Showing posts with label nurses. Show all posts
Showing posts with label nurses. Show all posts
Thursday, November 22, 2012
Happy Thanksgiving
A very Happy Thanksgiving to all of those who are working today (and everyone else not working too!). But especially to the nurses, midwives, doctors, patient care assistants, unit secretaries, housekeepers, and dietary personnel who are working this holiday to help care for those who are dependent upon us to care for them.
Wednesday, September 12, 2012
Mother-baby friendly status
I figured that my current hospital where I work as a nurse was moving to be more "mother-baby" friendly. First it was the move to all mothers of well babies having in-room mother-baby care 24hrs/day. Then it was improving early breastfeeding rates. Then, improving skin to skin in the delivery room for vaginal births.
Now, we're going to start implementing (finally!) early (within 5 minutes of birth) skin to skin in the OR for c-section mothers. Whoa baby, I just cannot wait to see how well THAT will go over (or rather, won't go over so well) with the neonatalogists who attend every c-section birth. I brought up the fact that perhaps we don't need a neo at every c-section birth? After all, most of our scheduled c-sections are very atraumatic (normal, no labor, no anticipated problems with the baby) and the baby has no problems transitioning from the birth. Why have neo there for what is essentially a normal birth? The true reason why neo is there for every c-section is that it generates income/money as a NICU consult. There -- I said it --- it's financially driven, not evidence-based practice!
It is also going to be an expectation that EVERY mother will do skin to skin with her baby within the first hour, ideally, within the first five minutes after birth - unless she outright declines or has a true medical indication why. If it is not done, there will be a drop down selection list of acceptable reasons why she does not do skin to skin. Even formula feeding mothers will be expected to do skin to skin after birth (of course, unless they have a reason why they don't want to). I'm fine with skin to skin after birth -- for women who want to do it. I am not for the forcing of women to do skin to skin if they really do not want to do it. That is just ridiculous! Hell, it's downright assault if I place a baby skin to skin (after removing the woman's gown) without her permission to do so. I always ask if I may place the baby against her skin after the birth. With most of the women, I try to ask this before they give birth. There are certain cultures who will not touch the baby at all after birth, much less have the baby lie skin to skin against them. Then there are the teen mothers (and sometimes older mothers) who find the birth fluids "icky" and want the baby to be at least wiped down before holding him/her. My thoughts are this: not every woman is created equal, nor does every woman have the same beliefs or desires for their immediate birth experience. One size does not fit all here! I hate when my facility management decides to put everyone into this one size fits all box.
Oh, and it has been super stressed to us that all breastfeeding (healthy, term) babies MUST be at the breast before one hour. Seriously? Not every single baby wants to go to the breast within one hour of birth. We have mothers who receive narcotics during labor, epidurals during labor, stressful and prolonged labors, and then we have.......drumroll........dopey babies who want to sleep after birth. I am NOT forcing a baby to the breast. In fact, I teach new mothers to NOT force the baby to the breast. It's one thing to hold the baby skin to skin against your chest/breast. The baby may very well start to do the "head bob" thing and migrate down towards the nipple and latch himself on -- all on his own -- with little to no active encouragement. Or, the baby may need some time to recuperate from the birth, maybe a little stroking of the cheek with a finger or the nipple. The fact of the matter is, not all newborn babies will latch on to the breast within one hour of age. Some...just don't. It's really not a big deal, and it does not ruin the breastfeeding relationship if a latch does not happen within an hour. Once again, I find that the hospital is trying to put all mothers and babies into this one size fits all box. We have to look at each mother and baby as separate beings. They are not the same from room to room, day to day.
The good news is that formula will not longer be available for supplementation unless medically indicated, along with an MD prescription, for breastfeeding newborns. So many nurses (and new mothers) think that if they are breastfeeding, the baby isn't "getting enough milk" and start supplementing with formula, filling up their itty bitty stomachs. Also, nurses (and new parents) are feeding way too much formula to these newborn babies. We had quite the discussion at work a few weeks ago, and I was trying to educate my fellow nurses on the true size of a newborn's stomach. At birth: think almond sized. That's 5-10 cc, max. Not 1/2 to 1 ounce.
I predict lots of turmoil among the nursing staff (and the medical staff too) when these new changes are implemented. There are more changes coming, other than what I have discussed. Some good, some not so good, but all in the name of being more "mother-baby friendly". We shall see.
Now, we're going to start implementing (finally!) early (within 5 minutes of birth) skin to skin in the OR for c-section mothers. Whoa baby, I just cannot wait to see how well THAT will go over (or rather, won't go over so well) with the neonatalogists who attend every c-section birth. I brought up the fact that perhaps we don't need a neo at every c-section birth? After all, most of our scheduled c-sections are very atraumatic (normal, no labor, no anticipated problems with the baby) and the baby has no problems transitioning from the birth. Why have neo there for what is essentially a normal birth? The true reason why neo is there for every c-section is that it generates income/money as a NICU consult. There -- I said it --- it's financially driven, not evidence-based practice!
It is also going to be an expectation that EVERY mother will do skin to skin with her baby within the first hour, ideally, within the first five minutes after birth - unless she outright declines or has a true medical indication why. If it is not done, there will be a drop down selection list of acceptable reasons why she does not do skin to skin. Even formula feeding mothers will be expected to do skin to skin after birth (of course, unless they have a reason why they don't want to). I'm fine with skin to skin after birth -- for women who want to do it. I am not for the forcing of women to do skin to skin if they really do not want to do it. That is just ridiculous! Hell, it's downright assault if I place a baby skin to skin (after removing the woman's gown) without her permission to do so. I always ask if I may place the baby against her skin after the birth. With most of the women, I try to ask this before they give birth. There are certain cultures who will not touch the baby at all after birth, much less have the baby lie skin to skin against them. Then there are the teen mothers (and sometimes older mothers) who find the birth fluids "icky" and want the baby to be at least wiped down before holding him/her. My thoughts are this: not every woman is created equal, nor does every woman have the same beliefs or desires for their immediate birth experience. One size does not fit all here! I hate when my facility management decides to put everyone into this one size fits all box.
Oh, and it has been super stressed to us that all breastfeeding (healthy, term) babies MUST be at the breast before one hour. Seriously? Not every single baby wants to go to the breast within one hour of birth. We have mothers who receive narcotics during labor, epidurals during labor, stressful and prolonged labors, and then we have.......drumroll........dopey babies who want to sleep after birth. I am NOT forcing a baby to the breast. In fact, I teach new mothers to NOT force the baby to the breast. It's one thing to hold the baby skin to skin against your chest/breast. The baby may very well start to do the "head bob" thing and migrate down towards the nipple and latch himself on -- all on his own -- with little to no active encouragement. Or, the baby may need some time to recuperate from the birth, maybe a little stroking of the cheek with a finger or the nipple. The fact of the matter is, not all newborn babies will latch on to the breast within one hour of age. Some...just don't. It's really not a big deal, and it does not ruin the breastfeeding relationship if a latch does not happen within an hour. Once again, I find that the hospital is trying to put all mothers and babies into this one size fits all box. We have to look at each mother and baby as separate beings. They are not the same from room to room, day to day.
The good news is that formula will not longer be available for supplementation unless medically indicated, along with an MD prescription, for breastfeeding newborns. So many nurses (and new mothers) think that if they are breastfeeding, the baby isn't "getting enough milk" and start supplementing with formula, filling up their itty bitty stomachs. Also, nurses (and new parents) are feeding way too much formula to these newborn babies. We had quite the discussion at work a few weeks ago, and I was trying to educate my fellow nurses on the true size of a newborn's stomach. At birth: think almond sized. That's 5-10 cc, max. Not 1/2 to 1 ounce.
I predict lots of turmoil among the nursing staff (and the medical staff too) when these new changes are implemented. There are more changes coming, other than what I have discussed. Some good, some not so good, but all in the name of being more "mother-baby friendly". We shall see.
Friday, May 20, 2011
I know I'm at work too much when....
--I hear call bells go off in my sleep.
--I answer the phone at home "Labor and Delivery, how can I help you?"
--I measure things with my fingers, in centimeters. Random things. And I'm accurate down to about 0.5 cm. No need for rulers in this house! (Seriously, I did this to help my daughter with one her homework papers, where she was measuring small lines. Here, momma will just measure with her fingers....don't need no silly ruler!)
--I sign checks, credit card slips, permission slips, and absence excuses with an RN at the end. Oops.
--I keep birth/labor management pocket books in my purse. For casual reading.
--I had a dream of a difficult birth. The doctor is trying to deliver the baby after the head and shoulders are out. He's pulling and pulling, the mom is pushing and pushing. Still won't come out. I flip her over into all fours (Gaskin maneuver), and the doc reaches in to pull out............another baby attached to the first. Siamese twins! Connected at the lower half of the body. He hands me the babies, I take them to the warmer, call NICU to come. NICU gets there, and I have no clue how to handle siamese twins. I end up calling other nurses to come see this rare sight that we will probably never see again. (Note: I have never been witness to siamese twins, personally.)
--Come to think of it, almost all of my dreams involve birth. I recall another dream where I gave birth to triplets. In my bed, at home. They all weighed about a pound each.
--True story here. I'm taking care of a woman in labor. I look around and see familiar faces among her family/support people. Then I realize: I've taken care of two other couples that are present during their births. Like, less then 6 months ago for all of them. Talk about deja vu! They all recognized me too. (Not a bad thing - they're all really great couples.) Turns out they're all friends! Small world.
--I answer the phone at home "Labor and Delivery, how can I help you?"
--I measure things with my fingers, in centimeters. Random things. And I'm accurate down to about 0.5 cm. No need for rulers in this house! (Seriously, I did this to help my daughter with one her homework papers, where she was measuring small lines. Here, momma will just measure with her fingers....don't need no silly ruler!)
--I sign checks, credit card slips, permission slips, and absence excuses with an RN at the end. Oops.
--I keep birth/labor management pocket books in my purse. For casual reading.
--I had a dream of a difficult birth. The doctor is trying to deliver the baby after the head and shoulders are out. He's pulling and pulling, the mom is pushing and pushing. Still won't come out. I flip her over into all fours (Gaskin maneuver), and the doc reaches in to pull out............another baby attached to the first. Siamese twins! Connected at the lower half of the body. He hands me the babies, I take them to the warmer, call NICU to come. NICU gets there, and I have no clue how to handle siamese twins. I end up calling other nurses to come see this rare sight that we will probably never see again. (Note: I have never been witness to siamese twins, personally.)
--Come to think of it, almost all of my dreams involve birth. I recall another dream where I gave birth to triplets. In my bed, at home. They all weighed about a pound each.
--True story here. I'm taking care of a woman in labor. I look around and see familiar faces among her family/support people. Then I realize: I've taken care of two other couples that are present during their births. Like, less then 6 months ago for all of them. Talk about deja vu! They all recognized me too. (Not a bad thing - they're all really great couples.) Turns out they're all friends! Small world.
Monday, December 20, 2010
From the patient's perspective
I had the pleasure (gack!) of being a patient recently. Well, I can actually tell you quite a few stories of being 'the patient' -vs- being 'the nurse' -vs- being 'the patient that's a nurse'.
Often times, I have been very tired, sore, aching, and ready to leave when it's the end of my shift as the nurse. I hope I don't come across as super eager to go home at that time to my patients.
Note: I'm not one to go to the ER. Seriously. But when I recently had a severe incidence of abdominal pain that didn't abate, and I had other alarming symptoms going on, I hated to do it........but I ended up needing EMS. Unfortunately, I was also physically unable to walk, much less get to my car to have someone drive me to the ER.
I had the unfortunate pleasure of being a patient during change of shift in the ER. My first nurse was obviously ready to go home. She had that haggard look of having come to the end of a very long day. I don't know if it was an 8, 12 or 16 hour shift for her. Her shoes made fairly loud clomping noises when she would come into my cubicle. (Then again, that could just be her shoes!) She was on her cell phone (work cell phone) when she started coming into my cubicle area, but was still talking on it. I heard a snippet of "are you relieving me?" before she glanced at me and turned back out of the room to finish her short chat on the phone. She came back in, wrapped up the end of her shift duties with me, then left the room. All interactions between her and I were very no-nonsense. No warm and fuzzy connections either.
Oh, did I mention, I did NOT say to anyone that I was a registered nurse. Except to the ER MD when he was discharging me. (He offered to keep me overnight for observation, but I said I was ok to go. The only reason why my being a nurse came into discussion was when he asked why I decided to come to his ER that evening, when I had all of my surgeries and hospitalizations at another hospital. I explained that I work for that hospital group as an RN, but this ER was closer to where I was that evening.)
Anyhow......back to my point of view as the patient. This first nurse - was either tired and ready to go home, or didn't like her job. That's just how she came across to me. I wonder if I come across that way to patients at times? I just know that it annoyed me that she seemed distanced from her role as the nurse.
The next nurse (night shift): she was better. Then again, she was at the start of her shift. She actually hung around in my cubicle to listen to me explain a little bit more of what was going on, and how I was doing. She was cool.
The x-ray transport dude: either hated his job (it sure seemed that way), or he was also at the end of a very long shift and ready to go home. I was not impressed.
The x-ray tech: nice girl. Professional. No -nonsense.
The ER doc: I was impressed. He did a quick assessment immediately upon my arrival via EMS. Even though he didn't know what was going on by my test results, he offered to keep me overnight. I declined. My symptoms by this point were much improved, and I was able to go home. He even gave me a copy of my lab/x-ray results for my surgeon to have a copy, since this hospital wasn't associated with the hospital I normally go to. (Thank you, kind ER doctor!)
Oh, and you want to talk about feeling like you wasted everyone's time? That would be me. The pain and symptoms I had were all pointing at a serious GI complication, but yielded no firm diagnosis and eventual abatement of symptoms. Although I was 1000x grateful for the pain to be tremendously decreased, I felt like I came across as someone who abuses the EMS system.
By the way: the pain? Still there. Very dull.
Often times, I have been very tired, sore, aching, and ready to leave when it's the end of my shift as the nurse. I hope I don't come across as super eager to go home at that time to my patients.
Note: I'm not one to go to the ER. Seriously. But when I recently had a severe incidence of abdominal pain that didn't abate, and I had other alarming symptoms going on, I hated to do it........but I ended up needing EMS. Unfortunately, I was also physically unable to walk, much less get to my car to have someone drive me to the ER.
I had the unfortunate pleasure of being a patient during change of shift in the ER. My first nurse was obviously ready to go home. She had that haggard look of having come to the end of a very long day. I don't know if it was an 8, 12 or 16 hour shift for her. Her shoes made fairly loud clomping noises when she would come into my cubicle. (Then again, that could just be her shoes!) She was on her cell phone (work cell phone) when she started coming into my cubicle area, but was still talking on it. I heard a snippet of "are you relieving me?" before she glanced at me and turned back out of the room to finish her short chat on the phone. She came back in, wrapped up the end of her shift duties with me, then left the room. All interactions between her and I were very no-nonsense. No warm and fuzzy connections either.
Oh, did I mention, I did NOT say to anyone that I was a registered nurse. Except to the ER MD when he was discharging me. (He offered to keep me overnight for observation, but I said I was ok to go. The only reason why my being a nurse came into discussion was when he asked why I decided to come to his ER that evening, when I had all of my surgeries and hospitalizations at another hospital. I explained that I work for that hospital group as an RN, but this ER was closer to where I was that evening.)
Anyhow......back to my point of view as the patient. This first nurse - was either tired and ready to go home, or didn't like her job. That's just how she came across to me. I wonder if I come across that way to patients at times? I just know that it annoyed me that she seemed distanced from her role as the nurse.
The next nurse (night shift): she was better. Then again, she was at the start of her shift. She actually hung around in my cubicle to listen to me explain a little bit more of what was going on, and how I was doing. She was cool.
The x-ray transport dude: either hated his job (it sure seemed that way), or he was also at the end of a very long shift and ready to go home. I was not impressed.
The x-ray tech: nice girl. Professional. No -nonsense.
The ER doc: I was impressed. He did a quick assessment immediately upon my arrival via EMS. Even though he didn't know what was going on by my test results, he offered to keep me overnight. I declined. My symptoms by this point were much improved, and I was able to go home. He even gave me a copy of my lab/x-ray results for my surgeon to have a copy, since this hospital wasn't associated with the hospital I normally go to. (Thank you, kind ER doctor!)
Oh, and you want to talk about feeling like you wasted everyone's time? That would be me. The pain and symptoms I had were all pointing at a serious GI complication, but yielded no firm diagnosis and eventual abatement of symptoms. Although I was 1000x grateful for the pain to be tremendously decreased, I felt like I came across as someone who abuses the EMS system.
By the way: the pain? Still there. Very dull.
Monday, August 23, 2010
Answer: muscle spasm vs kidney stone
Question: What is the cause of my left flank pain?
Oh yes, time to nurse the nurse. I've been having intermittent left flank pain for over a year now. Plus 2 episodes of rust colored urine (aka, blood in the urine). I don't have a history of ever having stones, but it sure does point in that direction.
My urine was clear of infection (and blood) today. I am spilling some ketones, and the specific gravity is at the highest level -- both indicating dehydration - a constant state I have been post gastric bypass. I never can get enough liquids in each day! I'm awaiting word on my KUB (kidney/ureter/bladder) x-ray done today to see if it's stones.
Having had gastric bypass, I am at higher risk for kidney stones.
Oh joy!
Oh yes, time to nurse the nurse. I've been having intermittent left flank pain for over a year now. Plus 2 episodes of rust colored urine (aka, blood in the urine). I don't have a history of ever having stones, but it sure does point in that direction.
My urine was clear of infection (and blood) today. I am spilling some ketones, and the specific gravity is at the highest level -- both indicating dehydration - a constant state I have been post gastric bypass. I never can get enough liquids in each day! I'm awaiting word on my KUB (kidney/ureter/bladder) x-ray done today to see if it's stones.
Having had gastric bypass, I am at higher risk for kidney stones.
Oh joy!
Tuesday, July 20, 2010
Jumping ship: away from a worsening fire or into shark-infested waters???
I'm becoming rather frustrated at how things are progressing at work. We're losing nurses - GOOD nurses - left and right. Nurses are becoming frustrated, angry, disillusioned. Our management seems to be operating on some other level than the nurses. Management comes out with dictates left and right that are overwhelming the staff nurses and angering them. We're being treated like children: Big Brother is watching you! We're getting nitpicked over a sundry of minor (sometimes bigger) things.
Nurses aren't taking it anymore. We've lost about 6 nurses alone in the past few months. They are moving on to (hopefully) better environments. Are the nurses being replaced? NO. The end result is short staffing. Management asking nurses to work overtime, pick up extra shifts. We have a nurse who calls off sick constantly, leaving more holes in staffing that the rest of us are expected to fill in and cover.
I think it's time that the remaining staff nurses stick together, write up a joint letter to management to voice our concerns and complaints, and see to it that things get better, and not worse, as they seem to be.
There are moments when I am ready to jump this ship too.
Nurses aren't taking it anymore. We've lost about 6 nurses alone in the past few months. They are moving on to (hopefully) better environments. Are the nurses being replaced? NO. The end result is short staffing. Management asking nurses to work overtime, pick up extra shifts. We have a nurse who calls off sick constantly, leaving more holes in staffing that the rest of us are expected to fill in and cover.
I think it's time that the remaining staff nurses stick together, write up a joint letter to management to voice our concerns and complaints, and see to it that things get better, and not worse, as they seem to be.
There are moments when I am ready to jump this ship too.
Friday, May 07, 2010
Nurses' Week, the L&D Version
Let's see........
I found out Miss AMA (against medical advice) came in the next day and delivered her baby. I'm so glad to not have to worry about being her nurse should she come in, because now that point is moot.
Nurses' Week - we're not officially celebrating it at work until next week. Go figure. I think we get cookies from management for being such hard working, fantastic, Magnet nurses. Can I have more vacation time instead please? Or a nice raise? Or ... how about we actually hire more nurses so we're not chronically short staffed?
Like I've said before, labor and delivery is either feast or famine. It's rarely anything in between, or so it seems. My last shift, we started out ok, but we were pretty much all doubled up with patients and I knew that if the crap hit the fan, we'd be done for.
Incoming! Incoming! Incoming!
It's like all of the pregnant women go into labor at one time. Like I said, we're all doubled up already, and no less than (at least!) 6 pregnant women come in, one right after the other.
One looked like she was about ready to deliver in the wheelchair. (Actually: only 1 cm dilated. Dodged a bullet with her.)
Another one looked like she was actively laboring. Her nurse checks her: 7cm and ruptured membranes. She precipitously delivers her baby a few minutes later. Absolutely NO doctors or midwives available - all are in deliveries. The patient's doctor was on her way in.
Rule out preterm labor - ruled out, sent home.
Rule out preeclampsia - not preeclamptic on initial assessment. Needs more evaluation to finish up her assessment.
Rule out labor - ruled out, sent home. She had probably the shorted outpatient visit of everyone, only because her doc was immediately available to assess, check, and send her home with discharge instructions.
Rule out labor - dunno what happened with her. I put her on the monitor and then my relief night nurse came and took over.
Status post seizure at home. Don't know what was going on with her, because she came in around change of shift.
I'm working on giving report on 1 of the 4 (or more?) I ended up taking care of when.......help needed in the PACU immediately. No one available but me, so I'm off and running. The poor lady back there was sick, sick, sick. She ended up going back to the OR. I stayed to help out, assisting the doc and the other nurses caring for her, trying to get her stabilized. I hope she does ok. It was looking pretty bad when I left.
Happy Nurses' Week indeed.
Thursday, May 06, 2010
Happy Nurses Day!
Happy Nurses Day to all of my fellow nurses and nurses-to-be!
How will you show the nurse(s) in your life how much you appreciate them?
I plan on working this evening with some of the most awesome nurses I know. We are amazing team players, always helping each other out, even when our own patient load might be on the heavy side.
**************************
Last evening I had two births. The first was a vaginal birth of a big 8 lb baby in a first time mom who did AWESOME with pushing! Yeah momma!
I went right from the vaginal birth into a prep for an urgent c/s. What a contrast in size with the babies. The c/s birth was for a very tiny preemie baby, who was about 1/4 to 1/5th of the size of the baby in the vaginal birth.
What an amazing thing -- to be able to be present and witness the birth of two unique little beings, and witnessing the birth of new mothers. As always, I am privileged to assist women in the birthing process.
Happy birthday to all of the Cinco de Mayo babies born yesterday!!
Sunday, April 25, 2010
Bias in healthcare
For one of my classes, we had to write a forum post about specific instances of bias in healthcare that we have either experienced or have witnessed. I wrote about weight bias in healthcare - specifically on L&D.
Obesity is a huge issue. Not just in one area of nursing, but in all fields. Bias against obese people is also another huge issue. (No pun intended.)
Without totally copying and pasting what I wrote for my assignment, I'll just hit the highlights.
Nurses have biases. We are not supposed to, but we're human. It doesn't make it right though.
I get frustrated when trying to maintain continuous EFM on obese pregnant women. It's frustrating for me because: the signal for the fetal heart rate doesn't stay consistently in place due to the difficulty in transmission through the extra adipose tissue. Sometimes I cannot even find a FHR on a very obese woman - that is just how difficult it can be, at extremes. I find that I cannot "allow" the woman to move out of a supine position, or I cannot trace her baby. This is especially so if she is on pitocin. If I can't trace the baby, I can't run the pitocin.
Physically, it's getting harder and harder on my own body to push a 300+ pound woman on a stretcher. It just about kills my back, legs, knees and feet.
Same thoughts on holding a leg on an obese woman when she has an epidural and is pushing. I just don't do it anymore. I need to save my back.
The irony of my own biases and judgments that I sometimes think in my mind: I used to be that 300+ woman! How can I - of ALL PEOPLE - make assumptions and judgments on obese women?
Some interesting reading:
Puhl, R., Moss-Racusin, C., Schwartz, M., & Brownell, K. (2007, September 19). Weight stigmatization and bias reduction: perspectives of overweight and obese adults. Health Education Research. doi:10.1093/her/cym052
Schwartz, M., Chambliss, H., Brownell, K., Blair, S., & Billington, C. (2003). Weight bias among health professionals specializing in obesity. Obesity Research, 11 (9), 1033-1039.
Obesity is a huge issue. Not just in one area of nursing, but in all fields. Bias against obese people is also another huge issue. (No pun intended.)
Without totally copying and pasting what I wrote for my assignment, I'll just hit the highlights.
Nurses have biases. We are not supposed to, but we're human. It doesn't make it right though.
I get frustrated when trying to maintain continuous EFM on obese pregnant women. It's frustrating for me because: the signal for the fetal heart rate doesn't stay consistently in place due to the difficulty in transmission through the extra adipose tissue. Sometimes I cannot even find a FHR on a very obese woman - that is just how difficult it can be, at extremes. I find that I cannot "allow" the woman to move out of a supine position, or I cannot trace her baby. This is especially so if she is on pitocin. If I can't trace the baby, I can't run the pitocin.
Physically, it's getting harder and harder on my own body to push a 300+ pound woman on a stretcher. It just about kills my back, legs, knees and feet.
Same thoughts on holding a leg on an obese woman when she has an epidural and is pushing. I just don't do it anymore. I need to save my back.
The irony of my own biases and judgments that I sometimes think in my mind: I used to be that 300+ woman! How can I - of ALL PEOPLE - make assumptions and judgments on obese women?
Some interesting reading:
Puhl, R., Moss-Racusin, C., Schwartz, M., & Brownell, K. (2007, September 19). Weight stigmatization and bias reduction: perspectives of overweight and obese adults. Health Education Research. doi:10.1093/her/cym052
Schwartz, M., Chambliss, H., Brownell, K., Blair, S., & Billington, C. (2003). Weight bias among health professionals specializing in obesity. Obesity Research, 11 (9), 1033-1039.
Thursday, February 11, 2010
A tale of a blizzard, firetrucks, a hotel, and not much sleep
Oh what a wicked adventure!
Remember, the snow that was expected to come here in the Northeast? Oh, it arrived, for sure.
In anticipation of more snow coming (in addition to the 2 feet+ we got over the weekend), I hightailed it in to work on Tuesday evening. I didn't have to work until Wednesday evening, but the snow was coming. I knew it would be too difficult, scratch that - impossible - to drive in the forecasted blizzard on Wednesday.
So, I checked into my suite, complete with cabana boy and pina coladas, at the Big City Hospital. In actuality, it was a patient room on the pediatrics unit. I "slept" in a room with another nurse, next door to a room with a sick and crying baby all night. Sleep? Sure, right. Where was my cabana boy and pina colada??
I putzed around until my shift at 3pm, then proceeded to work a horrendously busy shift. Many nurses couldn't get in, so we were severely understaffed. Several management people had to stay and work the floor with us (heck, they couldn't get home, might as well work, right?). Unbelievably, even though major thoroughfares and highways were closed, a state of emergency was declared, and a CIVIL emergency was also declared.............pregnant women still came in. It was busy with a capital "B"! How did they get in? Via ambulance a/k/a taxi service. Some were real medical/labor issues, but some....not so much. How would they get home when there was no medical reason to keep them? Simple. They didn't. Almost everyone stayed. Super nuts, I tell ya.
I had a birth with some complications afterwards. It looked like a war zone when it was all said and done. Luckily, everyone was nice and stable, after continued care and observation on L&D. Got mom and baby transferred and tucked in for the night, then I was finally DONE.
Ate some cold chinese food. Yep, only the chinese restaurant was open. Nothing else was open. It was like a disaster zone outside the hospital walls. All of the major highways declared closed. In fact, snow plows had piled snow onto the entrance and exit ramps to keep people off of the highways, so the plows could do their job! The snow finally stopped coming down sometime in the evening, but the winds kicked up to 40-50 MPH, so it was blowing all over the place. We received probably another 18-24 inches of snow.
Driving home in that? Nope. I went halfsies (or, foursies) with 3 other staff members on a hotel room across the street! Ahhhhhhh, several drinks in the hotel bar to wind down, then we hit the hotel room. A mighty sweet room it was. They were giving hospital employees an awesomely good rate for the night, since we were all snowed in. $69 for a normally $179+ room per night. Wooooweee!!!
Never realized there was such weird --- ummm, crap? ---- on cable TV late, late at night. Some super strange sex show on HBO I think? We were up giggling, having a grand old time watching it, before finally conking out to sleep.
Only to be rudely awakened bright and early by........ding ding ding ding!! EVACUATE!!! Yes, a fire alarm. In our hotel. On minimal sleep for the past 2 nights.
You've got to be freaking kidding me, is this for real? Yep. Tossed on clothes, grumbling the whole time. Walked down 6 flights of stairs, to walk outside in the cold and snow. Firetrucks with lights flashing outside. Get out there, only to have them say that it's all clear and we can go back in. What the heck?!?!?!!
Angry, tired, with a massive headache, we stomped to the service desk. Told them our predicament. Asked kindly for a refund or something (my God, I think I've slept less then 5 hrs total in the past 2 nights!). No refund, but free breakfast. And we can keep the room until we have to trudge back to the hospital at 3pm again.
So, here I sit. Telling my tale of fun and excitement of being a nurse while being stuck in a big city, away from my family for 2 days and counting now. My belly is full from an excellent breakfast and coffee (to get rid of my headache). My body is tired but cannot sleep. And to think, I have to go back to work again in 3 more hours?
Being a nurse is so glamorous, eh?
Hugs and kisses..........trying to go take a nap if possible.
Remember, the snow that was expected to come here in the Northeast? Oh, it arrived, for sure.
In anticipation of more snow coming (in addition to the 2 feet+ we got over the weekend), I hightailed it in to work on Tuesday evening. I didn't have to work until Wednesday evening, but the snow was coming. I knew it would be too difficult, scratch that - impossible - to drive in the forecasted blizzard on Wednesday.
So, I checked into my suite, complete with cabana boy and pina coladas, at the Big City Hospital. In actuality, it was a patient room on the pediatrics unit. I "slept" in a room with another nurse, next door to a room with a sick and crying baby all night. Sleep? Sure, right. Where was my cabana boy and pina colada??
I putzed around until my shift at 3pm, then proceeded to work a horrendously busy shift. Many nurses couldn't get in, so we were severely understaffed. Several management people had to stay and work the floor with us (heck, they couldn't get home, might as well work, right?). Unbelievably, even though major thoroughfares and highways were closed, a state of emergency was declared, and a CIVIL emergency was also declared.............pregnant women still came in. It was busy with a capital "B"! How did they get in? Via ambulance a/k/a taxi service. Some were real medical/labor issues, but some....not so much. How would they get home when there was no medical reason to keep them? Simple. They didn't. Almost everyone stayed. Super nuts, I tell ya.
I had a birth with some complications afterwards. It looked like a war zone when it was all said and done. Luckily, everyone was nice and stable, after continued care and observation on L&D. Got mom and baby transferred and tucked in for the night, then I was finally DONE.
Ate some cold chinese food. Yep, only the chinese restaurant was open. Nothing else was open. It was like a disaster zone outside the hospital walls. All of the major highways declared closed. In fact, snow plows had piled snow onto the entrance and exit ramps to keep people off of the highways, so the plows could do their job! The snow finally stopped coming down sometime in the evening, but the winds kicked up to 40-50 MPH, so it was blowing all over the place. We received probably another 18-24 inches of snow.
Driving home in that? Nope. I went halfsies (or, foursies) with 3 other staff members on a hotel room across the street! Ahhhhhhh, several drinks in the hotel bar to wind down, then we hit the hotel room. A mighty sweet room it was. They were giving hospital employees an awesomely good rate for the night, since we were all snowed in. $69 for a normally $179+ room per night. Wooooweee!!!
Never realized there was such weird --- ummm, crap? ---- on cable TV late, late at night. Some super strange sex show on HBO I think? We were up giggling, having a grand old time watching it, before finally conking out to sleep.
Only to be rudely awakened bright and early by........ding ding ding ding!! EVACUATE!!! Yes, a fire alarm. In our hotel. On minimal sleep for the past 2 nights.
You've got to be freaking kidding me, is this for real? Yep. Tossed on clothes, grumbling the whole time. Walked down 6 flights of stairs, to walk outside in the cold and snow. Firetrucks with lights flashing outside. Get out there, only to have them say that it's all clear and we can go back in. What the heck?!?!?!!
Angry, tired, with a massive headache, we stomped to the service desk. Told them our predicament. Asked kindly for a refund or something (my God, I think I've slept less then 5 hrs total in the past 2 nights!). No refund, but free breakfast. And we can keep the room until we have to trudge back to the hospital at 3pm again.
So, here I sit. Telling my tale of fun and excitement of being a nurse while being stuck in a big city, away from my family for 2 days and counting now. My belly is full from an excellent breakfast and coffee (to get rid of my headache). My body is tired but cannot sleep. And to think, I have to go back to work again in 3 more hours?
Being a nurse is so glamorous, eh?
Hugs and kisses..........trying to go take a nap if possible.
Friday, January 29, 2010
Changes to the blog posts
You might notice that some (a lot) of past posts are gone. I deleted most of them. Most especially, ones that could lead readers to who I am. We have had issues at the hospital that I work where staff members have been fired for supposed privacy violations on public networking sites.
Because of that, in fear of being "found out" by my employer, I will be making posts even more vague and general. I already change things around to privatize the stories that I write, but they are based on real life people and situations. I do not want to get into any kind of legal tangle or potentially lose my job for being such an active nurse blogger.
Because, well, I LOVE TO WRITE! I love to write about birth and birth issues. This blog is something I'm really excited to have, and would hate to have to ever close it down.
So, things that I post will be more vague, as far as birth stories. (Cause I know you all love some good birth stories!)
I'm still quite the opinionated L&D nurse though! That, my friends, will never change. I do apologize that if you go to look through archived posts, that you do not see them. They are gone. Forever deleted. Poof. Just a distant memory.
xoxo
AtYourCervix
PS - and always remember - take whatever you read on the internet with a grain of salt. When you have a question about your own health or health care, please talk to your doctor, midwife, nurse practitioner, or other health care provider.
Because of that, in fear of being "found out" by my employer, I will be making posts even more vague and general. I already change things around to privatize the stories that I write, but they are based on real life people and situations. I do not want to get into any kind of legal tangle or potentially lose my job for being such an active nurse blogger.
Because, well, I LOVE TO WRITE! I love to write about birth and birth issues. This blog is something I'm really excited to have, and would hate to have to ever close it down.
So, things that I post will be more vague, as far as birth stories. (Cause I know you all love some good birth stories!)
I'm still quite the opinionated L&D nurse though! That, my friends, will never change. I do apologize that if you go to look through archived posts, that you do not see them. They are gone. Forever deleted. Poof. Just a distant memory.
xoxo
AtYourCervix
PS - and always remember - take whatever you read on the internet with a grain of salt. When you have a question about your own health or health care, please talk to your doctor, midwife, nurse practitioner, or other health care provider.
I've been nominated - at Doctor D
Thanks Doctor D for the nomination!
Nominees for the Big D in Nursing
There are some great blogs listed there under the nursing blog nominations - several that I already follow. Go check them out!
Nominees for the Big D in Nursing
There are some great blogs listed there under the nursing blog nominations - several that I already follow. Go check them out!
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