January 20, 2010

Another Weekend

Last weekend was a typical weekend these days. I was charge nurse Saturday night and labor was quiet, there weren't too many mom/babies on post-partum and no sick babies. Pretty quiet, but a long night. Sunday night, we come in to a full board, with one c/s getting ready to go back to OR, and my patient was scheduled to follow. She was a multip who had delivered vaginally before, but this baby was breech. I'm getting report when the on-call doc called and asked that we just verify by sono that the baby was really breech and call him back. He would then call her doc and we would proceed. I grabbed the sono and found that the baby was vertex! Yeah!!!! There was a doc on the floor so I asked her if she would mind double checking before I called. Yep, vertex. Mom was happy to not have a c/s but disappointed because she thought she was going to be having her baby in the next couple hours. The on-call doc wanted to keep her until morning since she was contracting (but not changing her cervix, so not in labor). At 11pm, the evening nurse was heading home, so I took over her vag recovery and moved her to post-partum. Then we had a few people come in, we'd treat their complaint, and send them home. False labor, UTI, the usual. One patient was a nursing tech in ER that had miscarried a week ago and came up because the normal pads she had been using weren't big enough for her flow, so she wanted our bigger pads. Too much flow for being a week out. We told her to call her doc and let him know how much and how long she had been bleeding like that. Like we figured, she ended up admitted, and she had a very low H&H. By this time, it's 5:00am., and I get the 7:15 c/s mom admitted and prepped. Mom, her mom and grandmother were all nurses at Hospital, so it was fun to hear about what is going on in the hospital on other units. Her grandmother had been a labor nurse at one point in her career and she had some great stories. She said that with one of her children, she had a placenta previa and went into labor. They had set up the OR for her, since her placenta was over her cervix, but she said she felt a lot of pressure. She grabbed her nurse and said, "You might want to take a look, the baby is coming". And sure enough. On the OR table, she delivered her baby right before she was delivered by c/s. Now she said the placenta came before the baby, and it seems like maybe she had some details confused because the placenta delivering before the baby would be a very bad thing, but nonetheless, it was interesting listening to her stories. Monday night I was put on-call. I had looked and knew it was my turn, I had just hoped that it would pick up enough I wouldn't be flexed. I keep hoping that we'll get busier again, but this time of year is usually slower than the rest of the year. I'm sure when it does pick up again and we're crazy busy, that I'll be wondering why I wished for more patients.


Anonymous said...

I've heard a similar placenta previa story -- forget where, but it was a long time ago, and is probably online somewhere. I think the woman was planning a UC, although it may have been a mw-attended home-birth; and she started bleeding during dilation, but dilated quickly, and then felt her body say, "PUSH NOW," and she pushed with all her might, and the placenta and baby came out in that one push -- placenta first. The baby was fine because the speed of the birth didn't leave time for him/her to have a lack of oxygen nor to lose blood. Not that I'd suggest doing that!

Here's another vaginal-previa story -- a partial previa with a Hmong woman who believed if her child died it would be reincarnated, and that if her body was cut open, good spirits would leave and evil spirits would enter, so there was no way she was having a C-section, even to save her child's life. Or even her own.


BirthdayNurse said...

I have to ask...how does the charge nurse work on your unit! It sounds so amazing to hear about a charge nurse actually jumping in and helping with patients! We have 1 charge nurse for all our Women's and Children's unit (L&D, Mom/Baby, NICU) and NONE of our night charge nurses are L&D nurses (all from the M/B side) and 9.5/10 nights it is SO frusturating from the labor side. They can't help with anything labor related and as far as moving over our PP patients, it only happens if it's convient for the M/B nurses. Just wondering you your hospital does it's charge nursing...