October 25, 2008

Evening in Charge

Earlier this week, I agreed to work 3-11 shift and be in charge. I had called to let them know that if they needed another nurse, since they had 3 RN's off on maternity leave, that I was available. I ended up agreeing to work for the nurse scheduled to be in charge. It was an agreement that afterwards, I sat there wondering, "what did I just do?". Evening shift, especially on Fridays, tends to be a bit chaotic. Post partum is full of moms and babies, due in part to all the scheduled inductions and c-sections. The book is usually full of inductions/c/s on Fridays because docs want to deliver their patients before the weekend and patients want to deliver before the weekend when their doc will deliver them, instead of the on-call docs. Now I've worked some busy night shifts. And I do work the back half of 3-11 every weekend. So I kinda know what to expect. And boy, was is busy. Luckily, I had plenty of staff. We started the shift with a c/s for failure to progress. After that c/s was done, another patient was taken back for repetitive late decels. As that mom is being taken into the recovery room, our last labor patient was pushing. 10 minutes or so later, heart tones start to get crappy, so it was decided that the doc would try forceps to get the kid out, but we needed to open for a c-section, just in case. You can see where this is going, right? Forceps are donned, heart tones look like crap, and I'm just hoping this baby comes out and that we don't end up with a shoulder dystocia. One pull with the forceps, baby decides "no way", heart rate dives to the 40's and we go a-running back for our 3rd c-section of the night. Our first c/s patient is wheeled out of recovery just in time to replace her with our 3rd mom. All 3 of these deliveries happened before 5:30 pm. Finally, it settled down, and after these moms were moved out to post-partum, labor would be empty. Moms get taken out, and wouldn't you know it, but ER calls letting us know we have a 30 week mom, ruptured on her way up. She is evaluated, and she is indeed ruptured. Her doc comes in, we get her transferred out to a higher level facility to care for her preterm baby. By now it's 7pm, and pediatrics gets their 2nd admission of the shift and they need another nurse. Done. Post-partum patients are pretty needy, due to having so many post-op day/ delivery day moms. I did manage to get staffing for night shift done and get most of my paperwork done by 0030. I crawled into bed at 1:30 a.m, after feeding Isaiah. I swear he sensed my presence as I walked up the stairs. Man, I was worn out. I'm not sure how those regular 3-11 charge Rn's do it all the time. The busy patient care was no problem. I've been staff nurse on many a night where it's a revolving door of pregnant women coming in. But it was a struggle being in charge, trying to keep a handle on everything back in labor, making sure we have baby care for deliveries and that the nursery is covered, maintaining post-partum with their new deliveries and discharges AND pediatrics/infusion admits/discharges and then doing staffing for the next shift. And I get to turn around and work all weekend. Hopefully I can get in a nap.


AwkwardMoments said...

that is alot of work .. i'm tired just reading it.

Taking Heart said...

Yup... that pretty much sums up my weekend in a nutshell... I'm done with OR... done with abruptions, FD & tight nuchals for the month. Done.

Have a good week.