October 23, 2009

Ranting and Raving

Dear Charge Nurses, when there are two nurses back in labor with 5 labors, and 2 outpatients, if there are 2 labor nurses on post-partum, please send at least one back to help, before a patient precips because she is moving quickly. We were stretched too thin. Your 2 labor nurses were in catching a baby while no one was out monitoring the other patients. It could have been ugly. Plus now you have two grumpy labor nurses who will repeatedly tell you "we told you we needed help". You are lucky we are experienced, work well together and know without having to ask what needs to be done. You got lucky this time. Let's not keep playing Russian roulette.

Dear elective inductions who don't give us a working phone number, we are very sorry you didn't get the message that you were being bumped because we don't have a labor room to put you in, or the staff to care for you. Yes, we know you were "scheduled" but shall you or I go tell that mom who is 8 cm with no epidural laboring in a triage chair that she needs to close her legs because you were "scheduled" and should get a labor room? These people are in labor, you are not. We'll reschedule you when we can.

Dear Physician of the Year in my book, thank you for seeing how nuts the unit was, and told your elective induction that she would have to go home after we made sure her baby looked great, and be scheduled later. You did this with no prompting from us nurses. We love you. Really, we do.

Dear Physicians, if you see that there are only 3 labor nurses for umpteen billion patients, please, we beg of you for our sake and especially for the patients sake, please do not break your 3 patients bags and order pitocin at 1am because you came for a delivery. And please come up with more creative diagnoses for medical inductions than swelling when my lower extremities are more swollen than your patient, or for PIH when her BP's are 90/50 and no other symptoms. If you were worried about PIH, how 'bout ordering extra labs? Oligohydramnios would be a good one. That I can't rule out without an US. Try that one, make me feel like you don't think I'm an idiot. Again, talk with some of your colleagues, take notes, treat the nurses like professionals, don't make a bad name for the majority.

Dear Mother of my labor patient, I just want to thank you for the comic relief this morning when after a cervical check you said "Why are you carrying on so much, did you do this when he was sticking his weenie in your stuff?" Patient laughed heartily and I about wet myself at your colorful remark. Thank you. I needed that.

And please, dear God, can you let this weekend be more manageable? I pray you send an experienced labor nurse, or 3, who wants to work nights to our hospital.

10 comments:

Knitted in the Womb said...

Okay...sounds like you had a rough day (or couple of days?) and my heart is with you.

Until the last comment about the patient freaking with vaginal exams. Vaginal exams are not ANYTHING like having sex...you should know that. Different setting, different person, different size object being inserted. At least the patient did laugh at her mother's comment...but that still doesn't change the fact that vaginal exams and sex are not the same.

If the mom is having such a difficult time with vaginal exams, how about considering if they are REALLY medically needed? (yeah, I know you've got Dr's who want to do them, and you have limited power over that...but you could be like some other nurses who actually inform their patients about their informed consent rights and about the limited medical value of certain procedures) I've seen a mom stay at 9 cm/90% for 6 hours...I've seen a mom go from 4 cm/80%/no contractions to birth in less than 2 hours. Knowing dialation really does not have any predictive value.

Erika said...

Amen, sista!

Erika said...

I mean, Amen to Nurse Lochia! :) Hope you are doing better..

Taking Heart said...

Great post... I agree with you 100 percent... I have had those nocs on more than one occasion!

Nurse Lochia said...

Okay, sorry to offend about the vag exam comment, and like I said, I've been there. I've had 3 babies, I know it is uncomfortable, I know that it isn't like sex, and yes, I know this. In this case, the PATIENT requested to be examined much more frequently than I usually check. I tried to explain that checking her cervix every hour wasn't necessary. Really, I care less what dilation a patient is as long as the baby looks fine, all that really matters is if she's ready to deliver. It was supposed to be funny, b/c the patient thought it was funny. Otherwise, I wouldn't have posted it. No one should take me too seriously on anything I post here. I guess I need a way to add tone of voice and seriousness to my posts.

Penny Lane said...

Brings back so many memories! Thanks, even after my own rant about being a solo Nurse Midwife in private practice, I am still glad to be doing it!!

BirthdayNurse said...

Amen to having to beg the charge for help...while you have L&D nurses doing postpartum! We can't tell the patients we can't take them just 'cuz we have no nurses...so find us more nurses before someone gets hurt!

Amen to understanding docs! Why can't there be more of them?! We had a doc sitting at the desk offering to take the next patient who came in because she saw how swamped we were...

Amen to putting those elective inductions on hold. "ELECTIVE" means not-necessary at the present moment!!

Amen to the SVE comment...funniest thing I've heard in a while. And honestly...I wonder the same thing the mom did everyonc in a while...

Hope your nights get better soon! :D

wife.mom.nurse said...

Love this post, well done...


yep, the last comment almost made me wet my pants :)

Sharpiegirl said...

That last comment almost made me snort with laughter.....at work! Thanks for the smile! I hope things get calmer at work.

Nurse Hoo-Ha said...

LMFAO...do you work at MY hospital? ;)