Since being off of orientation I've been put in the rotation of "being pulled" to other units of the hospital if we have a low census and all of the scheduled nurses on OB are not called for. I have gotten pulled twice so far.
The first time I got pulled to a medical surgical floor for a "One on One." This means I was sitting with one patient for my entire 12 hour shift because she was elderly and confused. She kept trying to get out of bed and pulled at tubes/wires, etc. So, needless to say that was a LOOONG 12 hour shift!
The second "pull" was to the Neonatal Intensive Care Unit (NICU). I enjoyed that pull. I got assigned two babies to care for... they were stable and basically needed meds given, monitored, fed and rocked every now and then. Eventually I am supposed to be cross-trained to the NICU... and I think I will enjoy this training.
Since being off orientation, I'm experiencing everything for the "first" time... For example, My first time circulating on a c-section ALONE... my first time tirating pitocin on my own.... etc. etc... Surprisingly, I get a little nervous... I know I can still ask people questions, etc... But I do love my job!
Friday, June 26, 2009
Sunday, June 7, 2009
Deliveries
This past week I delivered a baby! The doctor didn't make it in time and it was up to me to handle the situation. It was only my second night off of orientation..... Mom and baby did well and I realized I was capable of more than I imagined.
It wasn't the first time I was present at a birth the doctor didn't make it to... But previously, I was on orientation and I always had a preceptor with me and I wasn't directly in charge of the safety of the mother and baby. This time was different. It was a very good experience.
It is amazingly more common than I thought that the doctors miss deliveries. In fact, the night I delivered the baby, there was another birth the same night that another doctor missed as well.
It is really a balancing act that the RN is asked to preform. She must be the eyes and ears of the doctor. Manage the labor and inform the doctor of the progress and any complications. Carry out all orders. Then, when it comes time to deliver, the RN has to get the doctor there at precisely the right time. Doctors do not like to come too soon or too late.
The optimal time for a doctor to enter the room is sometime between +3 or +4 and crowning.
One tip I'll pass along to L&D nurses in training: DO NOT break down the bed until the doctor has committed to being in the room. If the birth does happen without the Dr, at least you have the bed there for the baby to slide out onto. It helped a lot not to have to worry about holding onto a slippery wet squirming newborn as I was worried about checking for a nuchal cord and delivering the shoulders, etc.
It wasn't the first time I was present at a birth the doctor didn't make it to... But previously, I was on orientation and I always had a preceptor with me and I wasn't directly in charge of the safety of the mother and baby. This time was different. It was a very good experience.
It is amazingly more common than I thought that the doctors miss deliveries. In fact, the night I delivered the baby, there was another birth the same night that another doctor missed as well.
It is really a balancing act that the RN is asked to preform. She must be the eyes and ears of the doctor. Manage the labor and inform the doctor of the progress and any complications. Carry out all orders. Then, when it comes time to deliver, the RN has to get the doctor there at precisely the right time. Doctors do not like to come too soon or too late.
The optimal time for a doctor to enter the room is sometime between +3 or +4 and crowning.
One tip I'll pass along to L&D nurses in training: DO NOT break down the bed until the doctor has committed to being in the room. If the birth does happen without the Dr, at least you have the bed there for the baby to slide out onto. It helped a lot not to have to worry about holding onto a slippery wet squirming newborn as I was worried about checking for a nuchal cord and delivering the shoulders, etc.
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