Melanie Bryant was the name, now Melanie Fox. I am a Labor and Delivery nurse working in a rural community hospital. I am the charge nurse on 3rd shift..the shift where the fun stuff happens..and im not talking about IV pole races down the hall way.
May 20, 2004
There are the type of women who have no choice..they come in ready to deliver (8cm or more). Then there are the women who are just plain good! I firmly believe that your mind is the most important "muscle" to use in labor. I once had a woman chant "row, row, row your boat" through each contraction, or music, or humming..whatever works for them. Warm baths and jello with friends..that one was fun. There are the girls that put themselves somewhere else and that becomes very amusing..."the hiking path in rockville..the big tree..climing the tree...sun is shining..." I start to feel like I am almost there. I love this job.
When do you know its time for medication?
Ohh..thats a good one. I have several theories on that question. First of all, if you resemble linda blair in the exorscist..then its time for medication. I mean that with all the humor I can display through my blog. Second, some women just need a little IV medication to "take the edge off". All women have different pain thresholds and one can never tell until your there. The women who tend to say "oh no, here comes another one..I cant , I cant..." are going to need extra support. We have a wonderful medication called the "sufenta block" and it works for approx. three hours. It does wonders when women get it at 5cm. Epidurals are common for first time moms, they can deliver medication through the entire labor, regardless of length. They do tend to "weaken" eventually.
I also use the tear factor. When a woman begins to fear her contractions and tears start coming..its time for medication. It is always good to have an IV put in when you get to the hospital in labor. You can ask to have a "hep lock" so you can walk around with out tubes connected to you. When you get back to bed the nurse can connect the hep lock to fluid and give you medication when you need it. If you have this put in when you first get there then you wont have to be "stuck" again when you are really in pain. I let my patients shower with the hep lock in. It is important as a nurse to know I can give her IV fluid or medication easily if needed.
I have rambled enough...good night
May 17, 2004
We have settled our contract and I have decided to stay at my hospital and see it through it's rough times right now. I have been asked to take hold of a new program we have enlisted in. We are now part of a national stillborn study and we have a lot of work to do to get ready to participate. This will keep me occupied at work.
In life. I have looked at 12 houses in 5 days and let me tell you that this sucks..big time. I live in Rhode Island and for all of you who are not familiar with real estate in new england..it sucks, sucks, sucks. Houses that would cost 100,000 in any other state in the country cost 250,000 here. It is absolutely ridiculous and it forces me to ask myself why I am living here! I have my family and friends here. People love this state so much that the houses are mostly being purchased by people out of state. This is a problem in the long term. Our schools are being paid for by people who only live here in the summer. Their children don't attend our schools and now they don't want to pay taxes for that particular reason. Not to mention that taxes in this state are at a national high. Let me also include that as a nurse, RI is the 48th in the country for medical reimbursement costs. That means that 47 other states are reimbursed more money for the same procedure. This country has some interesting ways of doing things!!
Deep breath. We also found out that I may need to take fertility drugs in order to get pregnant, which means that we could have twins right off the bat. That's a lot to digest, we decided to wait a month or two.
This is why my labor and delivery stories have been few and far between lately. I am working for the next 3 nights so..im sure more stories will come.
May 12, 2004
May 11, 2004
I suppose this is what makes the world of nursing go around. I dont mind taking care of a 3.5lb baby, others wouldnt go near that with a 10foot pole. I hate dialysis, my friend scott loves it.
I am not getting what I want from my current job and so I have applied for other postions. The only one I really wanted was not given to me and infact given to someone with much less experience than me..no labor and delivery experience to be exact. But you need to hear this wonderful rationalization..ok..here I go....
I believe in Kharma..and I know that this happened for a reason. I was going to take a big chance by leaving but it was going to be in the same field but second shift. (Im growing tired of third). I will now work perdiem for the new hospital and get my feet in the door. My mission is to show them what a good nurse I am and slip me in to the next second shift position. I also have some seniority at my current hospital. I am trying to get pregnant myself and also trying to buy a house. I may try to eliminate some of my goals. It seems to be a bit overwhelming. Until then...babies will still come at my hospital.
May 10, 2004
May 09, 2004
May 08, 2004
May 07, 2004
Heres my issue with early labor patients as mentioned earlier. Take all factors just mentioned and put them into a set of circumstances. First baby, water broke at home. When the water breaks it tell us two things..one..your cervix is changing and two..it will hurt more. The fluid acted as a cushion for the contractions..and now that cushion is gone. My patient had all these circumstances last night. When I checked her at 3am her cervix was so high I couldn't even reach it. Her contractions were 3-8 minutes apart and some weaker than others. 3 hours later her cervix was still not reachable and this was ok..but she thought her labor was going to last a few hours..she was not mentally prepared and we started medicating her at 6am with IV sedation. She had a small vaginal opening and became very very tense during exams. She did not expect any of it. Her veins were difficult and I stuck her 2 times before I called for help. I was starting to feel bad.
I think I started this entry to make myself feel better. I could have helped her a bit more I think..but maybe not. There are days when you are really in to your job and days when you are not. The longer I am in the field the more I realize why burnout is so common among nurses..and doctors. We all lean on each other so much. The chiefs lean on the doctors, the doctors lean on the nurses, the patients lean on the nurses, the patients lean on the doctors, the nurses lean on....hmm..they lean on.....well. Now I get it. This is a fact more obvious in labor and delivery. If you have had a child I don't have to explain...but I will for blogs sake.
When you come in at 1am we wake the doctor only after we have used our skills to evaluate your labor. We report to him..your cervix, ctxs, allergies, gbs status, pain factor, and any other important issues..there are too many of those too discuss here and now. If needed, we admit you and if needed, the doctors and midwives are close..at home, but close. We keep them posted on your progress until its time to have serious pain medication..or near fully dilated. Some times they will just come in.
We admit you, start the IV, draw labs, track your labor, and keep the doctor informed. It is a wonderful experience with many patients..and when you take away all the other political BS ..I would like to think it would be one of the top 5 rewarding jobs.
I worked all night..I should go to bed. My blog is skipping...thanks for listening..if anyone does.