Birthday Nurse

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...

No babies this week, but last week I went OOT (out of town) before I got to talk about the 2 nice deliveries I had one of the nights I went in extra. The first was a C/S that was walking to the back as I came on. I almost feel guilty "claiming" that baby because I hardly even got to say "Hi I'm BDay Nurse" to the mom before the drape goes up and the baby comes out. Then in recovery they are usually so out of it, and after laboring all day, all they want to do is sleep. Doesn't leave much time for the "bonding" time. But nice, quick section. We were actually in the OR from in time to out time less than an hour. That's pretty impressive! It was a one of my favorite CRNA's on too, so that always lends some humor to the situation. I was ready to go home after my section recovery was over and I probably could have, but there were 2 patients who were almost complete so I told them I would stay until both of them delivered so that then they wo...

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...

We've had 5 IUFD's ( Intra -Uterine Fetal Demise) in the last week. 21 wks , 33 wks , 32 wks , 35 wks and 36 wks . Come on! That is WAY, WAY, WAY too many. I haven't taken care of a demise in a long time, since that one last Christmas that hit me so hard. I feel like I've helped with almost every one, but last night was the first one that I've actually taken care of since last December. I hate them so much. All these babies who never have a chance, most of the time we never even know what happens. Mine last night was a rare case, he had a chromosome anomaly that the parent's had known about for most of the pregnancy. They were prepared, then were expecting something like this, and they knew exactly what they wanted. That makes it so much easier on us nurses, and in some ways, I think it makes it easier (at the time) for the parents. They had all their family there, they had all the little outfits for him there, they had their cameras, they had a name, they had...

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...

I'm still here...don't worry...haven't fallen off the edge of the earth. Even though, after working 6 out of 7 nights in a row...I was pretty sure that it was going to be a good possibility. I had a couple nights of antes, a couple good deliveries, several quite nights...except of course the one night that I asked for "call." That night it was crazy busy. One of my nights included a double-forceps delivery. Mom was a very petite woman, and baby kept turning OP and wasn't very tiny. Finally after pushing for an hour and a half the doctor came in and used one pair of forceps to turn the baby and then another pair to expediate delivery. This particular doc is a pro at forceps, and is one of only a few who I would trust to use them. But still...they always make me a little nervous. Especially since this was the doc who the LAST forceps delivery I saw with him was when he missed the stool he was sitting on and fell and knocked out one of the nursery nurses. This de...

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'...

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...

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...

When I walked into work I had a brief moment of celebration as to how nice the board looked! NO MAG!! a couple antes, a couple postpartum's , a couple of early recoveries...it was beautiful. Then when I left this morning...no empty rooms. That's what we did last night! I admitted 5 patients last night, ended up handing a couple of them off because I can't handle 3 active labor patients at the same time all being admitted within an hour of each other . Sorry... I started off with a post- partum bleeding, family practice delivery who needed suprapubic pressure, but was intact? I don't think so...when we finally got the laborist in and spec'd her they found a bunch of placental fragments and she used 3 sutures to fix labial tears. Reason #283 why I recommend going to an OB for obstetrical cases... Handed her off when I got 2 ROL's at the same time. Both ended up staying, and of course I balanced them so that I didn't sit down all night. My goodness...I...

I only worked 2-nights this week since I got call on Tuesday, but seriously, I think I'm just as worn out! I feel like I've worked 3-nights...and I guess I technically did work an extra 9hrs on Sunday night, but it still wasn't 3-in-a-row. Convinces me all the more that half the effort is the mental part, and I had to psych myself to get ready to go to work Tuesday anyway before they put me on call. Anyway, I had a nice delivery last night, well, I guess it was good. The poor girl had been in the hospital all day since about 0800 contracting randomly, but never changing her cervix all day. The day nurse tried 3 or 4 times to send her home but she said "it still hurts" so more stadol , etc, still no cervical change. So the on-call doc when in about 1930 to try to convince her it was just false labor and do go home...surprise surprised, she was 4cm instead of the 2cm! So she got to stay... I got her blocked, labored, started some pit, put on my very own scalp lead.....

Only one blog because by the time I went to bed at noon yesterday there was no energy left for blogging... After being off for 7 days after only working that one shift the week before I felt like the biggest slacker in the world! I just didn't want to go back to work! But I did anyway, 2 shifts of zero pay made this week's paycheck look REALLY bad. So night number 1/3 consisted of a cervidil and a ROL who had a horribly crappy strip and the doctor looked at it, did another C/S and looked at it again and said let's cut it. So we did. I always feel bad for the prime's who come in and get sectioned right off the bat for a bad strip or who never really labor. That means the next time when they're baby is fine and they're ready to labor on their own, very few docs are going to let them just because of that first C/S. Getting this gal delivered was the right choice though. The placenta came out in chunks, nasty mec , the baby had a .82 shift and a blood sugar of li...

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...

When at 1915 I wondered out loud if it really was only "7:15?" I knew it was gonna be a long night. My poor, sweet patient didn't speak english , but everyone was expecting her to deliver since she was 7cm at 1830. Well after 3 hours of pushing + vacuum, she delivered at 0240. I just got my new Dansko's yesterday, and wore them for the first time last night. After seriously being on my feet for all 12 hours, my feet are a little sore...those are high arch supports! But, I think they'll feel better tonight. Anyway, it was just a rough night all around. Everyone seemed to come in a little on eggshells, they closed down our parking garage and turned it into "visitors/doctor" parking (so now I'm gonna have to scrape frost in the morning!). I realized AGAIN, what a difference working with "team players" can make and the importance of having SOMEONE open for triage. I pray that the new unit that we're working on has a triage/antepartum uni...

Work 2 nights...off 1 night...work 2 nights...off 1 night...work 1 night, and I'm supposed to remember what DAY it is? I think not. I just finished the 2nd set of 2 nights working, am going to sleep my one day off, and then am back tomorrow night. I've done pretty good I thought. I did one vag delivery of a poor gal that had been there for 2 weeks with PPROM and her fluid finally got pretty low and shew as >36 wks so they induced her. She said I was the nurse at the top of her list when she realized she was going to deliver on the night shift. I don't know if she was just saying that, but it made me feel really good! Nice delivery just about an hour into my shift too :) As I'm just starting her recovery (hadn't even left the room yet...) I got a page that my cervidil was in her room and waiting for me. I didn't know I was going to be doing a cervidil ! Oh well. It just took me a few minutes to settle myself down, get her on the monitor, check her, page th...

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'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 haven't done 3-in-a-row in a while, but it really wasn't as bad as I thought it was going to be. I'm exhausted and going to bed at 1900 tonight, but I'm really OK with that! We were busy enough last night to keep us all on our toes... Story #1: Gotta love those shift-change catastrophes. When I walked in right at 1830 last night, the unit looked slightly deserted but everyone who was there was a little high strung. I guess about 1810 a lady had walked in 33 wks and said that she had severe right upper quadrant pain. She said it may be contractions, but they just felt funny. The nurse got her on the monitor, got about a 5 minute reactive tracing and then it was the crash. Baby didn't look HORRIBLE, but dropped from 150s to 90's. When I got there she was being rushed to the OR, general anesthesia and the doc was yelling "get the NNP , we're going to have a 33 weeker !" They thought her uterus was rupturing, but when they did the C/S her abdomen w...