Birthday Nurse

Only 2 birthdays in the last week :( We've been having babies right and left it seems...I just haven't been involved in them. That makes me sad!!! I want some babies!! It seems like I've had cervidils and antes a lot lately. Boo. Neither of my birthdays have been terrifically outstanding either. Pretty "run-of-the-mill" almost...for lack of a better word...boring! The first one was a close friend of the doctor...so get this...the doc stood in the room and pushed with her for an hour and a half!! Seriously?! I love this doc, she's great, one of our favorites. But come on. I can think of only a handful of things that can make an L&D nurse feel more useless and a waste of space than standing at the perineum and pushing with the patient the entire time. Makes it even worse when the patients husband is there, and so is her sister...who is a pediatrician. So for an hour and a half I stood in the corner, dumping some astroglide everyonce in a while while doc, pat...

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/...

Well, I guess this is technically talking about LAST Tuesday... shows what my life has been like! I went in at 1730 for J so she could go to a party, and so I took her c/s recovery. I had admitted the girl the night before...just a little on the high-drama side of the scale. I finished her recovery and the anesthesiologist wanted to keep her on L&D overnight with hourly vital signs re: some panic attack issues on the OR table (we don't ask questions...we just follow orders...). So I was set to take her for the night, then they tell me that actually, I'm going to give report on my post-op and go take a full team on Mom/Baby for the night. Come again? So...wait 'till 1900, give report to ANOTHER labor nurse to take my recovery back out to the floor, then hightail it over to Mom/Baby to get report on my team of postpartums and babies. I'm already flustered b/c I'm running behind schedule and that threw my whole night off. Here's the kicker that made me mad....

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 was so thankful to have a day off yesterday! I knew how crazy it had been, so I took brownies up to work last night about 2100. The board looked beautiful!! Couple green names and 2 ROL's . Why can't I work on nights like that!?! So I dropped the brownies off and on my way out the door I made a funny comment about "now I don't want my phone to ring tonight because I've already driven over here once tonight!" I should have kept my mouth shut...! Sure enough, about 0245 my phone rings. When I'm in a dead sleep I don't really think about what I'm doing and I just grab the phone and answer it. Sure enough "we need help! People just keep walking in!" Ok ...I'm on my way. I couldn't say no after what I'd said earlier, and after the week we'd had, I know what it's like when nobody will come in to help. Only as I was getting ready to walk out the door did I realize that it was torrentially pouring buckets outside...no wonde...

By Thursday night I was seriously dragging. We had all gotten our butts kicked all week long, and you could tell all us nurses were getting near the end of our strings... I took my patient back for a C/S about 1910 after her being a cervidil the night before and then on pit all day and having made NO change. That and the fact that every time she rolled or changed position baby would have a nice 5-6min decel . A C/S was definitely the best decision for her and her baby. She was a young mom, first baby, and she was giving the baby up for adoption after 24hrs. Got her all ready and back to the section we go. That's where things started spiraling out of control. We had a great anes team on that night, and usually it takes all of about 10 mins to get the spinal in and the patient comfy. So we started working in the back, since we didn't really want to move mom and cause another decel anes tried to put the block in while Mom was laying on her side. This is nothing new for them, ...

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...

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...

Probably should talk about Friday night before I talk about the craziness of last night! Friday night...I walked into a girl who was unblocked and on pit but who really hadn't changed all day. I walked down with the day shift nurse to check her right before shift change...she was 8. (Still unblocked). Got the room all set up, gave her a few more contractions...checked her again...she was 9.5...few more contractions , complete. Please let the doc get here! I didn't put her in stirrups 'till I had the doc present and accounted for and I was sure I was gonna catch the baby...but I didn't. Nice delivery, she was so proud of herself for going un -blocked, and with good reason! I love it when they think they're only 2 and then realize that they're like 8 or 9 or complete. It's amazing how well they stay in control that way vs. knowing that they're getting closer and closer. I wonder if it really is a mind game!! So I hung out with my postpartum cuplet (since ...

Needless to say, it's been beyond crazy at work. I somehow managed to slip by on-call for part of my shift Friday night, I couldn't believe it! Then the calls started coming... Saturday night...sorry I have a wedding Sunday morning! Sunday... the manager of the entire Women's & Children's department called...twice!...sorry, I've got a bridesmaid dress on and I'm getting ready to march down the aisle! Monday ...just got off a mower after 5 hrs in 100 degree heat. Tuesday... I was scheduled to work, and sure enough it was crazy. Somehow we've only had like 3 or 4 nurses scheduled every night, to cover an completely full board. We had more nurses there on time and a half pay than we did straight pay Tuesday night! I delivered a girl on mag about 2100, and as I walk out of that delivery with pressures of 160's/100's I get a page that there's a cervidil coming that I need to take. Since when is an unstable mag patient not 1-to-1? Whatever wor...

Last night will get blogged about AFTER I have not been up for 22 1/2 hrs and when I am in a better mood...

So because of a fetal monitoring class this week that's required (even though we're not getting paid for it...) my schedule got all mixed up. Instead of working Sun/Mon/Tues and then having my long stretch off, I work Sun/Mon, class all day Wed/Thurs, then work Friday night. Then they "had" to switch my schedule next week because someone else had to change nights so I'm working like Tue/Wed/Fri. It makes no sense to me, and I can't say that it's all working out just how I want it, but I'm sure I'll survive somehow. It will be nice only working 2 IAR this week for a change instead of 3!! Looking @ the positive :) I started out the shift tonight with a postpartum mag patient...plus the baby. So even though they still say that I need to orient to M/B, they feel free to assign me a M/B patient before I've been over there. Maybe now they won't feel the need to float me over there since they can just assign me a M/B team over on labor now! Whate...

It's been an interesting week...it was 1year ago (not by exact dates, but the 2 nd Wednesday in June) that I took my nursing boards for the first time. That is one day I will never forget. 3hrs, 270 maximum number of questions, left the test in tears. It was 1 year ago (again, 2 nd Friday in June) that I found out that I didn't pass boards the 1st time around. THAT is for sure a feeling I'll never forget. Seeing that big FAIL next to my name and that horrible sinking feeling in my stomach. I was the girl nobody ever expected to have any kind of problems with boards...and I was the one out of the class who failed. I felt like I was NEVER going to be a nurse, that maybe this wasn't what I was supposed to do, that all my years of work and dreaming had come to just that...work and dreaming without ever achieving my goals. I never felt as worthless, stupid and ashamed in my life. The next 45 days were the toughest ever, and I'm still not sure how I ever got through the...

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...

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...

They called me to work extra tonight in the middle of the afternoon...I told them that I am NOT super nurse and I can't work 8 nights in a row! Sigh... The rest of the weekend was as crazy as Thursday night, only with less staff. We all ran our butts off! I had really nice deliveries both nights, so that was at least worth it. My girl on Friday night pushed 2 1/2 times...I'm glad the doctor came as soon as I paged her or she would have missed it!! Baby came out with a nuchal and was a little floppy, but pinked up pretty quick once he got moving. Saturday night was just one of those nights that I got the triage crown and as soon as I would send someone home another would walk in the door. I did 7 admission data bases (the ump-teen screen computer form we have to fill out for everyone)...that is TOO many! I did get a nice delivery out of the night, so that was good. I felt sorry for Mom, it was her 2 nd baby, she precipted with her 1st baby, and almost did with this one...tha...