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!

No comments: