or even really woke up yet, and it takes me a GOOD 30 minutes to drive, but sure, I'll be there ASAP. I clocked in at 1710. ...

One of the big plus sides of working 3 nights in a row is that it makes the days go quick! It seems like I just woke up Thursday afternoon and now it's Sunday morning and I'm going to bed! It's gone quick (and I haven't worked out at all during those days...that makes me a little grouchy!)! I have decided a few things after the last 2 nights: I'm ready to have a baby, I've gone lots of days without a baby!!! I'm tired of Mag! I think our hospital is running a special on Mag. Friday night I sat on my butt the big majority of the night. I had one long-term ante and was triage. I did one trainwreck triage who decided she liked me, and wanted to ask for me by name when she came back for her "real" labor. Hey, a compliment is a compliment! After I sent her home I sat, and sat, and sat, and sat. We got a phone call that a hospital 2hrs away was going to transfer a 33wk PIH patient to us, so we all jumped and got ready for that. That was just before midni...

I made it 5 nights in a row! Last night was so much better than last night, I think a lot of it had to do with the fact that I KNEW that I didn't have to go back tonight! I about floated out the door this morning, I just need a break from being "responsible" for a few nights! I'll be ready to be back Sunday night I think. I did a fresh recovery, I did a little triage, I did a little C/S for a gal that walked in ruptured and transverse presentation. I felt bad for her, it was her 5 th baby, she's never had an epidural, never had a C/S, what a time to have to have to have a section for an upside baby! Everyone at work was making fun of me because the Bachelor finale was last night. If I work on Monday nights I always go home and watch the Bachelor Tuesday morning, so I really try not to watch it or see snatches of it at work. EVERYONE had it on last night, a bunch of nurses had a chance to go into an empty room and watch the end of it and I refused to go in because...

So I put things into perspective at work tonight when I half jokingly and half not jokingly got told I couldn't work more than 3 nights in a row again because I got grouchy after 3! I think I'm usually seen at work as a pretty happy, optimistic, enjoyable person who likes her job and is a good team player and always ready to help out with things. I didn't feel like that person last night, for the first time I really felt frustrated at some of the other people I was working with and really just couldn't take it anymore. I went in early at 1700 for a nurse so she could go home early and all I heard when I got there was about how busy day shift had been and how day shift is always swamped and they had to call in extra nurses etc, etc. So I took a brand new triage that had just walked in the door, got her all started and came out and my name was next to another patient on the board. Then I noticed it was just a cervidil coming that night. Ok , I can do that. I came back ou...

The first night after my "long stretch" is ALWAYS hard to come back to! I just had a great 8 days off, went on a little vacation to see my grandparents, got called 3 times to come in extra (of course I was either out of town or already had other plans...), then almost got put on call tonight but begged to come it, then realized I should have taken all ' cuz I would have gotten called anyway and then gotten time and a half for 6hrs...oh well. I am so ready to pass on the triage hat to someone else. I saw it by my name tonight and wanted to scream! Seriously, I'd be happy with two easy cervidils whose babies behave all night and mom sleeps with their ambien ! But that gets boring too, so I'm not going to complain anymore. All I could see was another 7-8 triages for the night and seriously, that's too much. So I had one antepartum all night, did a couple triages , then had a grand multip (10 th pregnancy...) come in SROM'd who delivered unblocked for m...

Thank goodness I am done for a few (8!) days! Of course I didn't get call last night, and the longer the night went on, the worse it got, and the funnier/more ridiculous it got. We knew ahead of time that we had a @#$% of stuff already scheduled, 5 cervidils , plus all the un -delivered people left over from day shift. So we walk in and the board looks like poop, and it just gets worse. I start out taking the fresh ROL that's sitting in the lobby, and the triage gates open. We had 11 triage patients walk in through the door, I took 7 of them, and the last one ended up being a repeat C/S. Of course our whole computer system was down, so I got to learn how to paper chart. I'm sure I missed SOMETHING, but at this point, all my people were breathing and that's what counts...right? So here's my night in a nut-shell: Pt #1 - rule out labor feeling "pressure". She was 2cm...sent her home in an hour Pt #2 - "I think my water broke" what's your due...

Normally...I hate triage, because usually that means I get stuck with a crazy patient or someone who walks in and shoots a kid out in a contraction or two or they're hurting so bad they're climbing off the bed. Last night however...I was the triage queen and did a delivery/recovery and then did 4 complete triage's and sent them all home. I was quite impressed with myself. I can't really count the delivery as mine because it happened at 1840 and the day shift nurse did it, I just walked in and helped with the housekeeping items that need to be done when a patient goes from 6 to complete in a few minutes. But I did that complete recovery, then it was just pretty steady sending one person home, then another walking in and then sending them home in an hour or so. I don't want triage every night, but last night wasn't bad, I'll take it! This is my last set of 3 before my 8-day-off stretch . I'm ready! 2 more nights, and then I'm out of town for a few day...

Here are my new thoughts about nursing staffing in general: 1. Shift change should be outlawed...because you always know that everything is going to go crazy at shift change , no matter what time it is. Everything can be smooth sailing and then right before shift change something will snap and the next shift walks in and wonder just what the @#&* the shift before them did to turn everything into a disaster. Like my ROL that walked in this morning...she was a lose 1.5 (same as she's been in the office the week before) and hurting. She changed to a very tight 2 in an hour, that's not too big of a change, but I didn't feel comfortable letting her just walk out the door. I already had a D/C order if she didn't change and she had a dr's apt scheduled for later that morning. So what is she when the day shift checks her an hour later...3-4cm. Now don't I feel dumb for not having an IV started and everything rolling! I got that impression from the day shift nurse...

Ok, my one night off, and it's gonna be after 0200 before I'm in bed! What is wrong with me? I could have fallen asleep the moment I got home from the gym about 2000, but now I'm going strong! Right after midnight everyone else headed to bed, I organized my CD's, cleaned up my room, and now I'm trying to convince myself that I'm sleepy and need to go to bed! This is my first night off since Saturday night, and it seems like it's been a long week! Maybe it's because one of those shifts was extra and I know that I still have one to go this week. But they've been good shifts, and I haven't completely broken any patients yet, so I keep going back to try again...haha! It seems like this week between Christmas and New Years we have triaged the entire pregnant population of the surrounding 250 miles! It's been one person in after another! I think I did 3 or 4 admissions/discharges myself last night! It strikes me as slightly humorus when a 23wkr com...

I know I shouldn't post this when I have two more nights left this week...but I can't remember a night being as good as last night. It started out way hectic and I wasn't sure how it was all gonna turn out, but it was busy enough that it kept me going and the night was actually really good! The worst I had of it was chasing babies, but even that was ok, at least the babies were behaving! My cervidil I expected to labor just because that doc has the reputation of delivering people off cervidil's, but she was pretty quiet all night and baby was a perfect angel, best looking strip I've claimed in a long time! She slept most of the night too, so I'm glad she didnt' hurt too bad. I walked in at the same time as a R/O PROM, and was trying to do that and get the cervidil started all at the same time. By the time I got the cervidil situated I caught the on-call doc for the R/O and he proceeded to do the 1-million dollar workup on the PROM and then decided that she w...

It seems like I've worked a ton this week, even though I really don't think I have...I worked Christmas night, it was f retty quiet, but got kinda "clinic-y" since the offices were closed. Lot's of "I'm cramping after I've been up and going crazy the last few days" so lots of hydration, vistaril and home. I had one long term ante who's gonna be around for awhile r/t a complete previa . Gave her a colace , took some vitals and visited with her. Other than that...she slept all night. I did one or two triages too but they all ended up going home. Read through some good trivial prusit cards though! Last night was a little busier, but still really, really "clinic-y" I started out with the same ante from the night before, sent another one home about 2000, then got a ROL about 2100 that was in labor (I suspect 8 hours of shopping gave her a pretty good start). She and her very supportive parents and FOB were really fun and nice. Sinc...

~~ Sorry the time/date is wrong on here! It should have been about 2045 on the 22nd...but I got called into work so this got posted after I got home :) ~~ So after I left work this morning I really am not sure that I'm ever going to feel confident in this job! I know there are shifts when nothing seems to go right, and everyone has them...I think I just had one. What a way to top off an already long weekend (even if I was on call Saturday night!). Started off the night with one ante who was in for a PIH eval and a 24-hour urine, 38 weeks, no big deal. Well then at 1855 another gal walks in, and guess who got elected for triage duty? So I took her back and got her started, it took me an hour before I got into my original patient's room. Finally get both of them somewhat settled and my PIH baby starts randomly "dumping." Baby was all around a little 'sleepy' but nothing too overly horrible, mom's uterus had some irregular irritability that she was sleepin...

So I went into work last night kinda sad that it was my last night on orientation, I even took brownies! Imagine my surprise when they told me I wasn't on orientation last night...I was just on my own and here's your patient that's 8cm. So, deep breath in, grab a pager and go. And guess what...I survived (and so did my patients!) :) The night went pretty good! Really nice delivery about 2000, first baby, mom and dad were both super excited and fun to talk to and get to know. Everyone showed up on time (nursery included) and it was a fun birthday party! Got the recovery all done and Mom moved over to her postpartum room before my triage showed up, so I was pretty excited! Triaged a R/O pre -term labor who was contracting, but not changing so vistaril'd her and sent her home before 0100. Then sat on my behind until about 0625 when the C/S that was scheduled for 1400 showed up in labor. Now here's what I can't figure out...when I took the traige at midnight, and...

I think everyone on the unit today would agree that today was just a day that went on forever. It wasn't bad, it just was never ending! I had an induction, multip who went from 1-"baby" in 3'50". Not too bad! Note to docs: when the nurses who are doing your induction don't start their shift 'till 0700, don't tell your patient to be there at 0630, and then when you show up at 0705, please don't be upset that she doesn't have an IV yet and that the nurse isn't just waiting around for you to AROM . I get nervous easily anyway, and when the doc is standing in the corner of the room drumming his fingers while I'm trying to start an IV and just say "good morning" to my patient that I've known all of 3 minutes, I get even more nervous! I don't think I really got my thoughts gathered 'till AFTER delivery. Oh well, live and learn. I ended up doing a bleeding/cramping triage later on. It amazes me how the patients we as n...

Friday was my day to work with my "other" nurse. I think it's been really good for me to have two main nurses that will let me work with them. J teaches me a ton every time I work with her, and then N makes me go out and do it on my own...and I ususally surprise myself with the confidence I come away with. Friday we had a carryover induction/cervidal from the night before. This was her second baby, and she was bound and determined she didn't need an epidural b/c she hadn't gotten one 18months ago with her first baby 'till she was 9cm, and by that time it didn't really help her. She was about 3 when I came on, and the doc came over and was denying any pain. Then the doc came over and broke her water...and then it started hurting. I figured it was gonna be a long day, especially after we started Pit and they weren't just "natural" contractions anymore. I figured I would be spending the bulk of the day in by her bed helping her through it. All t...