Oh! What A Night, Early September here in 2009...

Wow. That's all I can say after last night's shift. Wow, were we busy. Honestly, I don't think we've run our butts off like that since I've started working as a nurse. Oh yeah, we've had busy nights, but not like that. We started off with 4 labor nurses and all 7 rooms full of laboring women, plus 2 new patients in triage. 2 patients were probably going to be heading to OR, one was 8 cm, and the others were in all stages of labor. One nurse had both c-sections, which were done back to back. My girl delivered shortly after midnight, just a few minutes before the first c/s was done. Our scrub tech was back in the OR, and the baby nurse was as well. So it was just me and the midwife. Not a problem, but it is a bit hectic being the labor nurse, scrub tech and nursery nurse. She delivers, and I take over another labor patient, who by the way has the worst attitude in the world. She had a scowl on her face the entire night. Not sure what the problem was, but I think she wanted a cigarette. I had to have a discussion with her and her family, who looked like they were straight out of the Kentucky backwoods, why they could not smoke a cigarette in her room. Hello, oxygen tanks, smoke-free campus and it's a freaking hospital! Anyway, the second c/s is heading back and one of the patients in triage is found to be in labor and a repeat c/s...so she's taken back shortly after the second patient is in recovery: It's now only 2:30! I finish up mom and baby and I move my delivered mom to post-partum, check on the other laboring moms, who thankfully had been medicated and had epidurals. Come back, handed another patient who is on Mag Sulfate for PIH and needs pitocin started because her labs were bad. Get that going, start pit on my grumpy mom because she hadn't made cervical change in 3 hours, place FECG because baby was hard to trace, get her epidural redosed, and change her peripads that were soaked with amniotic fluid. I then run and check on the other moms who were doing alright, but were starting to wonder when their nurse was coming back. I reassure them that we are monitoring them at the desk and that if something were amiss, we'd be in. So in case you lost count, one nurse is tied up in recovery, one is tied up in the OR, one is in the process of transferring her patient and that leaves me back in labor with 4 labor patients at this time. After transferring the first c/s recovery to PP, that nurse comes back and we think we can finally catch a break only to get a call from ER: one of the 7am inductions was down there in labor. We crossed our fingers that she wasn't too far, but a G4P3 we knew it was probably the real deal. And she was: she was a rim with a bulging bag of water. The third c/s moves to recovery, we get the doc here for the new patient and then all the sudden her baby's heartrate drops to the 40-50's. We're all wearing brown scrubs by this point because the head wasn't coming down well. Her doc said "we may need to head back for a c/s". I thought our poor scrub tech was going to die. About that time, the baby rotated and was delivered. We were all breathing a sigh of relief. Time? It's about 3:30, still about half the shift to go! We do alright running around, getting the 7:15 c/s ready, doing patient care, not documenting, but taking care of the patients until about 5:30. My patient on Mag for PIH starts having higher BP's, and my grumpy mom's baby isn't looking so hot. Call doc, got order to increase the Mag on PIH mommy, and I flip and give a bit of O2 to grumpy mommy which eventually gets the desired results. Finally, the clock says 6:00 and the day shift charge nurses are here, and we realize we're on the last lap. But its not over yet. Grumpy mommy calls and says she feels pushy and she's now 8cm. And about that time, another of the 7am induction patients comes in early. But, one of the dayshift charge nurses takes her and finally, finally it's shift change and we can pass off our patients and go back and document everything we did over the last 8 hours. We considered going out for drinks when we were done, but decided to do it another day. With all the running we did, we were tired, figured it would be hard to drive home anyway, and if we got pulled over for weaving just because we were tired, we'd end up doing a sobriety test if the cop smelled alcohol. I'd hate to explain that to Husband. I do have to say that the patients didn't get the best of care, it was probably barely adequate, but it was the best we could do. No harm was done, we answered the call lights, and we have a huge monitor so we all can keep an eye on the monitor strips. No one else would come in to help, they tried, but every patient was well and healthy when we left. This afternoon after that exhausting shift, I had my follow-up visit with Doc, but I think I'll leave that for another post.