Today begins 3 days in a row of 12 hour shifts so that I can squeeze my work days together make my 4th of July break even longer. I am beyond excited to go home so it will all be worth it but right now I am so tired and I know I have 2 more shifts to work in the next 2 days!
I am learning a lot on Women's Specialty but I just don't feel the connection with it that I did with Labor and Delivery. But, I can do anything for 3 weeks and it is a great learning experience in general. However, my next rotation is in the OR and a girl in my program has a rotation there right now with the mentor that I am supposed to have and apparently it isn't going well and she doesn't get to do anything. When I heard this my wheels started turning in my head that maybe, just maybe, I could go back to L and D for my last 3 weeks instead of the OR. I asked the program director and she wasn't opposed to it but L and D will already have 2 externs and she doesn't want to overwhelm them. Soooo I contacted T, my first mentor and asked her what she thought and she's going to talk to the Nurse Coordinator on L and D tomorrow! I don't like to complain and put people in an awkward situation but I realized that this is such a unique opportunity I would rather spend 3 weeks learning and interacting than sitting in an OR just watching. We will see what happens...
Today wasn't too exciting except we had this one patient who was so odd I couldn't figure her out even by the end of the shift. If you follow me on Twitter you saw that I said "People should have to take a test to be able to have children" and while that may sound kind of harsh, this lady would have changed your mind if you disagree with me! She had a C-section and that was the only reason she was still in the hospital. She acted like she had been through the a war. She took forever to get out of bed, sent back all of her food and even refused to even wipe herself. As a nurse I am more than happy to help someone who needs it and even those who kind of need help. This lady did not need our help but refused to do anything by herself, which truly made me worried about her baby she was about to take home. Also, she was...for lack of a better work...nasty smelling and when we were helping her shower (she couldn't do it alone obviously) she went on and on about how "Cleanliness is next to Godliness"...my mentor and I couldn't look at each other in the eye because we were going to start laughing. It's moments like that that bring you back down to earth, I had been so frustrated with this lady all day, and in that moment I realized that it is easier to laugh about it (or blog about it) and let it go. I'm going to end two ways today...1. On a positive note today I realized that you can't enjoy every patient but giving them what they "need" is important. 2. http://whatshouldwecallnursingschool.tumblr.com/post/23555099106/when-your-friends-are-comparing-their-jobs-with-nursing
Sunday, June 24, 2012
Monday, June 18, 2012
My Second First Day
Today was my first day on my second rotation, Women's Specialty Obstetrics. Basically this is a floor where any patient comes if they have a problem and are pregnant. It is very similar to "Med Surg" nursing which is just general patients in a hospital but the only difference is that these patients are pregnant or just delivered their baby. (I'm getting to the point where it is strange to see a female without a pregnant belly...) While I enjoyed my first day I already know Labor and Delivery is the place for me! However this will be a great 3 weeks because I will get to see many different types of patients with varying issues which is always educational.
I love my new mentor, L. She is sassy and fun and calls me "California." She has had the most patient compliments in the past few months and I definitely know why. No matter how busy we were today she took the time to joke, laugh or even sit quietly with a patient. She made everyone on that floor feel like they were her only patient AND she took the time to explain everything to me!
We had quite a variety of patients today including a pregnant lady with a kidney infection, a post-hysterectomy patient, a hypertensive mom whose baby was in the NICU (neonatal intensive care unit) and a mom who had a stillborn baby. I have been used to having the same type of patients every day so this was very interesting. The hypertensive mom was definitely our most interesting patient. L said she has been in and out of Women's Specialty for her other pregnancy and this one. She has behavioral and psychological problems but L was able to deal with her very well. She is the type of patient who will only do things her way and it's usually the hardest way for the nurses. We tried to appease her all day with simple things like keeping her blood pressure cuff off until it was time to take her pressure, getting up to go to the bathroom by herself, wearing her own clothes, fixing her IV by herself, etc. because it was so much easier and it wasn't really hurting anyone. Her and her boyfriend have a history of drug abuse and I've realized now that when minimally educated individuals can name the generic and brand names of every medication we give them I don't need to look at her chart to know that they have that in their history. I took an intense course on pharmacology and I cannot name those drugs like they can! Maybe I should change my study habits...kidding!
I also was able to see a laparoscopic surgery today for an ectopic pregnancy (a pregnancy that didn't make it all the way through the fallopian tube before it began maturing. It needs to be removed from the fallopian tube before it ruptures which can cause serious complications). It is amazing how doctors can perform surgery through tiny holes in the patient's abdomen. The patient was able to leave a few hours later too which saves the patient, as well as the hospital, so much time and money! I loved being in the main OR and I can't wait for my next rotation too. Also, some of those nurse anesthetist's are quite attractive and very eager to explain things to me which I couldn't complain about!
I am exhausted from today and have work bright and early tomorrow morning so I need to get some sleep. We will see what happens tomorrow!
I love my new mentor, L. She is sassy and fun and calls me "California." She has had the most patient compliments in the past few months and I definitely know why. No matter how busy we were today she took the time to joke, laugh or even sit quietly with a patient. She made everyone on that floor feel like they were her only patient AND she took the time to explain everything to me!
We had quite a variety of patients today including a pregnant lady with a kidney infection, a post-hysterectomy patient, a hypertensive mom whose baby was in the NICU (neonatal intensive care unit) and a mom who had a stillborn baby. I have been used to having the same type of patients every day so this was very interesting. The hypertensive mom was definitely our most interesting patient. L said she has been in and out of Women's Specialty for her other pregnancy and this one. She has behavioral and psychological problems but L was able to deal with her very well. She is the type of patient who will only do things her way and it's usually the hardest way for the nurses. We tried to appease her all day with simple things like keeping her blood pressure cuff off until it was time to take her pressure, getting up to go to the bathroom by herself, wearing her own clothes, fixing her IV by herself, etc. because it was so much easier and it wasn't really hurting anyone. Her and her boyfriend have a history of drug abuse and I've realized now that when minimally educated individuals can name the generic and brand names of every medication we give them I don't need to look at her chart to know that they have that in their history. I took an intense course on pharmacology and I cannot name those drugs like they can! Maybe I should change my study habits...kidding!
I also was able to see a laparoscopic surgery today for an ectopic pregnancy (a pregnancy that didn't make it all the way through the fallopian tube before it began maturing. It needs to be removed from the fallopian tube before it ruptures which can cause serious complications). It is amazing how doctors can perform surgery through tiny holes in the patient's abdomen. The patient was able to leave a few hours later too which saves the patient, as well as the hospital, so much time and money! I loved being in the main OR and I can't wait for my next rotation too. Also, some of those nurse anesthetist's are quite attractive and very eager to explain things to me which I couldn't complain about!
I am exhausted from today and have work bright and early tomorrow morning so I need to get some sleep. We will see what happens tomorrow!
Wednesday, June 13, 2012
Biting My Tongue
You know when you say that something has never happened and then a few minutes later it happens and you wonder if it happened simply because you said it....well that happened to me 3 times today and they were all very interesting experiences on my second to last day on L and D.
1. Power Outage- Today we had a power outage in the entire hospital so everything was running on emergency generators. It wasn't a severe situation because crucial things like ventilators and OR lights still worked but the entire computer system was down. It was ironic because I had JUST been talking to my mentor about how I can't imagine ever doing paper charting because everything is so much easier on the computer, etc. Well, of course the power goes out and we have to spend the next 6 hours paper charting which is just more time consuming and unfamiliar. However compared to my next 2 situations this wasn't too bad...
2. Baby in the Bed- My mentor and some other nurses were joking the other day about how if the doctor didn't come quick enough a patient was going to deliver the baby without him. I asked T if this had ever happened and she said that every L and D nurse has delivered a baby at some point because sometimes a patient pushes and the baby just comes out easily without time for the doctor to arrive... Well, I didn't think I would ever see this but today a nurse said she was going to go check her patient and I went with her because I wasn't doing anything and we walk in the room and this patient was laying in the bed and there is a crying baby between her legs, umbilical cord still attached and all! Unfortunately this patient was from Burma so we couldn't really communicate with her but the nurse essentially clamped the cord, had the dad cut it and I brought the baby over to the table and did what we normally do. The funny thing was that not one person in the room changed their facial expression during this entire situation! They just watched as this occurred as if this is what happens all of the time (but hey, I've never been to Burma...)
3. 22 Weeks- This last situation was ironic but also very sad. I had an "extern update" lunch with the other girls in my program and I was telling them all how I love L and D, how many exciting things I've seen and how I hadn't encountered anything sad yet. Of course, the second I get back to the floor, T tells me that we have a pre term labor patient who is going to deliver at 22 weeks. At 22 weeks there is no chance of the baby surviving past a few hours so they don't even try to resuscitate it when it is delivered. This girl was 17 years old and woke up this morning with abdominal pain, came to the hospital, found this out and delivered 30 minutes later. I can't imagine what that would feel like to have such a 180 degree change in one day. When she delivered it was such a different feel compared to all of the other births because everyone was just silent when the baby arrived. She weighed only 1 pound and was so so tiny. The family was able to hold the baby for a few hours while we got her ready to be discharged and their grief was so obvious and heavy that it was hard to see. We took the baby for a little while into the bereavement room and took pictures of her in a tiny dress, took her footprints and compiled a memory box for the mom. It was so strange to hold the baby and take her pictures but when we gave the memory box to the mom upon discharge you could tell that it was going to help give her closure. While this was obviously a hard day, I know that this comes with the territory of L and D and I'm grateful I was able to experience it before I left the floor.
So, today had it's ups and downs but the moral of the story is be careful what you say because life has a funny way of teaching you lessons. I can't wait to see what my last day on L and D has in store for me tomorrow!!
1. Power Outage- Today we had a power outage in the entire hospital so everything was running on emergency generators. It wasn't a severe situation because crucial things like ventilators and OR lights still worked but the entire computer system was down. It was ironic because I had JUST been talking to my mentor about how I can't imagine ever doing paper charting because everything is so much easier on the computer, etc. Well, of course the power goes out and we have to spend the next 6 hours paper charting which is just more time consuming and unfamiliar. However compared to my next 2 situations this wasn't too bad...
2. Baby in the Bed- My mentor and some other nurses were joking the other day about how if the doctor didn't come quick enough a patient was going to deliver the baby without him. I asked T if this had ever happened and she said that every L and D nurse has delivered a baby at some point because sometimes a patient pushes and the baby just comes out easily without time for the doctor to arrive... Well, I didn't think I would ever see this but today a nurse said she was going to go check her patient and I went with her because I wasn't doing anything and we walk in the room and this patient was laying in the bed and there is a crying baby between her legs, umbilical cord still attached and all! Unfortunately this patient was from Burma so we couldn't really communicate with her but the nurse essentially clamped the cord, had the dad cut it and I brought the baby over to the table and did what we normally do. The funny thing was that not one person in the room changed their facial expression during this entire situation! They just watched as this occurred as if this is what happens all of the time (but hey, I've never been to Burma...)
3. 22 Weeks- This last situation was ironic but also very sad. I had an "extern update" lunch with the other girls in my program and I was telling them all how I love L and D, how many exciting things I've seen and how I hadn't encountered anything sad yet. Of course, the second I get back to the floor, T tells me that we have a pre term labor patient who is going to deliver at 22 weeks. At 22 weeks there is no chance of the baby surviving past a few hours so they don't even try to resuscitate it when it is delivered. This girl was 17 years old and woke up this morning with abdominal pain, came to the hospital, found this out and delivered 30 minutes later. I can't imagine what that would feel like to have such a 180 degree change in one day. When she delivered it was such a different feel compared to all of the other births because everyone was just silent when the baby arrived. She weighed only 1 pound and was so so tiny. The family was able to hold the baby for a few hours while we got her ready to be discharged and their grief was so obvious and heavy that it was hard to see. We took the baby for a little while into the bereavement room and took pictures of her in a tiny dress, took her footprints and compiled a memory box for the mom. It was so strange to hold the baby and take her pictures but when we gave the memory box to the mom upon discharge you could tell that it was going to help give her closure. While this was obviously a hard day, I know that this comes with the territory of L and D and I'm grateful I was able to experience it before I left the floor.
So, today had it's ups and downs but the moral of the story is be careful what you say because life has a funny way of teaching you lessons. I can't wait to see what my last day on L and D has in store for me tomorrow!!
Friday, June 8, 2012
Chemical Engineers and the Ten Pound Baby
So I haven't posted after the past 2 shifts and I have many crazy things that have happened. First, an overview: I am still loving L and D and have only one more week left until I move to Women's Specialty OB. I am so much more comfortable with the patients, nurses, floor and process of labor and delivery and can really see myself doing this in the future. I can't imagine that seeing a baby in it's first few seconds of life will ever get old!
Now, onto some of the crazy stuff. (This seems to be a recurring theme on L and D)...
I had my first two patients who were substance abusers...my shift ended before I was able to see the babies born so I'm not sure how they turned out but I know that since they receive oxygen and nutrition via the placenta, they also have been exposed to the drugs that their mother's were abusing. This means the baby will need to be weened off of the drugs when they are born. I can't imagine that this is a good way for a child to come into the world and this is why education about birth control is so important. My first patient was abusing prescription drugs but my second patient was abusing harder drugs. (Side story: apparently they are being monitored by DSS because the father runs a meth lab. When asked what he did for a profession he promptly reported that he was a, "Chemical Engineer"...nice try buddy). (Second side story: when I walked into their room just to throw something away he had his shirt off and I was so flustered I dropped what I was holding, picked it up, dropped it again on the way to the trashcan, and then got my sleeve caught in the trashcan...awkward...and I never figured out why he too off his shirt). Anyways, while we gave the same care to these patients as all of the other ones, its harder to feel joyous and excited for them, however, it is a good eye opener for me that there are so many different kinds of people out there.
Remember in my last post when I said I had to change my scrubs because someone's amniotic fluid splashed on me? Well today someone was pushing and she squirted pee on me...for some reason it wasn't as gross (is that weird?) but I'm realizing now that in nursing and especially L and D, you have to just roll with it. It's a good lesson for me to apply to my everyday life so I'm just going to look at it positively!
Last small story to end the post...I saw the biggest baby today! He was ten pounds and his mom was tiny. I know ten pounds isn't the biggest baby ever but it was the biggest I'd ever seen! I could barely lift him when we were weighing him (maybe I need to lift weights some more...) and his hands and feet were huge. He was very cute and chubby which I personally think makes babies look cuter.
Anyways, can't wait to see what my last week on L and D has in store for me!
Now, onto some of the crazy stuff. (This seems to be a recurring theme on L and D)...
I had my first two patients who were substance abusers...my shift ended before I was able to see the babies born so I'm not sure how they turned out but I know that since they receive oxygen and nutrition via the placenta, they also have been exposed to the drugs that their mother's were abusing. This means the baby will need to be weened off of the drugs when they are born. I can't imagine that this is a good way for a child to come into the world and this is why education about birth control is so important. My first patient was abusing prescription drugs but my second patient was abusing harder drugs. (Side story: apparently they are being monitored by DSS because the father runs a meth lab. When asked what he did for a profession he promptly reported that he was a, "Chemical Engineer"...nice try buddy). (Second side story: when I walked into their room just to throw something away he had his shirt off and I was so flustered I dropped what I was holding, picked it up, dropped it again on the way to the trashcan, and then got my sleeve caught in the trashcan...awkward...and I never figured out why he too off his shirt). Anyways, while we gave the same care to these patients as all of the other ones, its harder to feel joyous and excited for them, however, it is a good eye opener for me that there are so many different kinds of people out there.
Remember in my last post when I said I had to change my scrubs because someone's amniotic fluid splashed on me? Well today someone was pushing and she squirted pee on me...for some reason it wasn't as gross (is that weird?) but I'm realizing now that in nursing and especially L and D, you have to just roll with it. It's a good lesson for me to apply to my everyday life so I'm just going to look at it positively!
Last small story to end the post...I saw the biggest baby today! He was ten pounds and his mom was tiny. I know ten pounds isn't the biggest baby ever but it was the biggest I'd ever seen! I could barely lift him when we were weighing him (maybe I need to lift weights some more...) and his hands and feet were huge. He was very cute and chubby which I personally think makes babies look cuter.
Anyways, can't wait to see what my last week on L and D has in store for me!
Sunday, June 3, 2012
Hoon-gray baby
Today was a crazy day on L and D! Almost all of the rooms were full so we were very busy from the beginning of the day. T and I had two patients who weren't very far along so we were able to help out the other nurses which gave me a chance to do a lot of things. For example, I had never been a "baby nurse" before and I was able to do that three times today! A baby nurse comes in the room right when the baby is about to be delivered and washes the baby off, takes vital signs, gives him/her some medication, takes their footprints, weighs them and swaddles them up (my favorite part) and hands them to the mom or dad. I love this because it gives me a chance to be with the baby which is a part of L and D that I shamelessly am obsessed with. I was also able to be a baby nurse during a C-section which was a little more intense but even more exciting.
Later in the day I was able to help with a delivery which turned out to be pretty interesting...The mom that was delivering was very sweet as was her husband, but they brought their entire family clan into the room and they wanted to be involved in every aspect of the day. These people were definitely hillbillies. Now I'm not saying that in a derogatory manner but they were hillbillies and proud of it. I heard multiple yee-haws when that baby was born so don't even argue with me. (T teased me and said that I'd probably never seen anyone like them in the OC). Anyways, the reason the delivery turned out to be interesting was because the dad was a little queasy so he asked me to get up with the mom and help her push. I was standing right over/next to her when she pushed and something (I'd rather not know what exactly) squirted all over me and my scrub top. This was during the middle of the delivery so I had to spend the next 20 minutes in a soaking wet top while this baby was delivered. I was trying so hard not to freak out because I knew that this moment was about the mom and baby but I couldn't run out of that room and change faster as soon as that baby was born! Other than that, this day was another great one! I'm going to end this post with another ridiculous story that a L and D nurse told me even though I didn't witness it myself...
So this nurse was doing an exam on a patient and during the exam she found...a banana...an entire banana, placed somewhere a banana should not be. This nurse questioned the patient about why there was a banana there and the patient replied as if the nurse was dense, "The baby was hoooon-gray." The nurse proceeded to explain patiently how the baby is through what the mom eats, etc. While this story is so outrageous I am starting to realize that this is not that far fetched based on some of the people/things I've already seen after just 4 days! At least she was trying to feed her "hoon-gray" baby with something nutritious, it could have been a donut!
Later in the day I was able to help with a delivery which turned out to be pretty interesting...The mom that was delivering was very sweet as was her husband, but they brought their entire family clan into the room and they wanted to be involved in every aspect of the day. These people were definitely hillbillies. Now I'm not saying that in a derogatory manner but they were hillbillies and proud of it. I heard multiple yee-haws when that baby was born so don't even argue with me. (T teased me and said that I'd probably never seen anyone like them in the OC). Anyways, the reason the delivery turned out to be interesting was because the dad was a little queasy so he asked me to get up with the mom and help her push. I was standing right over/next to her when she pushed and something (I'd rather not know what exactly) squirted all over me and my scrub top. This was during the middle of the delivery so I had to spend the next 20 minutes in a soaking wet top while this baby was delivered. I was trying so hard not to freak out because I knew that this moment was about the mom and baby but I couldn't run out of that room and change faster as soon as that baby was born! Other than that, this day was another great one! I'm going to end this post with another ridiculous story that a L and D nurse told me even though I didn't witness it myself...
So this nurse was doing an exam on a patient and during the exam she found...a banana...an entire banana, placed somewhere a banana should not be. This nurse questioned the patient about why there was a banana there and the patient replied as if the nurse was dense, "The baby was hoooon-gray." The nurse proceeded to explain patiently how the baby is through what the mom eats, etc. While this story is so outrageous I am starting to realize that this is not that far fetched based on some of the people/things I've already seen after just 4 days! At least she was trying to feed her "hoon-gray" baby with something nutritious, it could have been a donut!
Friday, June 1, 2012
16 and Pregnant
Today was another great day on the Labor and Delivery floor! My mentor, T, had a family member who was induced for labor so we were able to help deliver her baby. I was able to be with her all day and through the delivery. The family didn't know the sex of the baby so I videotaped their reaction when they finally revealed it was a girl. That was very fun and a touching moment to witness. (Side note: All nursing students should have to take a class in videography because I have handled so many video cameras since I started my externship! I find it so stressful because I don't want to mess it up for the family. I am way more comfortable putting in an IV than videotaping!)
As the title of this post shows, my the rest of my day was straight up out of an episode of 16 and Pregnant. I only saw one patient who was over the age of 20! I understand that people come different backgrounds and lifestyles and age doesn't always correlate with being a good parent, but these patients didn't seem to want to even deliver the baby. It's amazing to see the difference in the excitement between a patient who is older and has a partner than a younger patient who is alone. I enjoyed spending my day with these girls but I also felt for them, and the baby, because I know the responsibility of a baby calls for maturity, etc. I just hope that these women receive some sort of education regarding family planning before they are discharged from the hospital. Annnyways, I'll get off of my soapbox now end with a funny story that happened yesterday...
I was admitting a patient (also 16 but besides the point) and she had a guy with her. As part of the admission process I needed to identify the relationship of the patient to the people in the room so I asked him what his relationship was to the patient. He quickly (and seriously) replied "Baby Daddy". Now, as you can imagine that is not one of the options in the drop down menu so I asked if I should just put "Significant Other" and both of them shouted, "No!!" I felt thoroughly awkward at this point because they were glaring at me as if I had tried to marry them on the spot so I said, "I'll just put Father" and he was like "Yeah, yeah, that's what I said...Baby Daddy"... Ohhhkayy, after being thoroughly embarrassed (and a little confused), I finished the admission as quickly as possible and left the room. But, even with moments like this I still love every minute on the L & D floor!
As the title of this post shows, my the rest of my day was straight up out of an episode of 16 and Pregnant. I only saw one patient who was over the age of 20! I understand that people come different backgrounds and lifestyles and age doesn't always correlate with being a good parent, but these patients didn't seem to want to even deliver the baby. It's amazing to see the difference in the excitement between a patient who is older and has a partner than a younger patient who is alone. I enjoyed spending my day with these girls but I also felt for them, and the baby, because I know the responsibility of a baby calls for maturity, etc. I just hope that these women receive some sort of education regarding family planning before they are discharged from the hospital. Annnyways, I'll get off of my soapbox now end with a funny story that happened yesterday...
I was admitting a patient (also 16 but besides the point) and she had a guy with her. As part of the admission process I needed to identify the relationship of the patient to the people in the room so I asked him what his relationship was to the patient. He quickly (and seriously) replied "Baby Daddy". Now, as you can imagine that is not one of the options in the drop down menu so I asked if I should just put "Significant Other" and both of them shouted, "No!!" I felt thoroughly awkward at this point because they were glaring at me as if I had tried to marry them on the spot so I said, "I'll just put Father" and he was like "Yeah, yeah, that's what I said...Baby Daddy"... Ohhhkayy, after being thoroughly embarrassed (and a little confused), I finished the admission as quickly as possible and left the room. But, even with moments like this I still love every minute on the L & D floor!
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