August 4, 2008

Weekend in Review

As usual, this weekend had it's highs and lows. Saturday I admitted an outpatient, possible labor. She was a G5 P4, repeat c-section who'd been in the night before. She came in because she was having occasional contractions and spotting that she thought was probably from vag exams earlier. Nothing going on, saw 1 contraction in 45 minutes...discharged to home. Admitted another patient, early labor, and she just wasn't changing her cervix and she was frustrated she was still 2 cm, but having contractions. She had that "labor feel" and I really thought she'd do it. Doc said to keep until the a.m. Her contractions started to slow down in frequency and intensity and she ended up sleeping for about 4 hours, but when she woke up, she was contracting regularly and she was 4-5 cm dilated. I had told her when her contractions were starting to slow, that maybe she would be able to sleep and when she woke up, she'd be in good labor...I love being right. we had a patient who was about 26 weeks who was afraid her water broke - it did not. Also had a couple of really nice deliveries without complications. We also had a fair share of sadness. One mom delivered her first baby, a girl, by c-section because she was breech. Her husband had committed suicide when she was 6 months pregnant. She said he never gave any indication that anything was wrong. The baby's middle name is her father's first name. I just can't imagine - he was so depressed that he chose death over life and meeting his unborn child. Another couple came in, she was about 21 weeks, not yet at viability, and she had noticed after a bowel movement that there was something in her vagina. Turned out to be her amniotic membranes bulging through. The hope was to keep her on bed rest and get her to at least viability. But, her lab work indicated she had some kind of infection, plus she started having contractions. She delivered a perfect baby girl. The delivering doc, who most everyone agrees is a moron, told the parents after the baby delivered that it was gone. As happens sometimes, the parents weren't ready to see the baby, so the labor nurse took the baby to another room to do footprints and pictures. She thought "man, this baby looks alive" and then she noticed it was breathing. Had a heartbeat. So she took her back to her parents where they had 2 hours with her before she died. Personally, I'd like my caregivers to know the difference between living and not. And I don't think that's too much to ask. The mom knew this doc because she is a nurse and wasn't thrilled he was on call for her regular doc to begin with. He's also made several incredibly inappropriate comments lately. This couple had suffered through 4-5 years of infertility, got pregnant with their first IUI. They said at least they got 2 hours with their daughter and had hope for future pregnancies. On a happier note, this morning, we had two patients, both laboring with their 2nd baby in a kind of race to see who would deliver before the other. There's always a fine line with privacy, but they knew there was someone else laboring who was about as close as they were. Believe it or not, they delivered within 3 minutes of each other. Both moms seemed to be into this friendly competition with a stranger they'd never meet. My grandmother was a nurse she always said that "the happiest and saddest place in the hospital is the labor and delivery ward". She was right.


Mrs. Spit said...

Thinking of the family. I wonder if the Doctor didn't decide the baby was dead because he thought it would be easier for the family?
People decide the most astounding things for grieving families.

admin said...

What a roller coaster! Your story about the 20 weeker is my biggest fear in the whole world. I just can not imagine anything more tragic.

Thanks for sharing you experiences, and for linking to folks like me. Your writing is an incredible window into the world I am currently wrestling with - in a futile attempt to get the care I feel I need. Seems in general nurses are much more perceptive than doctors. The training, the system, the people? Who knows why. I just know in my own experience thus far the nurse practictioner at my OB is my lifeline. The OB's are somewhat unhelpful and make me feel like I am a little nuts:)

joshnmaddiesmum said...

I know you don't know me, but I found your blog through a friend's bloglist and I must say that I really enjoy reading your posts. I used to be and L&D nurse before I had my son, and I'm starting to miss it more than ever (I haven't gone back since I had my son - three, and I have a baby girl too - 7 months)! And I completely agree with your grandmother! What a rough night. Take care!

Jennifer (Niffer) said...

I love having labor races... especially when the pts are in on it! I did this a few years ago with a good friend, her pt actually delivered her baby while throwing up.They were in rooms right next door to each other and delivered only minutes apart!

They demises are hard too! Thank God I haven't had one in a while. It really takes it out of me!