March 31, 2009

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

Prayers for Stellan

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.

March 30, 2009

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.

March 28, 2009

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.

March 24, 2009

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!?

March 23, 2009


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'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.

March 17, 2009

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!

March 16, 2009


* I signed up to take ACLS in May. I realized that all the cardiac stuff I learned as a critical care nurse is GONE. I knew all the cardiac drugs, what they did, when they were used in a code, and I could analyze any EKG strip. All of the labor nurses are taking ACLS so we can recover all of our general anesthesia c/s (we don't right now, just spinal recoveries) and I thought "Hey, I knew most of this stuff at one time. This won't be too bad" Wrong. Wrong. Wrong. I knew the obvious rhythms and a couple others. But, basically, I'm starting from scratch.

* My children are destructive. I woke up yesterday to find that there was more wallpaper missing from the walls, and Isaiah somehow messed up the stereo we have in the living room that we use for the tv, dvd's, etc. The CD changer keeps changing and opening. Not sure how to fix it. He also scattered several movies all over the house, Clara destroyed on of the drawers on her dresser, Jacob broke on of our gates by climbing over it and 3 of the plastic bins I bought for the kids toys now have holes in them because they use them as steps. And, yes, Husband was home and watching them yesterday.

* Fate can really pile it on. A couple days ago, after waking up every frickin' 2 hours with Isaiah, fighting all day with Clara to leave Isaiah alone, an unsuccessful lunch where neither Clara or Isaiah ate much of anything, breaking up fight after fight between Jacob and Clara the moment he got home from school, I got to the point where I thought I'd loose my mind. I turned on Baby Einstein, and went to make supper. I decided to make ham and scalloped potatoes - something they all like, usually. I was still fuming and frustrated and as I tried to open the bag of dried potatoes (yes, I use the box stuff), it wouldn't open as easy as before. So instead of getting scissors, I pulled harder until the bag finally gave and potatoes flew all over my kitchen. Not a good moment for me, but I did have to laugh at myself!

*Jacob is almost 6, and growing fast. He read ME a book the other night and did really well! Man, it was so weird to have my 5 1/2 year old son read me a book!

*Clara is going to be one beautiful young lady, with an attitude! Of course, I'm biased, and I think she's beautiful now. But, I gave in and let her play "make-up" with me. I let her put on some lip gloss, powder, light pink eyeshadow and I couldn't help myself from putting just a tad of mascara on her long, black eyelashes. I also gave her little curls and we had a good time, but I looked at her and saw her as a 16 year old. Scary. Her big blue eyes, long dark black lashes and blonde hair will have all the boys knocking at our door. Oh, and she's already writing her name, knows her letters and the sounds they make and can read a few words, just from watching Jacob do homework. She's more ready for kindergarten now than Jacob was last fall already...and she has to wait another year!

Isaiah is getting closer and closer to being a toddler and not a baby anymore. He still likes "mommy time" and will snuggle to fall asleep, but he won't just let me sit and hold him anymore. He's just to busy, what with all the buttons to push on the TV, the wallpaper to tear down and cats to chase! Before I'm ready, he'll be heading off to school.

March 11, 2009


The last 3 weeks, I've been picking up extra shifts at work. Basically filling a few holes that were left when my co-worker lost her job. And every shift I've worked during the week over the last 3 weeks, I've come on to find that we need another nurse back in labor and that the charge nurse is reluctant to send that nurse. I'm not one to shy away from a doable patient load, but when it's going to compromise patient care, just so the charge nurse doesn't have to take a post-partum mom or two, I'm going to raise a little hell. Which is what happened Monday. I head back to labor to find 6 patients, and 2 nurses: myself and one nurse who is 35 weeks pregnant and only staying until 3a.m. Granted, the patients were 1 vag recovery, 3 outpatients and a patient receiving cervical ripening agents for induction. The other patient was why I got a little irritated. She was a very unstable eclamptic patient. First time I've care for someone who actually had an eclamptic seizure. She had delivered over a week before, was discharge and a few days later, had and eclamptic seizure. She had been in ICU, was transferred back to us, stable, but shortly before my shift, her pressures shot up to a very unsettling 200/120 with a severe headache. So good ole Mag Sulfate was restarted. They had expected me to take her in addition to 3 other patients, because she was a delivered mag patient. No way in hell. She really needed to be one-to-one care, but I agreed I could do the induction with this mom, but that they HAD to send another nurse back. I have never had a patient make me as nervous as she did. I think everyone took for granted that this mom was delivered, and most moms we care for on Mag Sulfate are stable. But eclampsia is a very serious condition, one people do die from. And the fact that she was as sick as she was made it even more critical to keep a close eye on her. With every Mag patient we check reflexes every 1-2 hours, respirations every hour, strict hourly I&O, oxygen level, blood pressure at least every hour and lung sounds twice a shift. She did stabilize through the night, but close to the end of my shift, she started moving backwards a bit. Usually you see pre-eclampsia during the pregnancy and you figure everything is all well and good after delivery because "delivery is the cure for pre-eclampsia". But there is still a risk afterwards, and thankfully, most the time if it were to rear it's ugly head after delivery, mom is still in the hospital and she can receive care. It's scary to think that on rare occasion, it can happen after discharge.

March 9, 2009

Showing off the kids again

I'm pretty tired so instead of typing one of the many post I have floating around in my head, here are a few pics of the kiddos.

We had a fun night playing with this tent and tunnel set I had bought for Jacob when he was 12 months old. The tent has circle openings on 2 sides and this cool tunnel will hook up to it or you can just play with the tunnel. The kids had a blast.
Jacob and Clara, hanging in the tent, with lots of static electricity. I look at Jacob and can't believe that he's going to be 6 in a couple months. And Clara, poor girl, looks just like her Mommy. Isaiah, too, for that matter.
Jacob and Clara both got into the tunnel and were rolling around the room.
I still can't believe he's almost 15 months old already! He's developing quite the attitude. When Jacob or Clara takes something from him, instead of just letting it go, he's started running after them, hits or grabs hold of something, ie hair, clothes, the toy itself, and screams at them. Part of me is torn. On one hand, Isaiah does not need to do that, but at the same time, the older 2 need to stop taking things from him. He's such a stinker. Then later on, he'll come running over to you, wanting to be picked up and he'll give you a full body hug and kick his legs and lay his head on your shoulder. Then he wants a kiss and he leans toward your mouth, with his open and gives you a wet, slobbery kiss.

Group pic! Jacob and Clara still have cheese puff powder on their faces, and Isaiah had had just about enough at this point! We really did have a good time playing together as a family. This is what it's all about:
I had been working on my grocery list and had my envelop full of coupons out on the table. I walked away for just a minute and came back to fine Isaiah, The Destructor, scattering my coupons all over the dining room. He was picking up a few here and there and tossing them over the gate into the kitchen from time to time. Notice in the background the wall with the wallpaper missing in one place? Yep, Isaiah left his mark there!
Isaiah's mohawk

March 3, 2009

And the craziness begins again

Over the last couple months, L&D has been fairly slow overall. Yeah, there were some busier nights, but really, not like the craziness we were used to. Late January, and February are typically slower months anyway, but some people were starting to worry things wouldn't pick up. I had been watching the prenatal files thickening up in March and continuing into the next several months and thought to myself "Hmm, it looks like we could be very busy as people due in March start to deliver". And I was right. This past weekend, and last night especially was nuts. Last night we started the shift with a c-section for a mom who had been stuck at 9 cm for 4 hours. There were several other labor patients there and as that mom was headed into the OR, 2 more moms walked up. One a labor and one who fell on her belly and was contracting. The midnight induction, who we tried to call and tell to stay home until we had time to get her in, showed up, so I took her in a room with the plan to get her on the monitor and let her sit until the craziness let up. Wouldn't you know it, but as I place the monitor on her bellow, I hear the slow Thump, Thump, of the baby's heartbeat at 60 bpm. Not what I wanted to hear. So reposition, quick throw an IV in and as I'm thinking I'm going to have to pull her doc out of the c/s she was assisting in because it wasn't coming up, the baby recovers. Her doc comes in, puts internal monitors in and all is well, except now she can't just sit on the monitors. She's ruptured, starting to contract and within 45 minutes uncomfortable. And this was just the start of the shift. People would deliver and more would come in, all in active labor. By the end of the night, we had 3 people walk in who wanted and epidural for labor but delivered too quickly to get one, 1 that delivered without one and had planned on going natural, another who also delivered without an epidural but almost delivered before the doc got there. The only thing that kept that baby from coming was a mild shoulder dystocia, and man, was it a tense 30 seconds before the doc got in there. We also has a Laboring VBAC who delivered at shift change. We left dayshift with 3 labors, a twin c/s scheduled for 7:15, a 5:00 a.m. induction and a 7:00 a.m. induction. We would have post-poned the 2 inductions but of course the phone numbers we were given for them did not work. Needless to say, I was one tired nurse by the end of the night!