Birthday Nurse

I really do like work, I was just telling someone last night about how much I love work. But after working 6 out of 8 nights...I'm ready for a few nights of sleeping when it's dark outside! I know it could be a lot worse, it was never more than 3 in a row, but still, that's a definite switch to the night shift! Last night had the potential to be crazy, but turned out not too bad. We started with 3 antes, but one was a set of 35wk twins that everyone thought was going to deliver. We went 2 out of 3 home before 2100, and I had the twins pretty settled down but then another "early labor" patient walked in about 2145 that kept me running. I think ER sent up 4 patients in an hour and a half last night! That is too many... The twin mom had come in early in the afternoon and had been 2, then later on 3, then even after terbX 2, vistaril and fluid she was about 3-4. She was rating her pain and had gotten some nubain right before I got there. The doc said that she real...

So besides a C/S recovery last night, the only thing worth mentioning is the gal that came about midnight...carrying her baby. These are always a little scary just because you never know what to expect! (The last one of these I took from the ER brought her placenta with her and said she's dropped it carrying it down the steps and it was full of sticks and leaves and grossness...) The lady from last night said this was her 5the baby, and she just wanted to make sure it was OK. She said she had left her other 4 kids asleep at home and she didn't want to stay, but she'd already set up adoption stuff and wanted to bring the baby in. Baby was ok , just cold from being outside, so he went to the nursery. The laborest checked out Mom and found a bunch of clots to get out. We asked if Mom wanted some pain meds but she said no, she'd just delivered a baby, it couldn't be that bad...so the laborest did a 45min D&C in the room with NO meds . There were three of us stand...

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...

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 haven't put a pair of scrubs on since last WEDNESDAY morning! That's only 12hrs shy of a week! I must say, I'm feeling kinda glad to put them back on, simply because I feel like I haven't really done all that much this last week. I'm not married, I don't have kids, I'm still living at home (rent is WAY cheap and I don't have that bad of a family...), and besides several gym workouts, church over the weekend and some stuff with friends Saturday night the busiest I've been is when I cleaned all day on Friday! Maybe it's just me catching up on all the time I spent in college NOT being lazy, but I'm ready for something to do. So now I'll work 3 in a row and we'll see how I feel on Friday morning when I'm crawling into bed! I haven't worked a night shift since the night that I found out I passed my boards. I can't believe that night was almost/only 3 1/2 months ago! I'm sure night shift as a real nurse isn't going to...

So I haven't worked since Wednesday, and don't work 'till Tuesday, and I'm feeling like I'm missing something without blogging! I told myself that this blog wasn't going to be an online "diary" I was going to keep it work-related. So here's my weekend musing re: work. I've talked to several people and after reading lots of other L&D blogs, here's my question: in a delivery in "your" hospital, who all is there for the delivery? Obviously the doc and the L&D nurse, but is there anybody else typically "required" to be there? I know at our hospital all of our nursery nurses work really close to us L&D nurses. Our Well-Baby nursery (where all babies are admitted to at birth) is right next to our nurses station and they can see our "board" with patients and docs and progress, etc. All the nurses that work in Well-Baby are NICU nurses and everyday 2 float out and do "admits" and come to all our d...

I was so excited when I got a text message from J this morning. My 35 week VBAC did it this morning about 0900! I was so pumped for her! I guess she was 1, 1, 1, then got to 4 and stayed at 4 the rest of the night. I think the doc was about to call it when she came over this morning and she checked her and she was complete! I was over at the hospital working-out this afternoon and so I stuck my head in to see how she was doing and both she and baby were doing great. Baby was an automatic NICU admit because he was only 35 weeks, but he was rooming-in with mom and dad and was doing great! He was 6# something so he would have been huge if he had gone full term! I was so proud of her, she was super excited and I think her labor was more like what she wanted then what she had thought it was going to be like. I just really wish I could have been there to help. See if I ever doubt a laboring mom again! From here on on, I'm going into every labor believing that they can push out their b...

So the good news about going to night shift is no more alarms going off at 0515 every morning for work :) That makes me happy! It makes me very, very, very sad that I don't get to work with J anymore though. I actually got a little choked up and teary last night when I was writing her a card. J has been the most amazing preceptor/mentor whatever you want to call it, she's been it and more. She was the one who first every taught me anything on the floor about L&D out of nursing school. I worked with her for 3 months last summer as an student intern, did over 50 deliveries with her last summer and I really think that it was because of her that I got the job offer on L&D after graduation. She was the one who encouraged me through the last year of nursing school and even more this summer after I had to re-take my boards. She's done all of my precepting and has taught me everything that I know about L&D nursing. Everything I can do I have her to thank for it, and ev...

So after my experience on Friday, I walked into work this morning really excited to have at least 2 more inductions to round out my days orientation (I go to nights next week!). Boy should I have never have pre -planned what my day was gonna be like. Walk in, what color is my patent's name? Green. Next to purple names ( DIU's ), green names (ante's) are my least favorite! And this wasn't just an ante, it was stable 27+5 twins who had been on mag since yesterday afternoon. 2 mag patients in a row, give me a break!!!! That means no new patients for 12 hours. Just me and the twin mom. So after that put me in a very sad mood, my day wasn't too bad. I know I should just be happy with what I get and be ready for anything, but two days of sitting on my behind watching mag babies (or answering 24 un -needed call lights) I really am ready for a delivery! This twin mom was really nice though, these are her 3rd and 4 th babies, and we became friends after I let her eat food ...

So this is the blog that relates to Friday at work, and since it's Sunday morning, that should say something! J wanted me to do at least one more day of antes before I'm done with orientation, so we figured there should be some on a Friday after they've had all week to pile up on the board. Sure enough, we got a Mag patient on for PTL ( pre -term labor) and then another one... The mag patient was too fun, she'd come in the end of our shift on Wednesday , so had been there for a while, she was 1cm/100%/-1 and 30-something weeks. She was so sweet, and so scared, and ready for the mag to come off! Poor girl! She was so tiny that the toco was picking up anything little thing so she looked like she was really crampy and irritable, but I think she may had one or two decent contractions every hour or so. Personally I think the vistaril that we gave every 6hrs was doing her more good than the mag was...She hadn't really changed her cervix so I think the plan was to turn...

So after today, I only have 3 shifts left on days! That just kinda hit me today, and it makes me sad! I'm still a little ( ok , a lot) nervous about going to nights, I think just because that means that I'm almost on my own and nobody's watching my back, and I've never worked nights on L&D before. I've worked nights a lot as a CNA , but not on L&D. I love the day nurses, and now I have to learn a whole new group of people, how they tick (or maybe what ticks them off), a different routine to the unit, it's like taking a big step back! And I'm going to miss working with J, she's been my nursing "friend" for a long time, and she's the one that's taught me everything I know about L&D nursing. Shoot, now I'm getting all emotional and depressed about it! Anyway, today was another good delivery on my own. Another multip induction, really nice, young couple. I wasn't sure how it was all going to go at first, I think it ...

It seems like forever since I've actually gotten to do a delivery! I guess I should kinda get used to that, ' cuz I know I'm not gonna get to deliver every shift when I work nights. Speaking of, it looks like it's gonna be in about 2 weeks, but more on the mixed feelings on that in another blog (not tonight!) I knew when I went to bed at 0000 this morning that I was gonna be in for a long day. I went up and visited all my buddies who are still in school in Lincoln this weekend, and so had a great 5 days off, but then of course got back late last night and was all geared up from my long weekend and didn't get to bed when I should have. I don't think I really woke up 'till about 1000 this morning. I had a prime induction, the kardex (our cheat sheet that gets filled out when patients pre -register. It has basic health history on it, G/P, special requests for delivery, etc, etc) said that there was limited English, so that made me a little nervous. It's h...

I've seen several blogs where people say "people found my blog by searching for...X" how do you see how people find your blog? I have something that tells me who's visited my blog, but I can't tell how people find it, like what they search for and then my blog pops up? Is it something I need to add to my blog or am I just not looking in the right place?

I got a really good comment a couple days ago about nursing jargon and abbreviations, and it made me really think and smile and remember back to just a few months ago when I was learning how to "talk like a nurse" and to save my fingers when typing or writing, and since I'm a bad speller, how to save some face and just abbreviate! So I'll make a little list to maybe make reading my ramblings easier. I'm sure I'll forget something, but hopefully it will help a little! Primip /prime - woman who this is her delivery, it is frequently her first pregnancy too. These labors usually take a little bit longer because the woman's body has never done this before. These women usually come in and have lots of questions and are really nervous, as I would be too! I like prime's because I get to really ease their worries and concerns and help them through the labor. Multip - women who have had a baby before. Their labors are "usually" faster because their...

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...

This nurse is too tired and too grouchy and too frustrated to really go in depth about her day at work. I don't think I will ever understand why some people (in this particular case doctors) do what they do when they do it. I feel like I did absolutely nothing today, got nothing really accomplished except watching my patient get sicker and sicker before my eyes and then handing her off to night shift to section 45 minutes after I left. A section that should have happened at about 0900 this morning, and by 1500 at the latest.Let's say that at times today, my line monitoring baby's heart beat was flatter than my toco line sitting on a uterus that was picking up only breathing. The toco line was at least a little jiggly! Sigh...more tomorrow when I won't blog things I'll regret later. Bottom line is -- babies today: ZERO

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...

So after yesterday, I have yet ANOTHER card to add to my wallet :) My NRP card is not nestled next to my nursing license, CPR and BCLS cards. I'm aiming to have all the letters A-Z after my name soon... haha ! The class really wasn't as hard as I thought it was going to be. I was all worried, but I think I could have gotten through it and done the test and gotten in all filled out in way less than the 8 hours that it took yesterday. Oh well. My one BIG question about the class was: why did they pick instructors to teach the class who have nothing to do with NRP ? One of the instructors is the educator for all of Women's & Children who does NO patient care; one works Mom/Baby every once in a while and does a lot of education, and the other is the NICU manager. The NICU manager, I see that. She does NRP stuff and has done it for years, but she taught 2/9 sections! When I saw her today I told her that we voted for her to teach it ALL next time... J thinks I should go...