Done

In my last post, I was totally bored in the nursery. Hmm. How quickly things can change. The next day (or maybe the day after that...when you work 5 days in a row they all start to bleed together) was pretty much insane. We had multiple births and more than one "bad baby". I know, it's super mean to call a newborn bad, right? But what I mean by that si that they were kids with problems- mainly the fact that they couldn't breath properly. I was crazy busy all day, and once again, left feeling totally unprepared to be on my own. Whatever- I have a whole week off to get ready for being a nure on my own. Happy New Year Everyone!!!

Whoa

So yesterday was my last day on the "floor" (post-partum/antepartum unit) before I am off orientation and totally on my own. For today and the next three days I am in the nursery. I was kind of excited to have one last day to show my coworkers how ready I was to join them as a grown-up nurse. Hahahaha. Well it turns out that fate had a little something to show me about just how "ready" I thought I was. I started out the morning with 4 patients, 3 of which were to be discharged that day. (The whole discharge process involves a lot of paperwork and usually takes about 2-3 hours to complete). One momma informed me that she couldn't get picked up until 2 pm. This was problematic because the goal is out by 11, and if we are after 11, we have to write up exceptions (ugh). Patient 2 had uncontrolled pain, which I informed the MD about, and then he ordered a new med (injectable). The problem was that for this particular injection, you can't have ibuprofen for 8 hours, and she last got a dose at 6:20. She had basically maxed out all of her limits on other pain medications, so what that meant was that she would be in a lot of pain, with nothing I could do about it, for HOURS. Not good. The second discharge was an 18-year-old who seemed to be under the impression that she was at home. Her boyfriend slept in bed with her, and the room was a MESS. Stuff all over. And she refused to wake up and listen to anything I had to say until I literally had to turn on all the lights, and pull off her covers (some of you may remember doing similar things to your sleeping teenagers). The last patient was a fetal demise. The baby had passed away the day before and the mom wanted to see him one last time before the funeral home came to get him. So I had to go to the morgue and get him. In a picnic basket. Sorry to be graphic and disturbing, but I was a little disturbed myself! The basket looks like this:
Since the bodies are so super tiny, this is the easiest and most private way for us to transport them. Ugh. On the way back down, a food services employee asked if I was going to have a picnic. Um, no. I also just feel awkward being a nurse to a mother who just lost her child. There are just no words and nothing I can do to comfort her. It's hard. Meanwhile, woman in pain is on her call light every two minutes because she is so agitated from the pain. Teenager finally got up (once her mom came and yelled at her). We waited and waited for the doctor to come see the mom who wanted to leave by two, but she hadn't come be 1:30. So I page her: no response. I leave her a voicemail: no response. So I have to call the clinic and have them try to track her down. Finally at 3:45, she calls back and asks me to just put in the orders and discharge the patient. (Putting in the orders is an additional 20 minutes of work) and then the pharmacy sent the wrong meds. By 4:45 they were gone. At 2:30, finally my momma in pain could have her shot. So when I go to give it, the plunger comes detached from the needle and spays Tordol ALL OVER me and the patient. We were both stunned. This has NEVER happened! And then she almost had a huge meltdown when I told her I had to go order more! And then my arm got all itchy because Tordol is apparently not meant to be sprayed on the skin. Go figure. AGH! I almost cried about 4 times yesterday! It was very frustrating, and I left feeling like I had no idea what I was doing!
Today though, I felt much better about the situation. I think that "hell days" are really a good thing (even if you feel like screaming in the midst of them). They teach you so much more than any easy day ever could. And I feel like a better nurse for having handled all of it!
Today I was back in the nursery, which was horribly boring all day (we went form 3 babies first thing to none by 2 pm). Then during the last 2 hours we had 3 deliveries and we were super busy! Maybe tomorrow could be more of a balance. Please.

A new life

Last week was an...interesting experience. I am still processing quite a bit of what happened, so I won't go into too many details, but I want to tell you all about it.
One of my best friends had a baby. And I helped.
Liz and I have been friends since junior high, and I was maid of honor in her wedding. Since before she got pregnant she said she wanted me at the birth of her babies. I kind of laughed it off, and was a little surprised when she did get pregnant that she actually wanted me to be there, in the room, helping to coach her. I got a call on Tuesday that she was going to be induced that night, and that I should get in the car and drive up (Liz and her husband live in Madison, WI). I frantically packed up and drove ahead of a blizzard to get there by evening. When I got to the hospital, I was shaking with nervousness and excitement. It didn't last long. We were sent home. There was a communication error between Liz's doctor and the hospital nurses, and they didn't want to induce her, so they sent us home. Good thing too because the snow was starting to pick up. We went out to a nice dinner, and there was about 7 inches on the ground by the time we got to the house. Shortly after, Liz's mom and in-laws arrived. Then it snowed some more. In total, we got 18 inches of snow. It was A LOT.
So much in fact that we spent most of the next day shoveling. I do not like winter.
Thursday we went to a doctor's appointment where we were told that everything looked fantastic. They wanted to run one more test, and if everything looked good, they were willing to let nature take it's course. We packed up, I called and told Dad I was heading home, and went for the test. Which we did not pass. So it was off to the hospital to be induced!
Without going into the gory details, it was 18 hours of very hard labor, and not any sleep for this nurse or her friends. Liz's mom, husband, and I took turns being there for her as she went through labor. Finally, at 11:47 in the morning on Friday, December 11th, Belle Kristin McCartney made her entrance. She weighed 6 lbs, 13 ounces, and was 20 inches long.
She's perfect. I have never felt more love for such a tiny person! Aunt Katie is going to have to pace herself with the baby presents! I keep seeing tiny, adorable baby things that I just HAVE to get for little Belle! And I was blown away by my friend's strength and courage as she gave birth to her daughter. I have friends who have kids! I'm old!
Personally, it was way harder than I expected. Knowing what I know, with the experiences I've had since working in OB, it was torturous! Watching my dear friend in pain, and knowing there was nothing I could do was awful! Thankfully I can truly say that Liz's medical team was fantastic! There wasn't a single moment where I thought "why are they doing that" or "I wouldn't do it that way". It is hard to be a medical professional in a medical setting, not as the employee. I find myself hyper-critical, and the ladies and gentleman at St. Mary's more that exceeded my expectations!
Now, one week later, mom and baby are both doing well, although I miss them terribly! Coming back to working in Urbana was made a little easier by the return of my favorite person, my little sis, to the USA. There is a lot to be thankful for this Holiday Season.
She's Happy too. Really.

Getting Personal

So far, my entries have been pretty much about what I observe and do at work, but not how I feel. I have thought quite a bit about this post, and whether or not I was comfortable posting it, but I think that if this is about providing myself (and others) with an accurate account of my first job, than it is important to include. Please be sensitive as you read, because this is about as personal and private as I get.

On most days, my job is not only discouraging; it is the perfect birth control (as if I need it). I see women in labor, women with difficult, scary pregnancies, and women dealing with the dramas of a new baby. None of these things make me anxious to have any of my own. I am just fine not having kids any time soon. Normally.

Today, I was in MFM (Maternal Fetal Medicine Clinic). The regular MFM schedule allowed for many first trimester screens (and congratulations), hospital visits, and prenatal clinic visits. That is a lot of happy pregnant (or recently delivered) women. On top of that, Melissa Zahnd (the APN) is 16 weeks pregnant and just started telling people at work. Everyone was screaming and jumping around and talking baby names, and hugging, and I was not a huge fan of any of it. As the day progressed, I got to feeling more and more…depressed, lonely, sad, whatever. I felt like everyone in the world is pregnant except for me, and it is not even on the distant radar for me. I had to sit and listen to Dr. Shepard telling Melissa that it’s about time she has kids because she’s getting old (at 30). I had to listen to Rachelle (a nurse on L&D) say that while teen pregnancy sucks, “eighteen-year-olds can push because they were made to have babies”. I had to get asked (3 TIMES) “do you have kids?” “Did you have a baby here?” “How old are your kids?” etc.

I don’t want to be a single mother. I want the perfect little nuclear mom-dad-baby family. At this point, it would be selfish of me to have a baby in any other circumstance. I don’t want to do that to my child. I don’t want to raise a child on my own emotionally or financially. Partially I think I want a baby right now because I am lonely and it would fill a void. Which is one (of many reasons) why it would be wrong to do so. Not to mention the lack of a baby-daddy. And partially it’s because my good firend Liz’s due date is so close and I am reminded daily that my friends are having kids and moving on with their lives, and I’m standing still. Alone.

I have said for many many years that I believe I was put on this earth to be a nurse. More so, I believe I was put here to be a mother. I think I could be really good at it. It is a huge responsibility, and not one that I take lightly, but one that I am excited to do. Being a parent is scary. I get that that. I also get that I’m not getting any younger. I know that 25 isn’t old, but each impending birthday feels like another year closer to that time-bomb in the biological clock. UGH. It's hard being single when you are surrounded by babies.

Lucky for me, the MFM clinic day only happens once, and I never have to do it again. Tomorrow it's back to Antepartum patients on the floor, and my 3 month evaluation with my boss!

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.