Power

My nails are in dire straights. They are in need of manicure. I attribute most of their deterioration and malformations to last night. The soap in the waterless soap dispensers and the multiple uses last night are partially responsible, and my use of them as tools in opening IV med packets, vials, and for mechanical usage sucks up the rest of the liability.

Last night, or shall I report it to be early this AM because most of the action occurred just past 3AM, was a bit on the nutty side!

I went to work still congested and not feeling 100%. Helped deliver a beautiful baby boy @ 2309. The laboring and delivery was easy. Both parents were a joy to coach, concerned but not needy or whiny. Mom was a total trooper. I pushed with her just a bit past crowning and then called the doctor in for the delivery. Everything flowed just as text book delivery. This was all fine and dandy with the exception of a crabby post partum nurse who didn't feel like going above and beyond for her patient.

By 1AM it was just seven of us girls in the unit and one patient whom was just present for observation but not in active labor. We took turns with lunches, stocked the unit, swapped children stories and then the hour came. 3AM. The charge nurse had to let go of some of the nurses at this time because there was not justification for having the low patient to high nurse ratio. Two nurses joyfully left the unit, home bound to a nice warm bed. Not more than 15 minutes following the departure of our two sacrificial ladies, do we have the arrival of three pregnant moms all seemingly in labor. I needed a cough drop. My throat begin to hurt but as the world of nursing goes, the nurse comes second. I had to call down to ICU to find someone to tube me a cough drop, thank goodness I have friends in the right places!

While mom one and two are being assessed, triaged and put to bed, I find myself running from room to room assisting. I pop my head in the first room and the nurse states, "Yep shes ruptured, we need to admit and start an IV, she is also going to be a C section and she is already 6 cm." (this means we have to go into the operating room almost immediately and have the patient prepped and ready in 30 minutes)

I take note of the needs of nurse one and go across the hall where I literally run into nurse two who states: "she is ruptured and shes 8cm and feels like pushing and this is baby #3." (this means nurse two has the fastest moving patient) The adrenaline slams and I run down the hall to get the IV for nurse two as well as the birthing kit and any other equipment we might need when my charge nurse comes running down the hall and says: "we have a possible parking lot birth and Julieann you take the patient that just walked in!" I call another nurse to assist with nurse one and two and I go up to the front to assess the new patient. Unfortunately the housekeeping supervisor has decided that this is a grand time to wax the floors in labor and delivery and I have to hurdle over the ultrasound machine and IV pole and a wheelchair that he has convinently placed in my way! I will tell my supervisor about this one!

New patient does not seem to be in any pain but her pajamas are wet and she states that her water ruptured. I decide to ask her how it happened, because you can gather the accuracy from a patent's story most of the time and depending up on what they say it could have just been that they urinated on themselves, in this case it was most likely that her membranes had in fact ruptured, from the wet spot on her pants and the story.

I get the patient into bed and swab her vagina with nitrazine. It turns blue, most likely she is ruptured. I put her on the FHR monitor and the TOCO to assess for contractions and she is in fact contracting. I'm already on page five of the assessment and complete with the physical part when I look down at her belly again. Something is strange. I do Leopolds maneuver one more time just assessing her abdomen and pregnant belly, when it strikes me, she must be breech. So I ask her, "Where you ever told that your baby was breech, positioned with the head up?" She says to me, "Oh yea i forgot to tell you that, I'm breech so I'm scheduled for a C section next week." I smile but on the inside I really really wonder how and why this situation actually exists...it makes me cry on the inside out of frustration. At this point I have to do a vaginal exam and hope to God that I don't find a leg sticking out of a vagina. So i put her in trendelenburg position which is tipped with her head towards the ground at an angle and I preform my vaginal exam...and oh yea...there is a foot in there. Luckily she is only 3cm and the cervix is still closed enough to hold those little toes in the uterus. I call for whoever can hear me and tell them to call the MD stat. I finish assessing the patient, the OR is prepped and before you know it we are rolling.

The OR goes relatively well with the exception of a new RN who decides to assist me with the preparations. After everything is about done she asks the scrub tech and I, "What do you guys need?" The scrub tech and I both look at each other, exchange exasperated glances and then look at the new RN and shout in unison, "THE DOCTORS!" She runs out of the OR to tell the doctors to go ahead and scrub in. At this point I laugh, as it is the only thing left to do.

The rest of the procedure is fine. I take the patient to the recovery room. No vomiting, no hemorrhaging, vitals are stable, all is well and it's nearing the six o clock hour! She is also denying pain and allowing me to do fundal massage! Wow!

I get called out of recovery to assist some of the other RN's with starting IV's and moving patients when I find one of the patients to be an old friend and supervisor from ICU! Awesome! We chat for a while because frankly I need a break and its always refreshing to have this person to talk to as she shares the same sarcastic dry sense of humor that I do in the work place. We chat and I actually get to take her into the OR but that is where I depart.

I report off to the oncoming nurse who thinks it is funny to make jokes about charging me $5.00 for her to do HER job. She is one of the nurses that always leaves unfinished work for me to clean up and never stays over to help. I suck it up, smile, and I stay over and assist her hoping that she will learn from my gracious actions. A girl can hope right?

I'm home. I survived. I needed that night back at work. It reminded me that i love what I do despite the insanity behind it and the fact that it can be chaotic. The feeling of helping bring a life into the world is why I adore my job and what keeps me happy but the laughter, the companionship and being part of a team that can do amazing things is why I continue to do my job.

Being a witness to the abilities and natural orchestration of 5 completely different women in an overwhelming situation touches me deep down. There is something magical about knowing the power and strength behind seemingly gentle hands and hearts. Then after all of it is over and there is no more need for the display of these powerful qualities, the women tuck them away with grace, humility and thankfulness and smile understanding the paradox of how small it all is in the grand scheme of things.

A warm shower now beckons. Then the browsing of magazines that just came in the mail until my eyelids fall heavy with sleep.