Birthday Nurse

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...

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 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 ...

So after my little "bike accident" on Monday...I've turned down more extra shifts at work than I EVER have. Mark this one down for the record books...I didn't even step foot inside the hospital since I left last Wednesday morning 'till I went back for some simulation drills this Wednesday night! That's over 7 whole days...gotta be a record for me!!! I'm sad about all that extra that I missed :( I felt super guilty and stayed for 2 hrs after the sim drills to do a C/S recovery Wednesday night and counted it my extra shift for my week off. And then did a full 12hr shift Thursday night. Things haven't slowed down...that's for sure! I did have a nice delivery, first one in a while after having antes all week last week. I went in early for a nurse so she could leave @ 1730...it's amazing how just an extra hour or two at work can make the shift seem never ending. After the delivery I took a cervidil , then another cervidil , then handed them off, th...

Night #1 after having 5 wonderful nights off (except one night I went in @ 0300 so a nurse could leave early for her vacation)! Nice little recovery...nice little cervidil who actually slept...I swear mine NEVER sleep!....and a "nice" little PIH gal who came in at 0415. Severe Right Upper Quad rent pain/brisk reflexes/Liver enzymes of 400+ and 300+ ("normal" is mag'd her and then pitted her. Wonder what time she'll get cut? They were the sweetest couple, I would take them back tonight...

I probably just jinxed myself...but last night was so PEACEFUL!!! We had a nurse on call, and probably could have had more if we had really wanted to. We had 2 deliveries, 2 cervidils , 3 ante's and a few random triages that were in and out...and 5 nurses! I had ONE (1) ( uno ) cervidil all night...when was the last time that happened! It was WONDERFUL!!! Ah...for once I'm not "scared" about going back tonight! A bunch of us nurses were all talking about different charity or not-so-charity running events that are going around in the area this year, and I think we're going to try to get a group of us together and do some of them. I don't by any means call myself a "runner" but I go out and try to do 4-6 miles a couple times a week. I used to do 5+ miles 6+ times a week in college, but once "life" started, not so much any more. There are several 5k or 10k runs going on that look fun and I would never have guessed that some many of the nurse...

For as busy as my night was last night, it was actually pretty good, and I was pretty happy with it. Usually I would have been totally stressed out and grouchy, but even though I was running the entire night I never felt totally behind and hopeless, just constantly busy. I had two cervidils , and when I left they were both blocked and had no cervidils . One was a gal I had actually sent home a couple times several weeks prior who we kind of knew from the beginning was going to be a little "high maintenance ." Every time I walked into her room for something I knew I could count on spending at least half an hour or so doing this and that and fixing that and fixing this, but hey, it's all about patient satisfaction. She wanted a block so bad and I was so glad when she was finally 3cm and could finally get her blocked so she could be happy! She rated her contractions an 11/10 for pain, but if she wasn't watching the monitor and was talking to me instead she would talk ri...

My all celebratory post and I'm too tired to really think much about what to say in it... I survived my 2-day OB- ACLS class last week, it was a fun group of nurses to take it with and the instructors (two of our L&D nurses) made it lots of fun, practical and logical . So it was a fun 2 days. Working only 2 nights last week wasn't bad either, even if it did make it 5 nights in a row. I just keep adding letters after my name: RN, BSN , BCLS , NRP , OB- ACLS , CPR. Sheesh ! I sound super smart! Worked my 1st out of three last night, back for 2 more now. I was acutally "on-call" both Friday night and Saturday night and totally expected phone calls, but didn't get one either night. Speaking of, I should write that down for my hours at work tonight! Note to self... I was kinda expecting to get called last night, but I was there in all my glory, with 2 cervidils who actually behaved themselves. One of them had a "little dip" for about 2 minutes right a...

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...

It's been a long time since I have wanted NOT to go back to work. Usually I can have a rough night and then move on...but I seriously do NOT want to go back to work tonight. It's been a long first two nights of this set of 3, and I'm just not sure I can do one more. I'm trying to pick out the positives, like I get 8 days off after tonight, and I'm getting to go out of town tomorrow morning after I get off, and I made it though 2 nights I can make it through 1 more...but it's not helping too much! I had a nasty strip tonight, had to run to the ER and catch a baby and then do the recovery of the mom who spoke NO English. I loved my cervidil couple, they were amazing, but their baby just wouldn't cooperate! I'm still working on this "control" thing, and realizing that I can't control what the baby's doing and I can't necessarily "fix" anything, but it doesn't make my pulse any slower when the baby's pulse is! Anyway...

2 cervidils ...not too bad of an assignment. Until you see the two docs that they belong to. Some docs seem to use cervidil just to " guarantee a bed" for an AM pit induction and their cervidil's sleep though the night. Other docs use cervidil exactly how it's supposed to be used, and the cervix "ripens" and the patients cramp a little through the night, but are able to get some rest too. Other docs use it INSTEAD of pitocin and expect their patients to labor off the cervidil ...and most of them do! So...1st cervidil didn't seem to be working, it got pulled and another one got put in at 2300. She was sleeping, then all of a sudden woke up in rip-roaring "pain" is all she would say. Never described it, never said "it hurts here" just "it hurts". I swear I saw 1 maybe 2 contractions all night, she was extremely hard to monitor. Anyway, I finally convince her to let me do an exam and sure enough, she's 5 with a bulgin...

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...

So when I was at work Monday night I figured I would do my good "nursing duty" and sign up to be on-call from 1900-0100 last night (Wednesday night). There were already 6 nurses scheduled, and I don't remember the last time I heard them calling someone in from "off the door" where we sign up for extra shifts, so I really didn't think they'd use me. I finished teaching piano lessons about 1700 and thought I would just call to see if they had an idea if they would need me or not...and the day charge nurse said "Come in!!" and sounded pretty desperate. So I dashed to the gym, only got in a 40 minute run and then jumped through the shower and went to work, and they really used me the whole 6 hours! I only had a cervidil , but everyone else was either doubled up or in the back doing sections, so I guess they really did need me! I guess the "ante" world hit today and there were 7 or 8 antes who were gonna be longterm or at least until they...

Cervidils...cervidils...cervidils! But I survived my 2 nd night of "unsupervised" nursing...and both my patients were breathing when I left! I was 1/2 expecting to get put on call, but I didn't...until 0315. I was the only person who hadn't had a "call" date yet, and the one person who wanted to go home had left about 2100, so I was the next one up when we only had a recovery and my 2 cervidils . I was on call for 11 1/2 hours Sunday night, but they ended up sending people home that night too so I didn't have to go in. I'm signed up for call tomorrow from 1900-0100 and am crossing my fingers they really don't need 7 nurses! Then I work this weekend and I'm sure I'll be there for the duration of it, but that's ok ...I need Christmas money! Got some pretty snow today that started right after I got home, so I'm glad I got to drive home and miss it instead of driving home in the thick of it at 0700! Babies today : 0 Babies total : 28...

So I was all set for nights to be lots of sitting around after Tuesday night. Last night, I think I sat down and took a drink about 0200 or so... Chipotle is still pretty tasty about 0245 when you're starving! We did a delivery about 2130. Kid was seriously +1 or +2 when we started and she could have delivered a lot sooner of she had given any effort to pushing. There were 3 of us in her face really trying to get her to do anything. There was no pressure against that kid's head with that first 45 minutes or so of pushing. Then her lower uterine segment oozed and oozed, methergine , still oozed. So she got extra pit, and she's gonna have some bruises on her stomach from our "mashing." I think it's the weirdest thing when you check the fundus and the cervix sticks out like a tongue. Ha!! Our cervidal across the hall came in the same time we started pushing in the other room so another nurse kinda helped us tag team. She came in saying "I've been havi...

So I'm nervous after the first night goes decently well...I actually thought about sitting down and blogging about 0200 this morning since I was doing nothing, but thought it wasn't very good "nursing practice" to do my first shift with a bunch of new people. The night group seems really relaxed though, and it was a good group of nurses to start out with. I wasn't sure what kind of welcome it was when I looked at the schedule sheet when I got there and my name wasn't on the list. I guess the message hadn't gotten relayed that I was beginning orientation last night, and the nurse that I was supposed to orient with was orienting someone else, and it was slightly a mess. But I refused to go home, so after some assignment switching and swapping, I ended up with a different nurse and a different patient, which I was ok with. That nurse ended up leaving about 0100 and so then I got passed around to whoever else was watching over my shoulder. Ha! I felt bad for...

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...