My day on the Mother/Baby unit

While working on a women’s post-op floor, I was asked to float to the mother/baby unit. I had a strong history in pediatrics, had shadowed a nurse there a few months before, and was told that taking care of the mothers would be “a piece of cake.” They were desperate for help, so I hesitantly agreed, hoping for the best.

One of the charge nurses showed me how to do a “fundal check” – this consists of pressing hard on the woman’s abdomen to feel where the uterus is and making sure it feels firm. It seemed simple enough.

They assigned me to several easy patients- women who had delivered the day before and should have been uncomplicated. Their IV’s had already been removed since they were no longer needed, and the women only needed to be checked on every few hours.

The first patient I assessed was an ER nurse in her late twenties who had delivered the cutest baby girl I’d ever seen. I’m not sure if it was the fact that my ID badge said “Women’s Surgery” instead of “Mother/Baby” or because I thought the closet was the bathroom, but she immediately asked if I was new.  I told her the truth– I was a “float.” She promised to take it easy on me, but mentioned that she’d noticed some heavy bleeding while going to the bathroom.

I fumbled through my fundal check, pressing on her abdomen as I’d been taught. But I didn’t feel her uterus. And as I pushed, I noticed a gigantic blood clot plop onto the bed between her legs. I’m not exaggerating, this thing was HUGE.

“Is that normal?” She pointed at the blood flowing from her body.

Yeah, I seriously doubted it. “I’ll be right back!” I said as I sprinted out the door.  The charge nurse hadn’t prepared me for this situation.

The hallway and nurses’ station were completely empty. I felt a huge lump in my throat and started to squeak when I breathed.

I ran to the nursery and thankfully there were two nurses there. “Is a clot this big normal?” I showed the size with my hands.

“Which room?” One of the nurses, Stacey, started running.  I took that as a “no.”

We ran to the room and the patient was still bleeding. “She’s hemorrhaging, we need Pitocin and to do a fundal massage,” the nurse said.

Maybe my memory is unreliable due to the state of shock I found myself in, but I swear that mother/baby nurse started punching my patient’s stomach. The patient was screaming, blood was gushing, I was crying… well I wasn’t actually crying but I wanted to. “You take over while I call the doctor,” the nurse told me.

I began “massaging” (beating) the poor woman’s stomach. Her uterus was starting to firm up, which I knew was a good sign. Several nurses appeared and took over. An IV was started, meds were given, doctors called… and finally, the patient stopped bleeding.

Once everything was cleaned up and the patient was considered stable again, the charge nurse apologized. “Usually patients only hemorrhage the day of delivery, but sometimes that happens. Sorry it happened to you.” 

“No problem. But I’m never coming back. Ever.” Even if I was given a proper orientation, I didn’t want to do that to a patient ever again. They called me five times over the next month begging me to come back, but I refused. I was scarred for life.

I do believe that everything happens for a reason, though.

A few years later, I was pregnant with Samantha.  I watched several biased birthing documentaries, such as The Business of Being Born and Pregnant in America. I didn’t believe most of what I heard or saw, but liked the idea of a home birth or going to a birthing center. After working in a hospital, I really wanted a more natural experience without all the machines and doctors. But something kept holding me back– the memory of that patient’s bleeding. Had she been at home, she could have easily bled out before she’d made it to the hospital.

I struggled with the decision for several months, and finally decided to deliver naturally, but at the hospital. That patient was my deciding factor. I had an extremely fast labor, and ended up having complications. Samantha was in distress and I had an emergency C-section. Samantha’s APGAR score was a 4, and she was taken straight to the NICU. The doctors and nurses saved her life, and although she had a rocky start, she’s perfectly healthy now. Had I delivered outside the hospital (at home or a birthing center), we would not have had the resources she desperately needed. I don’t want to even imagine what would have happened.

So now with every new milestone that Samantha reaches, I thank God that I had that horrible experience on mother/baby, because I truly believe that it saved my daughter’s life.

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Signs you’re becoming a nurse

1. You enter a restroom and the person before you forgot to flush. Instead of thinking, “EWWW..”, you think, “Semi-formed large BM…”
2. You start rating everything on a scale from 1 to 10.
3. When someone farts, you almost start cheering.
4. Grey’s Anatomy isn’t fun to watch anymore. You just spent all day at a hospital, why would you want to watch other people in a hospital?
5. When hanging out with friends, you start noticing how good their veins are, and deciding which vein you would start an IV on.
6. You realize you walk twice as fast now.
7. You start diagnosing strangers with medical conditions. “That woman has really big eyes- she had better see a doctor about her hyperthyroidism.”
8. When you are asked, “How was your day?” you respond, “How was YOUR day?” to avoid talking about it.
9. People start showing you their moles or ask you to look at their tonsils.
10. People in your life are now much more comfortable telling you very personal things, and you aren’t embarrassed by it.
11. You are allowed to say “SOB” to your boss. (shortness of breath)
12. You can recite all the normal serum lab values, but forget your own phone number.
13. You begin to appreciate the little things in life, such as being able to breathe.
14. When driving, instead of humming a song in your head, you are humming the respirator alarm signal. “do do de da da”

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I’ll never forget…

Although this happened a few years ago, I still get chills whenever I think about it.

I was working as charge nurse on our small (13 bed) post-op unit. My coworker Lisa and I were the only two nurses on the floor because we only had 8 patients. One more patient and we were allowed to call in our coworker Jackie, who was sitting at home on call. Around 8 pm the pager went off alerting me that we were getting a new admission– a post-op hemorrhoidectomy patient having severe pain. Her surgery was scheduled as outpatient, but she was being admitted for pain control. My patients weren’t too difficult, and Lisa had things under control with hers as well, so we debated if we should call Jackie in or not. I called Jackie to see if she wanted to come in, and after some debating back and forth, she decided to come in instead of getting called in the middle of the night if we got another admission.

The patient arrived on the unit before Jackie arrived, and I did her initial assessment and took her admission history. I remember feeling silly asking if she had a living will– she was there for a hemorrhoid removal.  She was in pain but her medications still weren’t in the computer from our pharmacy yet, so I had to wait before administering anything.

Jackie arrived right as the pager went off with another admission, so I let her choose which patients she wanted. She chose the new admit and the hemorrhoidectomy patient. The patient’s medications finally showed up in the computer, so Jackie went in to give them.

She gave the woman some IV medication for her pain, which is when I would have left the room had I still been her nurse. But since Jackie needed to do her own assessment, she began taking the woman’s vital signs. Temp was normal, heart rate was ok. She put her stethoscope on the woman’s chest and said “Take a deep breath.”

The woman didn’t take a deep breath. Jackie waited a few seconds, and the woman didn’t take any breaths at all. She had stopped breathing. She called the woman’s name, shook her shoulders– the woman was unresponsive.  Jackie started yelling for help, which I heard from down the hallway. Lisa and I both ran to the room. The woman’s bed was in a sitting position but she was slumped over. She had no pulse. I hit the Code Blue button and ran to get the crash cart while they lowered the bed and began CPR.

It felt like it took forever for the code blue team to arrive. Once they did, it took over ten minutes to get a pulse back. She was transferred to the ICU where she ended up being ok.

Jackie had done nothing wrong- the woman had a severe reaction to the medication, causing her heart to stop. I couldn’t (and still can’t) stop thinking about what would have happened had I kept that patient. I’d already assessed her, so I would have left the room. When I went back ten minutes later (or longer, depending on if I got tied up in another room), I would have found my patient dead. I don’t think I ever would have recovered from that. What if Jackie had decided not to come in? Or had she picked a different patient to take over? Or if the medications had been in the computer earlier?

All I can say for sure is that someone had a guardian angel paying attention. I don’t know if it was mine or my patient’s, but I am forever grateful.

 

 

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Great nutrition

As a nurse, I have always known that my children would eat extremely healthy.  As a toddler, Samantha has always known that she is only going to do what SHE wants to do. Today, she had 1/4 cup of ranch for lunch. Not on broccoli or some other vegetable, just ranch by itself. That is all she ate.  Score so far– Mom: 0  Samantha: 20.

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Big brains?

At Samantha’s last checkup, her pediatrician told us she was 17th percentile in height. This means that most kids her age are taller than her. Her head circumference is in the 99th percentile. “Does that mean she’s going to be really smart?” Mike asked.  “No, it means she is really short with a big head,” the doctor replied.  :(

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Student nurse tips

Every August the top Google search that leads to my blog is “what is nursing school like?” By early September, it changes to “how to survive nursing school.” And by late September, “Should I quit nursing school?” starts creeping up. If you are struggling in school, please do not give up! My classmate used to ask me:  “What do you call a nurse who got all C’s in nursing school?”  The answer:  “A nurse!”       I’m not telling you to stop caring about your grades, because you should do your best. But your future patients will care more about how you treat them– your compassion, kindness, and genuine interest in helping them– than how you did on your health management exam your first year of school. You will have bad weeks. You will have bad tests. But you will also have amazing patients whom you will never forget. My advice– after you’ve had a great day in clinicals, write down how you feel. Write the nice compliments you receive from your patients, instructors, and classmates. Then if you fail an exam, hang it on your fridge. But make sure you put the paper with all your compliments right next to it. It will help you remember what is more important.

Always feel free to leave me a comment if you need advice! Please include your email address.

And for those who came for it, here’s my original advice for student nurses:

1. Never forget that every other person in that
classroom is just as scared as you are. If they always look confident,
it is just an act. So don’t let them stress you out.
2. Be prepared to work hard. You will have to do a
lot of reading, and it will be very confusing at times. Do the best you
can to get through it, and highlight anything that might sound
important.
3. Find a few classmates you get along with, and
stick with them through the whole program. At times when no one else in
your life fully understands what you are going through, they will. I
can’t emphasize enough how important this mutual understanding is, and

 I guarantee that these people will talk sense into you every time you
are 100% sure you are going to quit.
4. Be prepared to feel lost. My first time doing
everything (including putting a patient’s sock on her foot), I was so
scared I was shaking. It is normal to completely forget how to do
everything (even the most simple tasks) when you are nervous. So don’t let this make you feel stupid or inferior- it is NORMAL!!

5. Ask tons of questions. If you are told by a

 nurse to do something on a patient and you are not familiar with it or
are uncomfortable, ask for help. Don’t let it bother you that she rolls
her eyes at you, you have the right to learn, and your patients have
the right to receive safe care.
6. Be prepared to laugh at yourself. If you fail to
do this, you will be more stressed out than necessary. When you do
something stupid, laugh. Don’t be embarrassed, we all do dumb things.
Also, allow your patients to laugh at you. One patient told me that

 watching me frantically search for my clipboard (the clipboard I was
holding in my hand) and then laughing with me when I realized my
mistake, was the highlight of her week.
7. Even though you are extremely busy, take one
night off. This means do not do any school work whatsoever one night
every week. Thursday night is my night off. I watch TV, catch up with
friends, just do whatever I want. On Monday, when I really want to
watch something on TV or feel unmotivated to work, I keep telling
myself that I only have a few more days until Thursday.
8. Find an outlet for your frustrations. This site
has been wonderful for me- I just write about what I feel, and even
though I usually don’t end up posting those things for the world to
see, just writing about them makes me feel a lot better. Although this
takes away from my study time, it is well worth it. I don’t think I
could keep going all those hours if I didn’t have some way to release
some steam.banner51.jpg
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DIY Cake smash tips

DIY Cake smash tips

When doing a 1st birthday cake smash, I don’t recommend using a cake platter. Samantha pushed on the edge of the platter and the cake flipped up and into her face. She started crying and the photo shoot was over in less than a minute. Thankfully she was willing to try again later that day, so I did get a few good pictures. :)CakeYum copy

To get this picture, my husband pat her on the head, so she is looking up, reacting to that. I then cropped the picture to remove his hand.   :)

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