November 14, 2009

Another night in L&D

Last night wasn't too bad of a shift. I am pretty flexible and there are a couple weekends this schedule that I am working Friday/Sunday. Fridays tend to be pretty busy and Saturdays not quite so bad. Only problem is when I show up at 7p on Fridays, the evening charge has always forgotten that I was coming in, because the 12 hour shifts are usually on the weekends. Yeah, we work 8 hours during the week and most people work 12's on the weekends, some still do 8. It's a bit confusing at first. Anyway, I ended up orienting one of the new evening shift nurses. I think she'll be a pretty good labor nurse. It took me a bit to figure out where she was at, what her skills and comfort level was. I have a hard time sitting back and directing, instead of just doing. Our labor patient was one of those unfortunate moms who had the perfect birth in her mind: no epidural, no forceps, no episiotomy, no pitocin. minimal interventions, etc. Yet in the end, she had an elective induction (her choice) episiotomy, forcep delivery with an epidural, and thankfully, she was happy. Shortly after she delivered, another mom came in about 2215. She was a multip and said the contractions weren't too bad, but were getting closer. When I went in the room to introduce myself, I noticed she had the "look". Something about her face and the way she moved got me thinking she was much more active than she thought she was. She also indicated that this time she wanted an epidural. She had delivered in the tub her last 2 deliveries and wanted to enjoy labor. But, it wasn't to be as she was 9 cm with a huge bulging bag. I called the midwife to get her on her way, tried to get the tub full so she could at least deliver in the tub, but deep down I knew we'd never get it filled in time. Midwife arrived, the patient ruptured her membranes and out came baby boy. The couple had girls at home and the mom was sure it was another boy. Dad said he knew all along, and was right with their other children. Twenty minutes from the time she hit the door, she was holding her baby. I'm actually quite surprised the midwife made it, barely, but she got there. Afterwards, mom said "I was wondering why it hurt so much. I was thinking on our way in that it didn't hurt so much this early with the other kids. Now I know". Her total time in labor, from the time she noticed the first contraction? One hour and 45 minutes. Start to finish. Amazing.
After those 2 deliveries, we ended up and shut labor down, and no one came in the rest of the night. It always seems incredibly bizarre when we are able to do that. And after a slow night like that, we usually pay with a huge influx of patients the next night or two. That would be oaky right now. I'm on call tonight, and would love the extra 12 hours of call-in pay right before Christmas.


Joy@WDDCH said...

Wow great births!

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