June 3, 2009

Zero To Full In No Time At All

The funny thing about OB is that you can go from a quiet, empty unit to crazy busy and full in just a few hours time. That's how it was this weekend. Saturday night, it was slow. We only had I think 3 patients on post-partum and no one back in labor. Sunday, however was a different story. We started out quiet and slow like we did on Sat., but by midnight, I had called 2 people in. It just seemed like everytime we turned around, ER was calling with yet another patient. By morning, we had filled all but on of our rooms with 3 labor patients, 2 pretermers and a patient who delivered a 15 weeker in the ER. And as we walked out, they were wheeling 2 more moms in. So I knew Monday would be crazy, and crazy it was. We started out with all but 1 room full, and that room would be for the midnight induction. I was going to admit the induction and I had to move my delivered mom out because we would need the room at some point. I go in, get mom up to the bathroom, moved to her room, situated, reported to the new RN and I started finishing up my charting. Right as I'm about to head back to labor,that patient starts hemorrhaging. A lot. It turned into a huge, long ordeal to get her bleeding under control and make sure she was stable. Every time we'd massage her uterus, huge clots came out, followed by very heavy flow. After manually removing a ton of clots, fundal massage, Methergine, pitocin, fluid, cytotec and 2 fresh 16 gauge IV sites she was stable. That was one of a few instances where I was really starting to worry. So, it's now 1:30 and my induction patient has been waiting since midnight. Get her admitted, pitocin going, it's all good. We have all the rooms full because another patient was admitted while I was dealing with the hemorrhage. I sit down to chart and, yep, another patient on her way up, 4th baby, history of a 2 hour labor with her last. We don't have a labor room, so she gets admitted to our monitoring area where we only have recliners. She's 3 cm, 100% effaced and then the FHR takes a dive to the 80's and isn't coming back up. Here I am, no IV supplies, no oxygen and a recliner that is difficult to reposition a patient on her side. So we run down the hallway to the C/S recovery room, Iv started, O2, and FHR back up. She labors, decides she wants to see what it's like with an epidural because she had her first 3 without pain relief, so she gets one placed and finally, we have a labor room. We move yet again. And right before shift change, she delivers. Thankfully, the mom and dad didnt mind changing scenery and actually thought it was funny. And it was a nice delivery. While I was busy with my own patients, we had delivered 4, replaced those moms with other labor patients, had a mom being prepped for a repeat c/s, and we had 3 moms in our monitoring area, laboring, waiting for rooms. I guess you could call that job security ;)

2 comments:

Prisca: said...

sounds like a crazy couple of nights! summers are always nuts on my unit...

Joy said...

That sounds like one crazy night! I remember with my firstborn I got to stay in the same room the entire time (LDR room). I delivered my second at the same hospital but an hour after giving birth in my LDR room the room was cleaned up as I was put into a wheelchair and taken to another floor to a post-labor room (we have two floors at my hospital- one floor for LDR rooms and one floor for c-section and recovery).

Sounds like it was a VERY busy night after I had my second. They were in a real rush to get me out of there. But I didn't mind. I was in baby bliss heaven, which was all that mattered to me.

That was long! LOL! The stories just reminded me of that. I'm pregnant with #3, due in October (close to Halloween). Wonder if a spooky full moon or something will fill the L&D the night we have this one, too!