Birthday Nurse

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 got a comment on one of my previous blogs that I absolutely loved! A very smart woman said that her goal was to be the "perfect labor patient" and she wanted to know how to obtain that goal. So I've thought about it for a while and here are my suggestions...To preface my suggestions, remember these are my OPINIONS and don't worry, no good nurse will think less of you or take worse care of you if you aren't the "perfect" patient. #1. Come in with an OPEN mind. It seems like the patients who come into their labor experience with a cut and dried, this-is-how-it's-going-to-happen mind set are the ones who have labors that are nothing like what they wanted. Those who come in who say "a C-section is the worst thing I could ever have happen to me" are the ones who end up in the OR and feel like a failure for not having a successful vaginal delivery. Also, I in no way believe that a C/S is any kind of "failure." It's just a differe...

So instead of 3 shifts this week...1 works just as well for me (though maybe not as good for my paycheck)! I felt 150% better, and survived the night fine, but it was crazy busy. Moved one recovery, blocked my 1cm prime and got chewed by a doctor for an order the previous nurse wrote wrong. I guess "labor epidural PRN " varies from doctor to doctor. I guess maybe I should have called to verify blocking my girl, but most other doctors would holler for double-checking such a standard order. Oh well, the girl went from 1cm-4cm in an hour after her block, so I felt justified. Then she stayed at 5cm for most of the night, then went to complete and was pushing when I left. I delivered another gal who came in contracting on her own and delivered 3 hrs later. She SROM'd in the middle of her epidural, that was exciting, then pushed great and here was baby! All that after all I was going to do was "put her on the monitor." I should have learned that if you're the 1s...

So I knew even before I started orientation that there are 3 basic parts to being a labor nurse: antepartum patients, labor patients, and C/S. Of those three, I'll take anything that gets me at least 1 delivery on my shift, but I'd much rather have a labor patient all day and end with a vag delivery than do a scheduled C/S, and I'd rather do ANY of those than do antepartum patients. Not that it's the patients that I mind, but come on, if I wanted to do antepartums I'd work on MedSurg or something. It just doesn't seem any different to me than sitting around and doing NST's all day. Some nurses love it, and I give them 3903 props for that, because I don't have that kind of patience. I love labor because something's always going on, there's just enough adrenaline to keep the whole 12-hours interesting, most of the time. Anyways, so today was my first day with J and for some reason nobody remembered that, so she got 3 ante patients. Bummer.....