15 months, running, and more

Isaiah had his 15 month well-baby visit a few days ago, and he's now 22lb 8 oz, 31 inches long. I had been a bit concerned about his growth (I have to worry about something) because between 9 months and 12 months, he hadn't put on much weight, and he hadn't grown at all. Now I realize that might have been a measuring error, because, how accurate can you get when you have a wriggly baby? But he had fallen off the growth curve with height, but now he's making his way back up. He's in the 20% for weight, 50% for height and 95% for head circumference! So he's got a big head. What I don't get is how he is such a thin kid. He eats 100 times better than the other two ever did or do now. He isn't really picky about his food (yet) and can put away about as much food and Jacob and Clara can. So I'm surprised he's so thin. But, I guess he is all over the place, rarely slows down and still isn't a good sleeper. Oh, how I'd love if he'd sleep like Jacob did: he'd sleep for 1 1/2 hours in the a.m., 2 hours in the afternoon and he'd be ready for bed at 7pm, but we'd keep him up until 7:30...then he'd sleep all night. Oh well. Sleep is becoming less and less of a stranger at night. Isaiah will maybe wake up once in the night and we can get him back to sleep pretty quickly by patting his back. Sometimes, he'll actually sleep until 5:00 - 5:30, which is pretty good considering where we've been. So I am starting to believe he may actually sleep all night consisitently at some point in the future.
I've also been running a few times a week and I'm excited to say I ran 3 miles last week without stopping to walk! AND, the biggest excitement, is that it was an enjoyable run like I used to do. I was able to get lost just listening to my music, I wasn't feeling like I wsa gasping for breath or that my legs were going to die. It was pleasant. Only once, briefly, did I think "I could stop and walk now, but I think I'll just keep running through it". So I did. I'm also meeting with a co-worker on Wednesdays to run together. This is also very exciting because the last time I had a running partner was back in college. I'm also trying to eat healthier, because I have put on some weight over the last months that's settled around my waist and I hate it. And I know it's because of eating bad food and not excercising like I should. But, I'm taking steps in the right direction.
I also picked up a couple books that I read that I thought were pretty good. The first I Was a Really Good Mom Before I Had Kids. I also picked up Unbuttoned, which I thought was a great anthology of breastfeeding stories, from all angles. I plan on ordering a couple written by midwives The Blue Cotton Dress and Labor of Love. They were recommended to me by a co-worker. I guess I'm a sucker for books about motherhood and birth stories.

Another Prayer Request

I've been following this blog for awhile. Stellan's story is amazing, as the Great Physician did his work and got him this far, when doctors said he'd never live with his heart defects. After he was born, they were amazed that he seemed perfectly healthy. Check out his story. Send a prayer up for this little boy. The power of prayer is powerful, and we could all use a happy ending.

Prayer Request

Three weeks ago, 2 boys went missing when their father failed to return them to their mother on a Sunday night. An amber alert was issued. Today I heard that they have been found, dead in the backseat of a car, and the father was found dead 60 feet from the car. I know things like this happen, unfortunately far too often, but when it happens close to your community, a small community where "things like that don't happen here", it really strikes a nerve. Very sad today. My thoughts and prayers are with this family and hope God gives them the strength they need.

Two deliveries in one night

Once again, this past week had a shift start off with a c-section. This mama was measuring 5 weeks behind in dates, had noticed a decrease in fetal movement over the last week and hadn't felt movement for a few hours before she came in, had very low amniotic fluid, PIH and her 35 week baby was having variable decelerations in the absence of any contractions. They had talked it over with the perinatologist and neonatologist and they decided she needed to be delivered. They were already back in the OR when I came on, so it was a bit awkward to slide my way into a delivery in progress. The baby was pretty darn small for the gestational age, but she was a feisty little one. They had worried she might need transferred to another hospital that has a NICU, but she was doing fabulous. Her placenta was also very small, and looking at it, they noticed that probably only half of that placenta was working due to an old, huge infarct on one side. Scary stuff. After that, I finally had a vaginal delivery. It has been awhile. Like I said, I seem to be the c/s queen lately. Mom came in, 4th baby, wasn't really contracting that frequently, but she said last time she did the same thing, then went from 3 cm to complete in less than an hour. She figured baby #4 would come the same way. She didn't want to deliver in the car on her way to the hospital, nor did dad want to deliver the baby. So she hung out, used the birthing ball, walked, and sat in the rocking chair. And she was right about her labor course. All of a sudden, she was moaning, making all those "birthing noises" that women make in transition, and sure enough, she was 8-9 cm with a huge bulging bag of water. Called her midwife (a former RN colleague) and she had an awesome natural vag delivery. Not only that, but this was the first delivery I had done with this midwife since she finished midwifery school. She was always an awesome labor nurse and she was definitely in her element in the delivery room. I was nice to finally add a labor and vag delivery into the mix of surgical deliveries I've done lately.

Nurse Fantasy Land

In a perfect world, we would never be short-staffed. There would always be enough nurses so that you could do one-on-one labor support for each mom, and you had plenty of time for teaching. Gone are the days of juggling 3 labor patients. Charting would be minimal, as each nurse is equipped with a device that electronically(magically) charts every intervention that is done/heart tones/etc as it is being done, automatically. No more staying after your shift for an hour, looking at strips and charting - it's already done as you go! (Man, wouldn't that be wonderful!). Decisions about how patient care would be carried out would be made by people who actually are at the bedside...not people who haven't done patient care for decades, or ever. There would always be working equipment that was easy to use. Patient scanning devices for medications/labs/etc., would be user friendly. Call lights would become unnecessary because you would have plenty of time to care for your patient and so you are able to anticipate her needs. All members of the healthcare team: Nurses, Techs, Doctors, etc., would all treat each other with respect that everyone deserves. Communication would be exceptional. No one would ever feel left out of the loop or show up at work and find that something has changed without warning. Leadership would actually listen to the staff, value their opinions and run the unit/hospital/etc well. In OB, there would not be elective inductions - those patients would go into labor on their own and progress as nature intended. No continuous monitoring for healthy mama's, and in those who need continuous monitoring, there is an abdominal girdle that picks up baby constantly, regardless of movement and position. So, no need for internal fetal monitors. There would always be an OB and anesthesiologist in house for those emergencies(I know some hospitals have this, but mine does not). C-sections would only be done if there really was a need and VBAC's would be the norm instead of repeat c-sections. Medical inductions would be successful and episiotomies would be a thing of the past. Every breastfed baby would come out of the womb and latch right on. Aaaahhh, a nurse can dream, can't she!?

Frustrated

I am frustrated. Very, very frustrated with work right now. I think I need a new job. I love taking care of patients, helping them with labor and delivery and helping them adjust to the post-partum period and parenthood. I love my night shift co-workers. We work very well together, help each other out and we generally get along. I just think I need to go somewhere else. But I can't. I would be hard pressed to find a weekend option position in OB anywhere around here I could get into. It's the politics and all the BS that seems to be spreading like MRSA around the department. I'm fine all night at work...it's change of shift that brings out my agitation. I guess the main problem is there are too many people that have more power than they really should. Like they say, too many chef's in the kitchen. Decisions are made based on what works for them, not for the people involved.
For example, this a.m., I find out there is a mandatory meeting for relief charge nurses next week. Apparently an email was sent but I never received that email, and I'm a relief charge RN. There are 3 of us relief charges on nights, there aren't any on evenings and there are a couple on days. We are the only shift that really utilizes the relief charge nurses because the other two shifts have more regular charge nurses to fill in holes. But anyway, the meeting was made for noon, the day after we have neonatal resuscitation renewal and a staff meeting. That does not work for any of us night shift at all. I mentioned to the day shift charge who arranged it that it wasn't a good time for any of us and she rolled her eyes and said it was expected that we were all there so we could hear everything all together. That's fine but make it at a time doable for all involved. I explained that the only way I could make it was with my kids (I have a rule to not take my kids to meetings b/c it's distracting to all involved) but even then, it's a bad time because that's nap time. She didn't care. And the other 2 nurses? They work the night before the meeting and the night after. Noon is right in the middle of sleep. I realize the rest of the world sleeps at night and works during the day, but come on! Couldn't it be later, like 6pm? That's just one example. So many things are going on that remind me of junior high that I'm at my wits end. But, I just have to ride it out, and hope it gets better. Why can't we all just take care of patients and lose all the other nonsense, BS and whatnot? Sigh. It will get better. It has to.

Are you ready for a C-section?

Man, can I go one Monday night without starting out in the c-section room? Seriously, 4 out of the last 5 Monday nights, I go in, take a patient that I looks to deliver vaginally overnight, only to find out that they are heading back to the OR. Don't get me wrong, I don't have a problem with c-sections. Remember, I had 2. It just seems that it's becoming a Monday night trend for me. The first Monday night c/s in was for a failed induction - she had been stuck at 8 cm for several hours. The second and third was for a mom who had been pushing and the baby just wasn't going to fit. Last night it was for a mom who was not only not dilating, but her baby wouldn't tolerate the pitocin, and the FHR started climbing. Finally, after several calls about a FHR of 180, minimal variability and late decels, I get an order for a c/s. Okay, I guess that one wasn't right at 11:30, it was shortly after midnight. But you get my point. My co-workers told me I wasn't allowed to take labor patients anymore on Mondays - they'd give me the antepartums, that way those laboring mama's might actually deliver vaginally! Labor nurses are probably the most superstitious nurses you'll meet.

I've finally started running again, now that the weather has cooperated. My last couple runs I'm able to run a little bit farther than I did the day before. Granted, I'm probably only running 1-2 miles, but, hey, it's a start. I did get some motivation from my darling daughter. The day that I was about to loose my mind and I flung dried potatoes everywhere, Clara worked her magic. We were all at the table and she looked at me and said "Mommy! It looks like there's a baby in your belly!". Thanks, thanks for that Clara! Gotta love that 4 1/2 year old honesty! Now I know she didn't mean it to be mean, because she sees pregnant friends of ours, she remembers when I was pregnant with Isaiah and Boompa (grandpa) talks about his big belly and she talks abouthow his belly is big because there's a baby in there. And that day, the kids had said "it'd be neat if you had another baby. So she didn't mean it to be mean. But she's was right. My extra weight is concentrated around my belly (that's what 3 kids and 2 c-sections will do for your abs) and I look about 22 weeks pregnant. Really, this is a minor concern, but it was enough to get me up and running again. Oh, and I found out my cousin's wife is big into marathons and after she has her baby this month, she's going to give me tips on how to train. We'll see how it goes!