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Home » labor nurse

Labor Nurses: Do You Have a List?

May 30, 2017 by Patti 4 Comments

tear drop on leafCalling all labor and delivery nurses: do you have a “list” at your hospital to determine which nurse is “up” for the fetal demise coming to the labor unit? Do you rotate a demise assignment based on seniority, date order of who did it last, or do you assign the patient to somebody you think is good at this sort of thing? Or is it like every other assignment – you get what comes in, regardless of who did what when?

Lists.

Nurses have lists for everything. There is a seniority list (for holiday and vacation rights), a pull list for who got sent to another unit when, a list for who gets to go home in a snowstorm and who has to stay. There are sign-up lists for party food, who put money in for lottery tickets, and a list of who wants to order out. And a demise list. I like all those lists but the last one.

I hate that list.

What if you were the patient with a perinatal loss and you heard the staff fighting over which nurse should get the dreaded assigment? I daresay you would be appalled.

We’re nurses. We are caring, compassionate, and trustworthy. Patients and families with perinatal loss trust us to see them through the horror. They trust us to handle the tiny body with respect, photograph it, take footprints, get a lock of hair, measure and weigh it, swaddle it, then stay with them while they say goodbye. We have to support them during one of the most difficult events in their lives.

Nobody likes to go to the morgue and place a baby in the chiller. It’s horrible. It sucks.

Life and death.

Life comes with death. Granted, the death part is a less often in labor and delivery than it is on a medical/surgical floor, emergency room, or one of the intensive care units. Do the nurses in those areas keep track of who had the last patient death and make assignments based on the risk of which patient might kick the bucket this shift? I’ve worked at many hospitals in many specialties, and I’ve never heard of it before. Only in labor and delivery.

We are all going to die one day. I hope the nurses taking care us aren’t fighting over who should get stuck with the assignment.

I’ll do it.

Supporting families experiencing sorrow are some of the highlights in my career. Give me the assignment every time there is a fetal demise or non-viable infant due to deliver. I care about and for all patients and families, in the joyous moments and in the depths of their sorrow. It is why I became a nurse.

I’d rather take all the depressing assignments from now until I retire, lest these patients get stuck with a nurse who doesn’t want to do it, can’t handle it, whatever. Because if I can give even one moment of solace to a family in despair it will be worth it.

Nurses, spill your guts.

Do you have a list where you work? Do you like it? Hate it? I want to know how the rest of you feel.

 

 

 

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Filed Under: Labor and Delivery, Nurse Tagged With: fetal demise, Labor & Delivery, labor nurse, nurse, nurse problems, perinatal loss, RN, the list

April the Giraffe Labor & Delivery Live Cam – Addicted!

March 3, 2017 by Patti Leave a Comment

April the GiraffeeApril the giraffe is due to give birth at any moment. I’m hopelessly addicted to watching the live cam, waiting for the big event to happen. Sure, I could watch the video after the fact, but there’s something about witnessing a live birth as it happens. It must be the labor and delivery nurse in me.

It must be the labor and delivery nurse in me.

Labor and delivery and the birth of a new life fascinates me. Even after 30 years working as a labor and delivery nurse I still tear up and get emotional when a baby is born. Any kind of baby – human, animal, egg hatching, etc.

Addicted.

My name is Patti and I am an addict. I’m addicted to labor, delivery, and birth. I work as a labor and delivery nurse, I watch shows about labor and birth of all kinds of species, and I’m especially addicted to watching live cams. My current addiction is to April the giraffe. She’s due to give birth at any time.

Previously, I watched (was addicted to) Katie the giraffe’s live web cam as she gave birth to Kipenzi in April 2015 at a Dallas zoo. When she was pushing I wanted to shout “Well done! Well done!” in a British accent as the nurse-midwives do in the PBS series Call the Midwife. I watched Katie and her baby for months on the giraffe cam. When baby Kipenzi had an accident and broke her neck, dying instantly, I was devastated.

Before the giraffes there were the eagle cams (eaglets are so cute) and the panda cams. Any impending birth or hatching cam.

I need April the giraffe to birth her baby already so I can get back to my real life!

April the giraffe.

You can join the birth watch of April the giraffe on YouTube – the link can be found at www.aprilthegiraffe.com.

 

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Filed Under: Labor and Delivery Tagged With: addict, April the giraffe, Labor & Delivery, labor nurse, pregnancy, RN

Worst Day /Best Day of my Nursing Career

August 4, 2016 by Patti 3 Comments

worst/best day of my nursing careerLast week a question was posed to me on Quora : Can you tell me about the most stressful incident that happened in your nursing career? It got me thinking about the worst day and best day in my nursing experience. Although I don’t dwell on the bad times, I never forget them (as I mentioned in Running into My Labor Patients in Public and Working as a Labor and Delivery Nurse).

The Worst Day of My Nursing Career

I admitted a woman to the labor and delivery unit. She said she was 26 weeks pregnant and didn’t feel the baby move. At 26 weeks gestation (a picture, not for the faint of heart) the mother should feel the baby move often. Though it is too early for formal fetal kick counts, most moms know the patterns of their baby’s movement.

I turned on the fetal monitor and attempted to find the fetal heart rate. My own heart sank as I palpated her belly, looking for a likely spot to place the monitor. Her belly wasn’t firm and rounded, but soft and without tone. I couldn’t locate fetal heart sounds. The patient was becoming more distraught with each passing second.

I summoned one of our obstetrical residents and he came in right away with an ultrasound machine to look at the baby’s heart. I held the patient’s hand while he performed the ultrasound. The heart was still – an intrauterine fetal demise. It would be stillborn. We can use whatever medical terms we want, but in the eyes of the mom, her baby was dead. It was heartbreaking.

She cried. I stayed with her. She called her husband and family to come. I stayed with her, and also with her family, while the patient and her family grieved over the news.

When the initial shock eased somewhat, her physician explained what had to be done: induction of labor. She’d give birth, as usual, but there was nothing usual about it. The baby was dead. And she had to deliver that dead baby. The doctor explained what would happen, but it was the nurse’s job to carry it out (me). Draw blood, start an IV, give medication through the IV to bring on labor, see that her pain was controlled, push with the patient until delivery was imminent, receive the baby at delivery, and do post-mortem care. And, of course, provide emotional support for her and her family.

Meanwhile, I needed to ask the patient many emotionally difficult questions required by the State for filing the fetal death certificate. I also had to explain the “disposal” options, the autopsy options, and ask whether she (and her family) wanted to hold the baby. After the birth, I would need to try to make the baby presentable – clean it, take footprints, pictures, get a lock of hair, weigh and measure the baby, and swaddle it for mom to hold (and somehow prop up the chin, which invariably hangs slack). And the saddest part for me: later taking the baby to the morgue and placing it in the refrigerator.

The patient and her family (there were six or eight sisters and aunts present in addition to her husband) understood the baby was dead, and by the data obtained from the ultrasound measurements, it was likely the baby died a week or so ago.

Her labor was mercifully quick for a first-time mom. Her extended family remained present for support of their loved one (I never left the room except to obtain medication or supplies). She pushed a few times, and her baby boy slipped out. It was obvious to me, by the condition of the skin, that it wasn’t a recent death. Otherwise, the baby was perfect. They all cried. So did I.

I received the baby and put him in an infant crib. The patient previously requested I do all of the post-mortem care in the presence of her and the family.

And then …

What Made it the Worst Day in My Nursing Career

The patient screamed. I expect a patient in this situation to cry, and maybe scream in grief. Then the whole family screamed. They screamed at me:

“Do something!”
“Why aren’t you doing CPR?”
“Get one of those breathing bags!”
“You’re not trying to save my baby!”
“Oh my God, she’s letting the baby die!”
“Why aren’t you calling a pediatrician if you don’t know what to do?”

It was mass chaos. They were screaming all at once. I was frozen. There was no saving to be done, and I couldn’t abuse that little body with pretending. They expressed understanding beforehand – the baby was dead, probably for quite some time. I guess they were not able to process in their hearts what their minds heard.

I have never felt so useless, so helpless, so inadequate as a nurse in all my life.

It was nearly the end of my shift. I functioned like a robot, doing the post-mortem care and handing the swaddled baby to the mom. Her family gathered around and took turns saying hello and goodbye to their family member. At some point the screaming stopped. I don’t remember when, or what I said to them. Traumatized by my inadequacy as their nurse, I cried the rest of the night at home.

Their grief was greater than mine, I know that. They not only lost a baby, but the hopes and dreams of the man he would become and how their lives would play out. I’d only lost the notion and confidence that I was a good nurse, able to care for families in a way they need and make a positive difference in their lives.

The next morning, I dreaded getting up and going to work. But then something beautiful happened…

The Best Day of My Nursing Career

When the charge nurse gave out the assignments to start the day, she said the patient I had yesterday requested me as their nurse. It must be a mistake, I thought. So with a heavy heart and zero confidence, I went down the hall to the patient’s room.

The family was still there – they’d stayed all night with the mom. When they saw me they crowded around me, hugging me. Tightly. The patient thanked me for my care during labor and delivery, and said she would not have been able to get through it without me. Her family members each in turn thanked me for the caring and support I showed them during the ordeal. They said having me as their nurse made all the difference in their ability to get through the day and their thankfulness and appreciation knew no bounds. They couldn’t have done it without me. I made a difference in their lives, they said, and though they were grieving together they also had joy in their hearts for what they thought was the best care in a bad situation. And the mom said if it never happened, they would never have met me, and known how kind and caring a soul could be.

And those few words made my day, and made that day the best day of my nursing career, ever.

*Details were changed to protect privacy (no HIPAA violations).

 

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Filed Under: Labor and Delivery, Nurse Tagged With: best day ever, birth, fetal demise, Labor & Delivery, labor nurse, nurse problems, nursing career, RN, stillbirth, worst day ever

When is the Baby Coming?

April 5, 2016 by Patti 1 Comment

When is the baby comingWhen is the baby coming? I have the answer. And I will tell you. I promise.

The Questions

When is the baby coming? My labor patients, their families, and friends ask me this question all the time. Sometimes it is incessant. The same thing asked a variety of ways:

What time do you think the baby will be here?
Let me ask you something, what time will the baby be born?
How long is labor going to take? What time will he/she arrive?
You’re a labor nurse, you must have some idea when the baby will come, right?
When is the baby coming?

What the Labor Nurse Thinks

If I had a penny for every time. . . . .

I don’t have a crystal ball. I can’t see into the future. Yes, I’ve been doing this job for 30 years. No, it doesn’t help me make predictions. It could come in two minutes or two days. It depends on lots of variables.

Variables

The number of variables to the progression of labor and delivery would fill a book. Here are just a few:

Is labor being induced? Are you due? Overdue? Did your water break? Is there meconium? Is your baby showing signs of fetal distress? Is the baby in the vertex position (head down)? Do you have preeclampsia? Are you bleeding heavily? What is the estimated fetal weight? How dilated is your cervix? Is it effaced? Are you a good pusher?

Do you have patience? These things take time. There is no need to beg for a c-section because you are tired or because you think it is taking too long. You’re going to be a parent. You will be tired for the foreseeable future and then some. And you will surely need patience. Time to start practicing.

The list of variables goes on and on.

Labor Defined

Are you actually in labor? Dilated? Six is the new three when defining labor vs. Braxton Hicks contractions. Here is the current definition of labor.

When is the Baby Coming?

I know and I did promise to tell.

The Answer

When it gets here.

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Filed Under: Labor and Delivery Tagged With: birth, Labor & Delivery, labor nurse, pregnancy, time, when

Labor Nurse – IAmA AMA

July 15, 2015 by Patti 1 Comment

Reddit: IAmA AMA Labor Nurse

reddit.com

/r/IAmA

I’m a labor and delivery nurse. Two years ago I hosted a discussion on the Reddit IAmA/AMA (I am a…ask me anything) site. The topic was “I am a labor and delivery nurse (RN) – ask me anything”.  It was great fun for me, but I realized  people have many questions about labor, delivery, pregnancy, or a career as a labor nurse, but there was nobody they felt comfortable asking.  Some were just curious.

You can read the reddit session here. The session is closed, but I’m still a labor and delivery nurse.

If you have any questions about pregnancy, labor, delivery, or becoming a labor and delivery nurse, or would like me to post on a particular aspect, ask in the comment section below.  I’d be happy to provide answers, give you direction for more information, and clear up anything on your mind.

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Filed Under: Labor and Delivery, Nurse Tagged With: Labor & Delivery, labor nurse, pregnancy, RN

Welcome!

I'm Patti Turner, labor & delivery nurse by day and writer by night. I enjoy writing fiction, reading, cooking vegetarian food, traveling the world, and photographing everything. Read More…

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