July 3, 2008

Caution: Very Negative Venting Ahead

So I had a not so good night. Started out with bickering on the home front, then while getting gas for $4.11 per gallon on my way to work a short burst of pouring rain soaked me. Then driving a car that desperately needs new wiper blades is annoying in the rain, which luckily only lasted a short while. Then after arriving at work, I find I have the keys to the van that my husband has to drive to work tomorrow. Kinda hard if I have the keys. So I hope that it's slow and I can leave early, but no, it is insanely busy. Luckily a co-worker on the prior shift lives 2 blocks from my house happened to be working and dropped them off for me. Oh, and tonight my out-laws are coming to stay for a few days. I've been having a grand 'ole time. So bear with me...

Please, dear doctor, when you send in your patient for an induction for edema (aka elective, but by calling it "medical" it ensures that you induction won't be bumped until later) can they actually have edema? And 2 patients in 1 week being medically induced for edema who, ironically had less swelling that their non-pregnant nurse did (yes, I still need support hose)? How odd. Oh, and an accurate cervical dilation would be nice. It's rather difficult to check someone who's baby isn't even engaged in the pelvis yet, and it's her first baby. You told her she was 2.5 cm/80% and at a 0 station, locked and loaded for delivery. Imagine her surprise when after 2 other nurses try to reach her cervix and are unsuccessful, I pull my entire forearm out of her vagina trying to reach her cervix and announce "1 cm, still pretty thick, maybe 50% and -2 station". That made for a difficult explanation. Because I am only a nurse, I wonder who they will believe. I guess I really don't know what I'm doing. Although 1cm and almost 3cm are pretty easy to distinguish. The patient did say that you told her we might have to postpone the induction if she wasn't dilated enough. 2.5 and 80%, should be good for induction so that makes me think you knew her cervix wasn't favorable for induction. Not only that, but at only 38.1 weeks, and with a cervix like that, you're setting her up to fail. Induce if you must, but can we try a cervical ripening agent before pitocin? And maybe not break her water so when she doesn't progress she doesn't end up with a c-section, made possible by inducing,seemingly unnecessarily, an unfavorable cervix?
And to my dear co-worker, thanks for letting me know that my diabetic patient is taking her own insulin. Insulin and blood sugars aren't any big deal. Although it is absolutely against hospital policy to allow patients to take their own supply, unless it is unavailable in the hospital pharmacy, go ahead, and let it be a surprise to me. I like surprises like that. I like going in the room to be told "I gave myself 4 units of regular and 20 of novolin". Nowhere are there orders for this. But, that's okay. We don't need doctors orders.

*Disclaimer: Sorry, I had to get all of that off of my chest, and I did create this blog as my place to vent. I do not have a problem with doctors, nor do I feel I am superior to them. I also love my co-workers, and I realize I'm not the perfect nurse. I also feel that a diabetics routine is screwed up when they are in the hospital and that as long as they are controlled, it would be better to let them do their usual routine.


Mrs. Spit said...

Argh. That sounds like a very frustrating day.

For what it's worth, would you mind posting how a normal induction should go? Obviously mine was anything but.

Prisca: said...

Wow, do I work with you?? ;)

Cervidil can be a god send!

Jody said...

LOL hey don't apologize for venting. It's a healthy thing to do. And better here than at your co-workers face lol.
Does your hospital do loads of inductions? We have 3-5 moms come in every evening and morning for inductions. And for no reason other than they're 38 wks lol. Gosh I wonder how I ever had kids back in the day. I was never induced lol.