I’m officially turned loose. My orientation at my new job ended yesterday and I’m NERVOUS about being alone. Although everyone tells me that I won’t be alone because there are other nurses around willing to help me. Yikes… My first day on my own is on Tuesday. Wish me luck. I’m hoping that the woman and baby who’s birth I will be attending on Tuesday will be healthy. My preceptors both told me I was doing well but I still have butterflies in my stomach when thinking about everything I have to do. Especially since I had a really hard birth that I did yesterday.
Mom was 400 + lbs and had a chronic back injury. She had an epidural placed not once but twice and was pushing the button heavily by the time I had gotten there. Meaning her legs were completely numb. I arrived for my shift at 7 am with my preceptor and found out that she was complete and ready to start pushing. So… I go in and assess her, let the doc know that we were going to start pushing. Her legs were so sleepy from the epidural that she couldn’t labor on her side or in any other position except for on her back with her legs in full leg supports. She pushed for about 45 minutes with me coaching her and her husband at her side for support. She brought the baby down pretty low, about +2 station if you know what that means when she started to freak out. Her back started to hurt her. I told her that she needed to push her button again if she was hurting. She pushed it and I told her we were going to continue working to get the baby out. She starts screaming that the epidural wasn’t working. So I called the anesthesiologist and asked him to come see her to give her a boost of medication. She’s still screaming and refusing to push so I let her rest until the doc comes to give the bolus. The doc comes in to a horrific scene. The mom is screaming at me to let her stand up which of course she couldn’t because her legs were numb. I had a vial of fentanyl for him which is a strong pain killer. He tells me, “For God’s sakes, give a dose to the woman IV to calm her down.” After a boost of medication in the epidural and one thru the IV, she’s still screaming that her back is killing her. She feels no contractions at all which means pushing will not be as effective. I’m thinking to myself, “This is not good.” I stay with the mom while my preceptor calls the OB and tells him the situation. He comes into the room a few minutes later and she’s still screaming that her back is killing her and that she won’t push anymore. Doc tells her that she has to push. She asks, “Can’t you just take him out?” He flat out tells her that the baby is doing ok for now and that she must push the baby out. He tells her that she’s too fat for a C section and that she needs to show him that she can push so he can use the vacuum. She says ok. The birth ends with the vacuum, Mc Roberts maneuver, NICU nurses, 3 other nurses besides myself and my preceptor, the anesthesiologist, and the OB tech. The baby ends up going to the NICU for low blood sugars and grunting. (Not breathing well). And the kid was over 10 lbs. Ugh… what a way to end your orientation…. What a mess.
Knitting wise, I’m still working on CPH. I keep messing up on the sleeves otherwise I’d be done by now.