November 6, 2007

JCAHO, competencies and bleeders, oh my!

Last night I worked my 4th night in a row. That may not seem like a lot, but man, working night shift, 12 hours shifts a 32 weeks pregnant just was almost too much. Plus today I had to stay over for our annual competency day. And I LOVE competency. (catch the sarcasm). I know we have to do it and show that we are doing things correctly, but really it seems like we're just going through the motions to look good. Oh, and JCAHO paid us a surprise visit the last two days. We've been waiting for them to come to the hospital because apparently, they've hit every other hospital in the state before coming to us. It shouldn't be such an ordeal when they come, but the level of stress goes up about 300% while they are around, just making sure we are doing things we are supposed to be doing. Work last night wasn't too bad. I had a patient come up about 0330 that ER said was 40+ weeks, was gushing blood and they were bringing her up. Now when ER brings the patient up themselves instead of having us send or tech down to get her, usually that means bad news. I was all prepared for a quick assessment, call to doc, prep and c/s delivery because gushing blood is bad news. Thankfully, she wasn't gushing blood and was stable. She did say she had a lot of blood with clots at home, but was only spotting. All the labwork was normal, baby was fine, etc so we watched her overnight. I just wonder what exactly happened and what they decided to do.
This morning, I also made an appointnent to see the doc after my NST tomorrow afternoon. I've been contracting quite frequently, and although they aren't getting stronger or painful, they are pretty intense. I've also bee feeling A LOT of perineal pressure /aching, which is weird, as well as having a low backache, which is also new. I really think that everything is fine, but I decided to do what I would tell any patient to do with the same symptoms. So, I'm going to let my MD know. We'll see what happens.
32 weeks pictures coming soon. Last night, one of the nurses I work with told me at 5:00 that my belly looked bigger than when I first came on shift and asked it that was possible. Um, thanks, I guess, but I don't think it can grow quite that fast. It was kinda funny. On Thursday, another nurse I work with is going to do maternity pictures. She's into photography and her stuff is really good. I'm a difficult person to photograph because I usually end up feeling silly, but she does such a good job, I'm positive they'll look great.


Brooke (CrazyRN) said...

Ohhhh...don't you just love JCAHO!!

Get some rest girlie!! Working 4 days in a row (12's) is hard on anyone, especially someone who is pregnant!!

Kristina said...

I'd be interested on how JCAHO rates labor and delivery. L&D is so much different than the rest of a hospital just by definition, and I wonder if JCAHO's standards of care show that. Could that make an interesting blog post?