River's Edge Urban Academy

Homeschooling 4 kids ages 9, 6, 4 and baby while working as a postpartum nurse and lactation counselor.

Sunday, November 14, 2004

Overall work was much better tonight but I baby-received at my first C-section where we transferred the baby. The young mom had all ready lost a 23 weeker and this baby was 36.6 wks. This is the point of pregnancy where being off on your dates by two weeks can make a big difference and that may have been part of this baby's problem, though he didn't really look premature. She had to have a repeat C-section due to having a classical incision the first time and had gone into labor, which is why we sectioned her when we did.
It took a long time to get through all the scar tissue so we were waiting around forever. Once the baby was born they put it in my charge nurse's arms and she ran with it to the table. He was blue, floppy and making no respiratory effort. I was rubbing his back and face and body as hard as I could and begging him in my mind to breathe while trying to appear calm so the dad wouldn't freak. We were about to ambu bag him (same concept as mouth to mouth, but with straight oxygen and more sanitary) when he started weakly crying. We asked the dad his name, and called him by it while we told him to cry. We kept rubbing and suctioning him and giving him blowby O2, and he was very slowly pinking up centrally, but his tone remained completely floppy. We then tried to get an O2 sat on him (measure the level of oxygenation in his blood) but first couldn't find the sensors, then when I ran and got one from another OR had a horrible time getting it to pick up. This whole time we are giving him oxygen and stimulating him (we were by then scratching his feet and being quite rough to get him to cry more). I had to check his heart rate and listen to lungs several times and once got my stethoscope all tangled up in my OR hat and it felt like HOURS till I could get it untangled and out so I could listen. After 10 min of this we called Special Care Nursery down to evaluate him. By then our O2 sensor was working and he was satting anywhere between low 70s (pretty bad) without oxygen to almost mid 90s (good) when I would cup my hand over his face with the oxygen tube in it to increase the concentration of oxygen he was getting. We put him in the transporter and the SCN nurse pushed while I kept my hand inside it with the tubing in his little face.
After I passed along what information I had, I returned to the nursery. At that point I started shaking and was near tears for a couple minutes while I relayed the story to the nurse who'd been watching the nursery for me. Even though I'd been gone for about an hour, she still told me to go sit down and take a break.
Shaking and still near tears I called my mom. I was just going into how scared and dumb I felt when I looked up at the greaseboard in our break room. We often leave general messages to the staff there and someone had written:
Kudos to whoever had the great idea for putting a cut-down hat under the bili goggles, for our babies under lights.
And someone else had written in my name above it. It was an idea I came up with several weeks ago out of frustration with the little goggles our babies under bililites wear to protect their eyes. The dumb things never stay in place and we are constantly adjusting them. Now, I don't actually think it is that big a deal if the things are slightly off for short periods of time, but it REALLY bothers the parents of these babies. One night I got the idea to chop off the top of a hat (since overheating is a concern with these kids) and put the soft band of it over there eyes and the goggles over that. It has met with a really positive response from the other nurses and the parents, as well.
So, just when I was feeling really low and crappy and scared I got a major pick me up. A night nurse mentioned to me the other night that I had written her a little note wishing her a good night many months ago as she was starting what promised to be a rotten shift. She told me that it had meant so much to her that night and that she had taken it home and put it on her bulletin board.
I guess what has struck me tonight is how you never know when something that seems small to you can mean so much to someone else. I hardly even remember writing that note, but it really touched that nurse and helped her through her night. It probably took the nurse who wrote the message on the greaseboard less than a minute to write it, but it made the difference between feeling really rotten and feeling okay to me. It's like that book, "The Five People You Meet in Heaven" which is excellent, by the way.
Well, I requested an on-call for tomorrow after this awful weekend (though very profitable with all the overtime I got). I really hope I get it, cuz I have been fighting a cold for several days, though I haven't really gotten it yet. A quiet evening at home and getting to bed early would probably nip it in the bud, but another night at that madhouse will probably guarantee that I get sick.
Peace.
PS I listened to the new Eminem CD again last night and only love it more. I wonder how many other homeschooling moms there are in the world who listen to Eminem. Probably not too many. I know of one computer guy who claims to but I don't think I believe him.

5 Comments:

  • At 6:08 PM, Blogger Kate said…

    Katy, Great post from a great nurse. I love how you put your heart into your work. AND, I can attest to the power of your post-it-note notes. I still have the ones you wrote to me when I was one of those freaking out parents in the nursery while my baby was under bili lights. Your notes made all the difference to me at a stressful time.

    Kate

     
  • At 4:38 AM, Blogger KatyM said…

    Thanks, Kate. Knowing you has given me more insight into those parents. I can only imagine how difficult it must be to leave my baby in one of those plastic boxes and not be able to take her out and hold her except every three hours. It is easy to lose perspective on that when you are in the nursery with eight screaming babies but I think about you often when I have bili-babies.

     
  • At 12:54 PM, Blogger Anne said…

    Katy, you should really send that suggestion into some nursing journals. You know we nurses love to get good ideas like that. I'm so sorry you had a tough night, but you are a GREAT nurse. And I'd be much more concerned if you weren't emotional about it. It means you still care about your work.

    I was just wondering why stethescopes only get all tangled up when we A) really need them RIGHT NOW or B) are being watched by someone who needs to believe that we know what we're doing!

     
  • At 9:48 PM, Blogger KatyM said…

    Anne - You're right, I've never had that happen with my stethoscope when I was just doing a plain old assessment or when a kid is doing fine.
    Tim - When I used to be at codes (when I worked cardiac) and when I had my first patient die, I always had this urge to just run away. Even when I'm freaked, I now know I can't but I can see why you couldn't read the story all at once - if I could have taken a time-out I would have!

     
  • At 9:53 PM, Blogger KatyM said…

    PS I submitted a version of this to www.codeblog.com. Wish me luck, I'd really be psyched if it was posted.

     

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