Friday, August 11, 2006

Why I oughta...

Today has been the most frustrating orientation day to date. I am pissed off at the residents right now. While I understand that they are students, I also need them to understand that I don't know everything there is to know about being a nurse. I have a few choice profanities on my lips at this moment, but my level of professionalism won't allow me to type them. I digress...

Today I attempted to do my first delivery by myself. This is the second time. The first time I said screw it and let me preceptor take over. At most facilities there are two nurses that handle deliveries, the baby nurse and the mom nurse. At this facility I AM the baby nurse and the mom nurse. I have two preceptors. One lets me do whatever I feel comfortable doing and the other doesn't seem to trust me enough yet. Since I attended a very pretensious university in my area, I am reluctant to step up and say "Get back, I think I can handle it." I don't want people to say, that DiVa is a snobby bitch but in a minute, I am gonna let my nuts hang. Screw em!

In L&D, we have these tracings that represent the fetal heart rate. My preceptor was in another delivery and she was attempting to let me handle it, which I must say, I was kickin' ass. So I noticed that the fetal tracing was sucking really bad and decided to tell a resident. The first resident said, just turn her over and give her oxygen. I did that and the tracing was still not so good. So I asked a second resident what I should do and she pretty much reamed me out. And then was a little pissed off because I wasn't running through the halls like it was a full code situation. The DiVa just doesn't freak out like that, mainly because I didn't want my teenage patient having her first baby to freak out. Long story short, she was ready to push.

So then all the residents were in the room, and my preceptor told me to coach my patient while pushing. Here I go..."Take both arms and reach around your thighs, curl your body around your baby, take a deep breath and push down into your bottom like you are having a bowel movement." I practiced saying that 1,000 times so that I could sound like I knew what I was talking about. Before I could try it out, the resident takes over. This made me feel like she thought that I didn't know what I was doing, and I thought it kind of gave my patient the impression that I didn't know what the hell I was doing. I was cool.

Then the attending physician came in and reprimanded me about the way that I was holding the patient's legs. My patient wasn't complaining. The baby crowned and It was time for my "wonder twin" nursing powers to activate. While I was tooling around the birthing suite, running back and forth between mother and baby, the attending decided to ask me if I had addressed the mother's positive chlamydia test that was done on the 28th of July. Of course it was done by a resident, but not documented. Again making me look like an idiot in front of the patient. My preceptor was silent. So I assumed that I was doing okay. Then I guess I was moving too slow. I don't know, I guess I am still trying to find order in chaos.

I had extremely low confidence today. After that whole encounter, I wanted to walk out. But then , my preceptor told me I was okay and that I shouldn't feel too discouraged because I am cut out for this job. I felt a little better. I was supposed to leave at 11pm but I stayed until 3am because I am not going to let this job beat me. I am tired, so I think I am going to call it a night. Besides tomorrow is another day.

-DiVa...Birthin' babies with attitude and latitude

Friday, August 04, 2006

Long time no blog

I have been busy. It is time for the kids to return to school. Time for me to return to school. Time to get this job thing happening. I have seen some craziness these past few weeks. Babies born in the bed, women with infections so bad that a bath doesn't alleviate the vaginal odor. Kids born with congenital anomalies. Last week I had my first run in with a fetal demise. Yeah, what you want to hear I'm sure.

From what I was told, the young lady (age 16) called the hospital on a Sunday, complaining that she hadn't felt her baby move since Friday night and fluid was leaking from her woman parts. She was 37 weeks gestation, never had a baby before but she new that something wasn't right. So she came in and she was given an ultrasound. There was no amniotic fluid, which generally means the baby is no longer living. So her labor was induced. When a person is as far along as this young lady, she has to labor and push the baby out, even if it is dead.

The baby came out looking like a typical newborn, except not alive. I was sent back to look at her because they thought it would be better for me to see one before I actually had to take care of one. By the time I saw the baby, she had started to change colors and the head had become gelatinous. She was dressed in a onesie and had on a little cap. I asked how they thought that the baby had died and the said that it probably got tangled in its own cord. It was delivered with the cord wrapped tightly around the neck twice. I felt sick after observing this baby. I had a bad day after that.

On this particular day, I had an alternate preceptor, she was such a bitch. Thank God I only had to be with her for only one day. She was so mean to the patient's family it was embarrassing. When she found out that it was the family of the fetal demise, she felt bad, but she didn't apologize. My preceptor spent the whole day yelling at me for a variety of things. It took everything to remain professional. She observed me as a performed an IV stick. I have to do a pre-determined number of IV's and blood draws while I am in orientation.

She directed me to find a bifurcating vein and insert the catheter between the area where the two veins intersect while threading the catheter into the lumen of the vein that is straight. She also wanted me to anchor the vein above the sight which I am totally uncomfortable with because doing this increases the risk of needle stick injuries. I had never done an IV this way before and I was not wanting to experiment on the patient. The patient didn't want me experimenting on her either. The whole time she was saying, "You're gonna miss. "I know it." "I hate needles." As I am sure you could probably guess, I missed it. I felt defeated. At least she apologized for that.

Right now I am trying to treat me house for fleas. My darling kitten has them and now my ankles are getting bit the hell up. I set off a flea bomb while I was at work and my ankles are still itching like crazy. Aw hell. Gotta get ready for work tomorrow.

DiVa...Why won't these damn fleas DIE?