Saturday, June 02, 2007

Just when I thought I couldn't do something more idiotic...

I prove myself wrong by doing something ridiculously idiotic. Last night was a busy night and our nurse manager was working alongside of us. This is a cool thing because I love the fact that the manager is willing to roll up her sleeves and come down into the trenches with us. At any rate my patient had a negative blood type. Here's a quick tutorial on Rh negativity and pregnancy.

If the baby has a positive blood type and the mother has a negative blood type, the mother will build antibodies against the baby. Since she was a primipara (having her first baby) nothing bad happens. However with the second pregnancy, if the baby has a positive blood type and the mother has a negative blood type, the mother's immune system will reject the baby. By rejecting, I mean it will attack and kill the baby. So in this particular delivery, it was very important to find out what the baby's blood type is so the next time or even this time, the mother can be treated with Rhogam to prevent a rejection. It desensitizes Mom to the positive blood type baby.

The baby was coming out very slowly, probably because he weighed 9 pounds, but it made me nervous because I wanted at all costs to avoid a forceps or vacuum delivery. I called the charge nurse in for a little support. I was so wrapped up in the safety of the Mom and baby that I totally forgot to collect a sample of the fetal blood. So in my mind I am organizing requests. The doctor is asking for suture to repair the perineum, and then a light and maybe some lidocaine. I wanted to keep an ear out for the babies apgars and such. Oh, and I needed a syringe to draw the blood out of the placenta because I neglected to ask for a section of cord for the blood sample. The clock is ticking because if blood sits still for too long it will clot and then the baby would probably need a blood draw. The doctor asked for a stool.

I went into a room to get a stool and noticed that the manager was taking care of my other patient. I said Hi and returned to my room with a stool and a syringe. I proceed to draw blood up from the placenta. Good, it's not clotted. I take my vacutainer and who walks into the room? The manager. While she is watching me, I take the needle and stick it into the top of the vacutainer. She says, "Aahhh!" I look up but it is too late I have already done a big nursing no-no. What if I had stuck myself with the needle?

DiVa, needs to remember to protect herself at all times...

Coming soon, "Beware of flying babies, a cautionary tale."

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