So, this blog is supposed to be thoughts from an OB Nurse.... But recently, I've been feeling a little like a Med-Surg Nurse..... You see, when the census is low in OB, we take post-op Gyne patients... Sometimes it will be a hysterectomy or my all time favorite to say in report the "Salpingoophorectomy" AKA removal of an ovary and its fallopian tube...
Anyway, the last few days we've had a low census, so we had about half of our patients being Gyne patients. I was kinda disappointed at first when I saw my assignment...afterall, the whole reason I suffered through four near tortourous years of nursing school (and am still going) is so that I can care for women who are giving birth.... Not women who are loosing their reporductive organs... But, like other things in the past (scrubbing, to name only one), I was pleasantly surprised at how much I didnt' actually mind my post-op gyne assignments.
I've found out that I'm glad I have this aspect to my job as well. I have the opportunity to keep my general nursing skills fresh and sharp with the occassional med-surg assignment...and, I can appreciate more the whole circle of a woman's reproductive life.... Helping women to celebrate pregnancy and birth; then, encouraging them to embrace and accept menopause, whether natural or surgical...it is a new stage for them to acclamate to, one that they may not be prepared for.
I've found that allowing them to talk to you about their feelings in a general way is healing for them... For example allowing the woman to say to me, "I've always loved being a mother" without them having to verbalize, "I'm sad I'm losing my uterus." Listening and understanding is what they remember about you as their nurse, not that you kept their JP drain empty or their SCDs on or their IV going... You know?
I'm still in the honeymoon phase, I suppose. But, I still love my job - nearly every aspect of it - and think every single minute of nursing school was worth it!
Saturday, February 14, 2009
Monday, February 9, 2009
In My Opinion
If you haven't seen the ABC News segment with Selma Hayek in Sierra Leone, then follow THIS LINK and watch the video clip then come back here to read on.
Some facts from the story include Selma's humanitarian trip to Sierra Leone with a push towards erradicating neonatal tetanus, which is often transmitted via an infected umbilical cord stump. Protection from neonatal tetanus can come by sterile birth practices or via a maternal tetanus toxoid immunization during pregnancy. This latter method is what is being focused on here and by Unicef and Pampers. The two organizations have joined together to make tetanus vaccines available to women in need in developing countries.
Some points of controversy with the story:
During the nightline video, an infant is shown taking its last breath, dying from tetanus. The actual death is shown. Secondly, Selma, who is still lactating, breastfeeds a hungry african infant on camera.
Some of my admittedly random thoughts on the story.
It is enlightening to those of us in the developed world to hear of such easily preventable tragedies. Never would we think of packing an umbilical cord with manure or mud....as is done in Africa and other such developing countries, contributing to this horrible death for the infants. Yes, a simple, cheap vaccine can potentially save many babies from needless death. And, think what could be accomplished with the education of those women, teaching the importance of a clean environment for childbirth. It does inspire us to give to help reach the helpless babies in time.
However, I'm not so thrilled with the idea of pamper's "help" being tied to America's commercialism. "If you buy 1 pack of pampers; we will deliver 1 tetanus vaccine." Hmmm, not so heart felt, it would seem.
Secondly, I take offense to the airing of the infant's death on national media. Was consent to air the child's dying breath given by the baby's mother? If so, did she truly understand that it would be plastered across the internet and aired nationally on Nightline? Even if she did consent, is it humane? Is it necessary to make the point? Are we sensationalized enough to expect to see a dying baby in a journalism piece on dying babies in Africa? In my opinion, it was senseless, needless and in poor taste.
Lastly, I have issues with Selma's breastfeeding the infant who was not hers. I am not disputing the fact that breastmilk is superior food for all babies, especially babies living in such plain disadvantage as those on the piece in Sierra Leone. I am just .... shall we say concerned about the details of the act. Was the mother of the infant alive? Did she give consent for the infant to breastfeed? Was Selma medically screened at all? In light of the subject matter, compared to dying of tetanus, contracting an illness from Selma's milk is probably a mute point. However, breastmilk has been shown to transmit such diseases as HIV and Hepatitis.
And, there are established human milk banks designed to do just such screening on donor human milk, which is then made available to those in need. This program is small and in need of promotion and expansion, for sure. Perhaps selma could put her celebrity power behind this established method for the safe distribution of breastmilk instead of randomly picking up a hungry infant and so genersously allowing it to suckle, as was portrayed in this piece.
Again, my thoughts are random. What are your thoughts? I do think that the issue is important.
Should Americans help with the shortage of funds available to vaccinate pregnant women in Sierra Leone? Yes.
Should we go a step further and strive to improve the unsanitary conditions newborns are exposed to? Certainly.
Would it be beneficial for all babies - everywhere - to breastfeed? Absolutely.
Does this journalism piece do justice to any of these issues? In my opinion, No.
Some facts from the story include Selma's humanitarian trip to Sierra Leone with a push towards erradicating neonatal tetanus, which is often transmitted via an infected umbilical cord stump. Protection from neonatal tetanus can come by sterile birth practices or via a maternal tetanus toxoid immunization during pregnancy. This latter method is what is being focused on here and by Unicef and Pampers. The two organizations have joined together to make tetanus vaccines available to women in need in developing countries.
Some points of controversy with the story:
During the nightline video, an infant is shown taking its last breath, dying from tetanus. The actual death is shown. Secondly, Selma, who is still lactating, breastfeeds a hungry african infant on camera.
Some of my admittedly random thoughts on the story.
It is enlightening to those of us in the developed world to hear of such easily preventable tragedies. Never would we think of packing an umbilical cord with manure or mud....as is done in Africa and other such developing countries, contributing to this horrible death for the infants. Yes, a simple, cheap vaccine can potentially save many babies from needless death. And, think what could be accomplished with the education of those women, teaching the importance of a clean environment for childbirth. It does inspire us to give to help reach the helpless babies in time.
However, I'm not so thrilled with the idea of pamper's "help" being tied to America's commercialism. "If you buy 1 pack of pampers; we will deliver 1 tetanus vaccine." Hmmm, not so heart felt, it would seem.
Secondly, I take offense to the airing of the infant's death on national media. Was consent to air the child's dying breath given by the baby's mother? If so, did she truly understand that it would be plastered across the internet and aired nationally on Nightline? Even if she did consent, is it humane? Is it necessary to make the point? Are we sensationalized enough to expect to see a dying baby in a journalism piece on dying babies in Africa? In my opinion, it was senseless, needless and in poor taste.
Lastly, I have issues with Selma's breastfeeding the infant who was not hers. I am not disputing the fact that breastmilk is superior food for all babies, especially babies living in such plain disadvantage as those on the piece in Sierra Leone. I am just .... shall we say concerned about the details of the act. Was the mother of the infant alive? Did she give consent for the infant to breastfeed? Was Selma medically screened at all? In light of the subject matter, compared to dying of tetanus, contracting an illness from Selma's milk is probably a mute point. However, breastmilk has been shown to transmit such diseases as HIV and Hepatitis.
And, there are established human milk banks designed to do just such screening on donor human milk, which is then made available to those in need. This program is small and in need of promotion and expansion, for sure. Perhaps selma could put her celebrity power behind this established method for the safe distribution of breastmilk instead of randomly picking up a hungry infant and so genersously allowing it to suckle, as was portrayed in this piece.
Again, my thoughts are random. What are your thoughts? I do think that the issue is important.
Should Americans help with the shortage of funds available to vaccinate pregnant women in Sierra Leone? Yes.
Should we go a step further and strive to improve the unsanitary conditions newborns are exposed to? Certainly.
Would it be beneficial for all babies - everywhere - to breastfeed? Absolutely.
Does this journalism piece do justice to any of these issues? In my opinion, No.
The State of the OB Floor
So, What's been up on the childbirth front?
My sleeping after night shifts is getting considerably better. I used to have an awful time of sleeping the day after.... Waking up frequently, not getting to sleep easily... Well, that all seems to be changing. My last 3 day stretch of nights went great! I fell right to sleep and slept for hours before waking. In fact, the last night I worked, I went to bed at 9am when I got home and slept until after 4pm that evening before waking up even once! Sleep makes everything better.
I have scrubbed in on c-sections with every doctor with practicing privileges now. So, I'm scrubbing independently now. I still really like scrubbing... It is a surprise to me, but I don't mind it at all.
I am trying to make some positive headway with the one doctor who has been giving me grief. Out of all of the doctors there, every single one of them have gone to my nurse manager telling her what a great job I'm doing and how quickly I learn - every one of them EXCEPT this one particular doctor. I think I've written about him before.... Well, he's still on my case. The other nurses tell me he does the same thing to every new nurse and it is sort of like a right of passage or some such nonsense. Anyway, I think the ground is just starting to thaw, and hopefully his obsession with making my shift miserable will pass soon enough.
I've gotten a string of high risk patients recently, which is really what I need experience with. I've managed several PPROM patients (pre-term, premature rupture of membranes). I've had a stillbirth induction unfortunately, and I attended a birth where the doctor didn't make it....I nearly didn't either as the head was already out when I went in and I caught the baby, literally...clamping and cutting the cord and all.
Things stay pretty busy on night shift for us. The vice president of the hospital came around the other night to talk to us and reassure us that the hospital is still strong in light of the current economic condition. Hospitals all around are laying off and cutting back. Apparently our hospital is still making money and is not in trouble, but the struggling economy is having a trickling down effect -- People are cancelling elective surgeries because they lost their insurance coverage when they lost their jobs, etc... So, the VP informed us that they are putting a freeze on hiring right now. But they do not expect that any layoffs are in the future.
The good thing with a nursing degree, I believe, is that I will almost always be able to find work with it. It may not be in the department I want it to be or during the hours I would like... But, work as a nurse will nearly always be available. Luckily, the VP informed us, that we OB nurses picked one of the safest specialties to practice nursing in, as far as job security goes.
My sleeping after night shifts is getting considerably better. I used to have an awful time of sleeping the day after.... Waking up frequently, not getting to sleep easily... Well, that all seems to be changing. My last 3 day stretch of nights went great! I fell right to sleep and slept for hours before waking. In fact, the last night I worked, I went to bed at 9am when I got home and slept until after 4pm that evening before waking up even once! Sleep makes everything better.
I have scrubbed in on c-sections with every doctor with practicing privileges now. So, I'm scrubbing independently now. I still really like scrubbing... It is a surprise to me, but I don't mind it at all.
I am trying to make some positive headway with the one doctor who has been giving me grief. Out of all of the doctors there, every single one of them have gone to my nurse manager telling her what a great job I'm doing and how quickly I learn - every one of them EXCEPT this one particular doctor. I think I've written about him before.... Well, he's still on my case. The other nurses tell me he does the same thing to every new nurse and it is sort of like a right of passage or some such nonsense. Anyway, I think the ground is just starting to thaw, and hopefully his obsession with making my shift miserable will pass soon enough.
I've gotten a string of high risk patients recently, which is really what I need experience with. I've managed several PPROM patients (pre-term, premature rupture of membranes). I've had a stillbirth induction unfortunately, and I attended a birth where the doctor didn't make it....I nearly didn't either as the head was already out when I went in and I caught the baby, literally...clamping and cutting the cord and all.
Things stay pretty busy on night shift for us. The vice president of the hospital came around the other night to talk to us and reassure us that the hospital is still strong in light of the current economic condition. Hospitals all around are laying off and cutting back. Apparently our hospital is still making money and is not in trouble, but the struggling economy is having a trickling down effect -- People are cancelling elective surgeries because they lost their insurance coverage when they lost their jobs, etc... So, the VP informed us that they are putting a freeze on hiring right now. But they do not expect that any layoffs are in the future.
The good thing with a nursing degree, I believe, is that I will almost always be able to find work with it. It may not be in the department I want it to be or during the hours I would like... But, work as a nurse will nearly always be available. Luckily, the VP informed us, that we OB nurses picked one of the safest specialties to practice nursing in, as far as job security goes.
Still Smiling, somehow
This picture can be our starting point in our Pictorial journey to the orthodontist this year.If you look closely (or click on the picture to enlarge it), you can see the space between little Lance's front teeth. Then, on either side of the front teeth you'll see spaces again. Those spaces are where the incisors are supposed to be. They are in his gums, but there is not enough room for them to come down. So, we've begun the journey to hopefully allow them to come down.
The first visit was last week when he had spacers put in. It wasn't that bad, actually. Then today he had bands put on and an impression made for the expander. Well, today's visit was very uncomfortable for little Lance. And, to make it worse, they didn't want me to come back. They said kids do better if their parents wait for them. Lance seemed ok with it, so I (foolishly) agreed to wait in the waiting room. I'm a nurse for goodness sake, I should have known better!! Poor Lance came out almost crying. I said right then to them that I would be coming back from now on.
Anyway, after some motrin and milkshake, he is doing much better.
This will be a long year, for sure. I just hate that he has to have this done!!!
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