October 23, 2009

Ranting and Raving

Dear Charge Nurses, when there are two nurses back in labor with 5 labors, and 2 outpatients, if there are 2 labor nurses on post-partum, please send at least one back to help, before a patient precips because she is moving quickly. We were stretched too thin. Your 2 labor nurses were in catching a baby while no one was out monitoring the other patients. It could have been ugly. Plus now you have two grumpy labor nurses who will repeatedly tell you "we told you we needed help". You are lucky we are experienced, work well together and know without having to ask what needs to be done. You got lucky this time. Let's not keep playing Russian roulette.

Dear elective inductions who don't give us a working phone number, we are very sorry you didn't get the message that you were being bumped because we don't have a labor room to put you in, or the staff to care for you. Yes, we know you were "scheduled" but shall you or I go tell that mom who is 8 cm with no epidural laboring in a triage chair that she needs to close her legs because you were "scheduled" and should get a labor room? These people are in labor, you are not. We'll reschedule you when we can.

Dear Physician of the Year in my book, thank you for seeing how nuts the unit was, and told your elective induction that she would have to go home after we made sure her baby looked great, and be scheduled later. You did this with no prompting from us nurses. We love you. Really, we do.

Dear Physicians, if you see that there are only 3 labor nurses for umpteen billion patients, please, we beg of you for our sake and especially for the patients sake, please do not break your 3 patients bags and order pitocin at 1am because you came for a delivery. And please come up with more creative diagnoses for medical inductions than swelling when my lower extremities are more swollen than your patient, or for PIH when her BP's are 90/50 and no other symptoms. If you were worried about PIH, how 'bout ordering extra labs? Oligohydramnios would be a good one. That I can't rule out without an US. Try that one, make me feel like you don't think I'm an idiot. Again, talk with some of your colleagues, take notes, treat the nurses like professionals, don't make a bad name for the majority.

Dear Mother of my labor patient, I just want to thank you for the comic relief this morning when after a cervical check you said "Why are you carrying on so much, did you do this when he was sticking his weenie in your stuff?" Patient laughed heartily and I about wet myself at your colorful remark. Thank you. I needed that.

And please, dear God, can you let this weekend be more manageable? I pray you send an experienced labor nurse, or 3, who wants to work nights to our hospital.

October 15, 2009

Infant and Pregnancy Loss Remembrance Day

Tonight at 7pm, we will be lighting a candle for our own loss this year. Since 2003, I've remembered my niece who was stillborn and thought about her on this day and the day of her birth. This year, sadly, I will be thinking of my own baby, lost at only 11 weeks, but loved just the same. We will never forget and are forever changed.

October 12, 2009

Good Times

This past week went by in a blur. It was so busy on the unit we could barely see straight. Thankfully the rush is over and this weekend was actually pretty slow, except for the rare triplet delivery at 35 weeks that went off beautifully. What was funny is her waters broke, yes waters, 6 hours before her scheduled c-section. Baby B's water broke first, and Baby A's water broke as she sat on the OR table for her spinal, C's was broken when they got to him after the other two were delivered. A great outcome, and a rare treat for us. I actually circulated for a triplet delivery 4 years ago, and because a labor patient came in 2 hours before her water broke, I didn't end up getting to do this one. I had been taking care of triplet mom up to that point, and if that one patient hadn't come in, it would have been me. It was good someone else got to have that experience. That pay period, I ended up with 25 hours of call-in pay, which will make for a sweet check.

On a different subject, I learned a valuable lesson this weekend: don't pick fights with a dresser and TV. Okay, so we live in a 100+ year old house. Over the years as the house settled, the floors developed a slight slant to them. Generally, the house will settled out and the floors everywhere, except our bedroom, dip ever so slightly down toward the outside of the house. If you put a marble on the floor, it will roll toward the outside walls. Not the case in the master bedroom. The wall that my long dresser is on actually dips ever so slightly toward the center of the house. Well, Friday night my in-laws were in town. My MIL was passed out in Clara's room, and my FIL was still up watching TV down in the living room, right below the master bedroom. It was about 11pm, and Husband was in bed and I was headed that way. I got upstairs and wanted a pair of pj pants to wear. My dresser, I'll admit is overstuffed with clothes, and Husband's sock/undies drawer is always open. The TV, my jewelry boxes, etc are on top of the dresser. I tried to open the drawer that my pants were in but to no avail, so I lean over, start pulling, and you guessed it, the dresser came crashing over on top of me and the TV hit me straight in the forehead. I think my FIL downstairs about wet himself. The kids and my MIL never stirred, though. I did have a pretty good sized knot on my forehead and a decent headache for the rest of Saturday. No worries that I have a subdural hematoma, or even a concussion. Just a little bit of embarrassment that my dresser and TV fell on me, but I now have motivation to clean out those damn drawers! Now if that was the only uncomfortable thing this weekend, it would have been enough. Sunday night at work, at about 10pm, I felt a twinge after I had finished peeing that I had only felt 2 other times my entire life. And I thought "Great, I think I'm brewing a UTI". I knew if it was truly a UTI, within the next 2-3 hours, I would know for sure, because the first 2 I had progressed rather rapidly from that first twinge. The first two UTI's I have had, started after not getting up to pee after, um, well, shall I say a bedroom rendezvous after a night of partying years ago. I learned my lesson and always, always get up afterwards. So I"m not sure what happened this time because sure enough, about midnight, I was peeing red, and when I say red, I mean red, and about ready to lose it from the urgency, pain and pressure. And I still had 7 hours left in my shift, and another 9 until the doc's office opened. I started downing cranberry juice and water, hoping to flush things out a bit. I had a labor patient who ended up delivering for me and I was so uncomfortable I did something I have seen other nurses do, but have never done myself: I asked that delivering doc to write me a script for an antibiotic. By this time, it is 6am, and I'm actually starting to feel like I could possibly spike a low temp if I don't get treated. I could have waited another 3 hours to call my docs office, but I was tired after a 12 hour shift, and it would be at least an hour after I called to get my script picked up. The doc was kind enough to do it and didn't seem to mind, but I still feel horrible. I really try not to take advantage of the fact that I work with doctors and have never asked for something like that. I've seen other nurses do it and the docs don't care. And in all honesty, if one of the other nurses hadn't said "Nurse Lochia, there's Dr. H" and got his attention, so he was waiting to see what I needed, I wouldn't have asked. And it wasn't like I was asking for pain meds, or sleep aides. It was for a UTI, and we see UTI's all the time and I'm sure he knows after the years of working with me that I wouldn't ask if I wasn't miserable. He gave me a script for Cipro, offered pyridium, but I said I'd just do cranberry juice, and I was able to take the first dose at 8:15 a.m. When I was crawling into bed, I had that feeling I usually get right before I spike a temp, like my skin is super sensitive. Hard to explain, but anyway, I've got drugs. I'm no longer peeing red, but that urgency and burning pressure at the end of the stream is still there. So I'm in for more fun and glasses upon glasses of cranberry juice for awhile.

October 6, 2009

Full Moon Brings 'Em Out!

Man, oh man was work busy this weekend. I am wicked tired and sore. My usual 2 12-hour shifts and 8-hour shift turned into 13- and 14 hour shifts. Not only long, but busy and hard. And I'm on-call Wednesday night and there was no sign of it slowing down. Lots of walking, turning patients with epidurals, moving beds to the OR, stooping over to help with breastfeeding, and just running from one thing to the next. At one point Sunday night, I had 4 active labor patients (thankfully only for about 1 1/2 hours), one having late decels, and one who was a repeat cesarean. I wished I could just squat, grunt, push and deliver a set of fully-trained labor-nurse triplets to help out! There was no time to eat, drink or pee. This a.m., I realized I hadn't peed since I went into work, and still didn't feel like I had to go. That's the kind of busy we were. Gotta love a full moon and storm. Oh, and Saturday night, we had a bomb code. That's right, we had a code called because of a bomb threat. I never wanted to hear that code called. I didn't actually hear it called because I was admitting active labor #3, and when my co-workers told me, I thought they were lying. Nope. For about 2 hours, we waited, as patients were still coming in (yeah, lets bump of the census before the bomb goes off) wondering when they'd call it clear or tell us to evacuate. We figured it was probably bogus, but you just don't know. It turned out to be bogus, but man, was scary.

Saturday morning, before the chaos of L&D, I ran another 5K, this one was to benefit St. Jude. Let me tell you, when I woke up at 5:00 a.m., in the dark, to 40 degree temps and mist, I wanted to crawl back under the covers and go to sleep. But, I had pre-registered, and I thought of all the kids that would never be able to run a race, and all the kids that someday might be able to thanks to the money raised. Even though my money was already there, I felt obligated to go run. Before the race, they had a fun kids race, 1/4 of a mile. I'm a huge crier, and man, did the tears fall watching these little kids run. Who knows if these kids were ever patients at St. Jude, but at that moment, in my eyes they were. So here I am, a 30 year old woman, crying because some kids are running. I'm sure I was a sight. But, then it was time for my race. It was cold, but thankfully it had stopped raining. I had my best time ever, 27:15, and felt great afterward. They had marked every 1/4 mile, which was nice because you knew how close you were, but at the same time, you knew how far you had to go. Apparently, I do great and feel awesome the first 1 3/4 mile, then I start to tire, and want to be closer. At mile 2 1/2, I'm done. My muscles are screaming "stop, stop! we're tired! we can't go one!", but there's only a bit more than a half mile left, so I keep going. And once I see the finish line and the time clock, I'm able to maybe kick it, like a 4 cylinder engine running on fumes, and finish strong. It is a test of endurance and strength, finishing a race, but afterwards, it feels great. Just knowing I can do it, is awesome. I'm not fast by any means. Serious runners finish in 19 minutes. I'm happy to not be last! I'm working on getting a co-worker who runs regularly to run a 5K race in 2 weeks here in town. I'm not sure I can better my time at this point in the year. It gets dark so early and so it's hard to get out and run. But, it sounds like it's a fun race to do, so I'm hoping to get her to run it with me.

October 1, 2009

It's Fall!

I just love this time of year. The temperatures are great, you can wear long or short sleeves, the colors of the leaves are fabulous, and of course, I LOVE the pumpkin patches and apple orchards. It's become a requirement with our family that we go to the apple orchard and local pumpkin patch at least once. On Tuesday, the weather was great and we decided to go. There is a little pumpkin farm not too far from us, and it had been just a little farm where you could buy pumpkins, pay on the honor system in a cash box, and they had a turkey and rabbits for the kids to look at. I had heard they had expanded their farm, and boy did they! They have an actual store now, a little village for the kids complete with mini-houses, hay bale tower, and more animals. It was a ton of fun.