Get into the groove...

It's been awhile...guess I've been pretty busy lately. Work has been hectic, but I've had a string of wonderful births and I think I can finally say that Momma has her groove back! One weekend, I came on shift and took a laboring mom who had just gotten an epidural and the last she was checked she was 4cm. After report, I go in and introduce myself and check her cervix: 10cm and the baby's head was L-O-W. So called Doc, patient delivered and it was a nice, easy delivery. I get everything settled with the new family, baby is nursing like an old pro and I walk to the desk to give them some time alone. About that time, a patient came in after she fell on ice. She said she managed to keep from landing on her stomach, thankfully. She was in her late second trimester and needed some lab work, continuous monitoring, and a sono to make sure that everything was fine with the baby and placenta. Soon as I get her settled and gave a dose of terbutaline to stop the few contractions she was having, another patient comes in, preterm and contracting. I get her admitted and call the doc and got some needed terbulatine to stop her contractions. I'm running in between my two preterm patients, both contracting and needing terbutaline and labs. Thankfully, the pretermers settled and I was to keep the one who fell for 4 hours and then she could go if everything was stable, and the other I was given a discharge order. The charge nurse had been checking on my delivered mom while I got through these admissions, otherwise I would have never gotten in to check on her. Things start to settle for the moment, so I get my delivered mom moved to post-partum. As I'm heading in to discharge the now stable preterm patient, our OB/OR tech comes around the corner...and she's moving at a pretty good clip. I look at the patient and immediately understand why: the mom is sitting in that tell-all position that every OB nurse/tech/doc knows well. She's got sweat on her brow and upper lip, panting and sitting off to one side of the wheelchair, hands clenched around the wheelchair arms so tightly her knuckles are white. Me and my stellar critical thinking skills decide that I would have to discharge my patient later. We manage to get the patient in bed, pants off and I check her and she's 9cm. One of my fellow weekend-option coworkers came in to see if I needed help. We work together like a well-oiled machine. Within 15 minutes, we had her admitted, IV in (yes, I know an IV isn't always necessary but she wanted us to try to get her an epidural, but we all knew it wasn't going to happen), assessment and admission complete, delivery set-up done, and the infant warmer set and ready to go. I started to think that the doc wasn't going to make it in time, but the OB got there just in time to put on a pair of gloves and catch. Mom did fabulous. She had really wanted an epidural but her labor went too quickly and she was so in control that she really didn't need it. I think it was more the idea of not having one that was scary to her. Thankfully, the rest of the night seemed to be a bit calmer. I was able to finally discharge my preterm patient. It had been awhile since I had done a Leboyer bath (well, a modified Leboyer if you want to be technical) so I was able to help the parents give their new baby a bath. Since it was such a wham-bam-thank-you-ma'am birth, the mom said it was nice to be able to slow down, and just support her baby's head as he floated and kicked a bit in the warm water. Thankfully all the labwork and sono results came back normal on the momma who fell, so she was able to go home at the 4 hour mark. At the same time as all the action I was in on, there were a couple more births and other things going on, but by the time dayshift had come in, we had all but one of the delivered patients moved out to post-partum, and all the other outpatients were treated and discharged. It looked to them like we had a quiet night sitting at the nurses station, reading the paper and chatting while the patients sleep...that's all that happens at night, you know. ;)