Antes

Last week and this week I have been on Antepartums. This means moms that are still pregnant (and usually way too early to deliver) and on bed rest in the hospital. Mostly my day consists of trying to find babies in utero (with a doppler or the external fetal heart monitors), reading strips, and attempting to control symptoms of preterm labor, gestational diabetes, pregnancy induced hypertension. There is a lot of communicating with the doctors and other members of the healthcare team trying to keep things from getting out of control. Usually it works.
There is a patient on our unit who has been here since her 19th week of pregnancy. This week she is at 29 weeks. That is ten weeks of hospital time, laying in a bed, praying that her twins don't come too early. Needless to say she is frustrated and tired, and not always the most pleasant to deal with, but we have all come to care very much about her and the outcome of her pregnancy. Last night she started having contractions that we couldn't stop, and today after a small bleed, her cerclage (stiches that were placed in her cervix to prevent it from dialating) came out, and she dialated to 6-7. So they rushed her back to the OR and delivered her twins this afternoon. Mom is doing well, and both babies went to NICU. It was a tense afternoon for those of us who cared so much, but I think this is a best case scenario. We also have a mom with triplets inside, but hopefully she will stay pregnant for quite a while longer.
Today I got my "cycle" for the upcoming months. This isn't my schedule per-say, but it is the pattern that I work. Every month is the same: I always start on the first Wednesday. So while I can't always know dates, I know that the first Saturday, the second Saturday AND Sunday I will work, but the last two weekends I have off, and the last weekend I have 5 days off in a row- which is AWESOME! That means I can go visit my people! Yay! I'm just happy to be able to plan things in advance now that I know what to expect.
Oh, and also, we had a baby last weekend named: (get ready) KNOWLEDGE SINCERE. Seriously.

Boppi Blanket

So it was another super busy week in the nursery. Tuesday I was pretty much on my own while my cohort was at lunch when we got two new babies at once. Up until this point, I was feeling pretty good about being in the nursery--I thought I could handle it. One baby at a time. But two made me feel a little...crazy. I was still shaking when I got to my car that day. It's intense!
This week I also learned about a new and wonderful device we have in the nursery. One day a "code" was paged overhead. I realized that there are no speakers in the nursery, so if there was an emergency code, like a fire or a tornado that I need to know about, I might not find out. I inquired about this and my coworker agreed that it was poor engineering. "But," she said, "if there is a fire you get to use the Baby Boppi Blanket!" I raised an eyebrow, so she pulled it off the top shelf of our linen cabinet and put it on. Later I had to model it myself. Ladies and gentlemen, I present, the fire safe, Baby Boppi Blanket:
Oh yeah, you are supposed to just slide a baby into each of those pockets (there are two more on the back) and then run down all eleven flights of stairs to rescue babies from the fire. To me, this raises an important question: Which is worse: Burning in a fire or brain damage from suffocation and being jostled around in the baby boppi blanket?

Babies, Babies, and MORE BABIES!

As you may have guessed from the title of this post, this week I was in the nursery, NICU, and breastfeeding clinic. Which meant I was surrounded by babies, all week. I also worked 5 eight hours shifts, and while I know that's what most of the world works, getting up at 5:30 5 days in a row made me want to cry! And as this picture indicates- it was pretty intense at times! The way the nursery is intended to be staffed is with one nurse. One nurse and sometimes as many as 25 babies! The good part about this plan is that our unit nurses the dyad-meaning the postpartum nurses are trained to care for the moms and the babies as a pair, and we try to keep the babes in the mom's rooms as much as possible. First thing in the morning, when the pediatricians are doing rounds, all of the babies come hang out in the nursery. One starts crying, upsets his neighbor, and the next thing you know the whole room is screaming! Not very relaxing! As soon as the doctors are done we try to get the babies out to the rooms. Before a baby can be discharged, there are a whole list of things that need to get accomplished. They have to get a hearing screen, pictures taken, get blood drawn for the PKU test (genetic tests we send away to the state), and get their cord clamps removed (just to name a few). It is the nursery nurse's responsibility to make sure all of this gets done. The other part of the puzzle is that we admit all of the new babies that are born throughout the day. There are alot of things that have to happen within the first hour of life. The babies get a full assessment (takes about 10 minutes), vital signs get checked every half and hour for two hours, they get their "eyes and thighs" (erythromycin in the eyes and hep. B and vitamin K shots in the thighs), and they get their first bath. It gets comlicated when you have a twin birth, or a vaginal delivery and a c-section two minutes apart. HECTIC! Twice this week we had eight or nine babies born during the eight hour shift I worked. Yesterday, doing a new admission, I had an important first- I got peed on. My fault, I was standing at the end of the warmer, and I hadn't put a diaper on him yet...next thing I know-pee all down the front of my shirt. Ugh. Little boys are trouble. I also spent a day rotating in the breastfeeding clinic (interesting, but lots of boobs). And on Wednesday I spent a day in the NICU. They say we might float down to the step-down NICU sometimes (where the feeder-grower babies are, nothing too intense).
As most of you probably know, I went into nursing, in short, because of babies. I wanted a job where I could get paid good money to hold babies all day. Later in the journey I found the Neonatal ICU, and thought that that was my future-as a NICU nurse. I knew it was unlikely to get a job in a NICU right out of school, and the position I did get was almost too-good-to-be-true. However, going into it, I figured I would tolerate the moms, but nursery would really be my forte. After this week, I find myself anxious to get back out on the unit with the mommas! The one thing I really like about the postpartum nursing is the teaching...and you can't teach much to a baby. I was really suprised to find myself feeling this way- I'm a baby nurse! But I guess it just goes to show that God really does have a plan and things happen for a reason. Next week, more babies.