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Melanie Bryant was the name, now Melanie Fox. I am a Labor and Delivery nurse working in a rural community hospital. I am the charge nurse on 3rd shift..the shift where the fun stuff happens..and im not talking about IV pole races down the hall way.

June 18, 2005

Update 

Wow, It has been quite some time since I have been here, and to all who thought this was going to be "an interesting blog"....I do apologize. I am still happy and working hard at my job. I have focused so much attention lately on the new house, my husbands business, my career and school...oh yeah ..and knitting. We are on overdrive right now and just returned from a 3 week vacation of a caribbean cruise and visiting the southern folks in knoxville, TN and northern GA.
I returned to work to find that a student from the local university would like to work 3rd shift and shadow me. This is a fairly good opportunity for me seeing how my long term goal is to teach maternal/newborn health at the university level (kids would go to school for free!) The nursing students were on our unit last semester and I was told by thier instructor that she would love to write me a recommendation into the program. I am just not ready yet. I do enjoy working with the young girls though, such an impressionable age. I believe we don't really know what we are getting into until we are out of school looking for that first job. It really hits you the first time you are alone for your first delivery, or the first time you start an IV on a woman who contracts every 2 minutes and is scared. You slowly begin to get very comfortable doing what you have done before ...and then it feels like the whole picture fits. I don't leave work wondering if this is what I am supposed to be doing..I know it is. I only hope every nurse feels that way.

Oh yeah, I wanted to tell a short story about sean, kelly and max.

My mother in law usually doesnt drop names, and I am usually waking up when they come over for dinner...so I barely remembered her metioning this last name to me. I was leaving work at 7am and looked at the name of the woman who was coming to have her baby induced that day. It seemed familiar and I thought..well..I will ask them when I take care them tonight...after the baby was born. Almost all inductions are started at 8am and deliver long before 11pm..when I come on.
I came in at 1045pm and one of my favorite perdiem nurses told me that I had "to take the labor in room 253" because they were "awesome". There was another labor on the floor and I had a choice..I took 253. It was the same family that I had recognized. I was concerned now..."How come she hasn't delivered yet?" ( a nurse always wants to know what our chances of going to the OR are). The other nurse says "Well, she wasn't started until 10am and she just started dilating, she is 5 cm and comfortable with 'the block'." I was ok with that and confident that she would progress....I went to meet her and her family. She had her husband and her mother with her and I felt an instant comfort with this family. They were sensitive and humorous and she was all smiles and pain free right now.
I suddenly remembered my mother in law and the name she may have said and took a chance that they could fill the rest in. Well, to my suprise they could. Kelly (the mother to be) is best friends with my husbands only cousin and is in her wedding this september. Grandma to be knows my in-laws and thier family very well. We all were elated by this one degree of separtation and infact were excited to see each other again at the shower and wedding.
Kelly had had a long day and took 13 hours to get to 5cm. I showed up at 11pm and she was fully dilated by midnight. Max was born after 30 minutes of amazing pushing and kelly and sean couldn't have done it better. I was emotional for this one. It was a pleasure to take care of such a "with it" family and they were so amazing with the whole new parent thing right away. Sean and Kelly confided in me that they believe it was supposed to happen that way..and I want to believe that too!
The funny part about it (for me) is that they all thanked me so much, and I continue to explain to them that I am the thankful one. People like that make it too easy to enjoy your job. The new grandmother even sent my mother in law a long letter expressing her gratitude and how "fortunate" she is to have such a caring daughter in law...aw shucks.

Im telling you folks.....when its good....it's good...
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July 09, 2004

70 hours a week 

You got it..it hasnt stopped raining babies...Im talking about a full house with women delivering in non-labor rooms. Crazy...also going through a move so the computer will be down for a little while. I have not forgotten this blog..I had to "cut back" on my own personal time in order to keep up with work (and saving money)...plus..my stories would lack luster in this frame of mind..hope everyone is well.
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June 11, 2004

Been gone a bit..and busy 

I am sorry that I have been away so long. Busy, busy, busy. We bought a house and I have been working very, very much. My 3 cats have taken to biting each other and 2 of them have needed some serious attention for these bites. (They go unseen for a few days until it has infected underneath the skin) They get frisky with the warm weather...I truly think children would be too much for this house!!
The midwives only have 2 1/2 more weeks at our hospital and then we are down to just 4 doctors. This is going to be bad news for us in the long run and I can only hope that the Doctors decide to change their minds in the near future. They have to approve midwife based practices because they become ultimately responsible for intended normal births that need invasive care. When a midwife patient needs a c/s, the Doctor has to perform the surgery. In my state, there is a shortage of Doctors willing to do this. In other states there are many practices with 3 midwives to one Doctor. It just doesn't make sense.
I just purchased a house...Im stuck here!! On a lighter note, Doctors perform many more episiotomies than the CNM's (cert. nurse midwife) Ok..I tricked you..it wasn't a lighter note!! Until the next time..
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May 20, 2004

How do women go through labor with out medication?
There are the type of women who have no choice..they come in ready to deliver (8cm or more). Then there are the women who are just plain good! I firmly believe that your mind is the most important "muscle" to use in labor. I once had a woman chant "row, row, row your boat" through each contraction, or music, or humming..whatever works for them. Warm baths and jello with friends..that one was fun. There are the girls that put themselves somewhere else and that becomes very amusing..."the hiking path in rockville..the big tree..climing the tree...sun is shining..." I start to feel like I am almost there. I love this job.

When do you know its time for medication?
Ohh..thats a good one. I have several theories on that question. First of all, if you resemble linda blair in the exorscist..then its time for medication. I mean that with all the humor I can display through my blog. Second, some women just need a little IV medication to "take the edge off". All women have different pain thresholds and one can never tell until your there. The women who tend to say "oh no, here comes another one..I cant , I cant..." are going to need extra support. We have a wonderful medication called the "sufenta block" and it works for approx. three hours. It does wonders when women get it at 5cm. Epidurals are common for first time moms, they can deliver medication through the entire labor, regardless of length. They do tend to "weaken" eventually.
I also use the tear factor. When a woman begins to fear her contractions and tears start coming..its time for medication. It is always good to have an IV put in when you get to the hospital in labor. You can ask to have a "hep lock" so you can walk around with out tubes connected to you. When you get back to bed the nurse can connect the hep lock to fluid and give you medication when you need it. If you have this put in when you first get there then you wont have to be "stuck" again when you are really in pain. I let my patients shower with the hep lock in. It is important as a nurse to know I can give her IV fluid or medication easily if needed.

I have rambled enough...good night
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May 17, 2004

Real life.. 

Not that my career in labor and delivery is NOT real life...but it is the focus of this particular blog. And because it appears that the only blog that has caught on..(thanks to my friends at Stephens Place)...is this blog. And to be honest, this is my favorite blog too. I have great plans for this little site. I want fabulous links and soon I will learn how to put photos on the site....I promise to be good to my blog. BUT!! Real life other than nursing has taken ahold of me lately...and I apologize to all readers who look forward to my stories of triumph and truth in my profession, I am now facing a bit of it outside of the hospital.
We have settled our contract and I have decided to stay at my hospital and see it through it's rough times right now. I have been asked to take hold of a new program we have enlisted in. We are now part of a national stillborn study and we have a lot of work to do to get ready to participate. This will keep me occupied at work.
In life. I have looked at 12 houses in 5 days and let me tell you that this sucks..big time. I live in Rhode Island and for all of you who are not familiar with real estate in new england..it sucks, sucks, sucks. Houses that would cost 100,000 in any other state in the country cost 250,000 here. It is absolutely ridiculous and it forces me to ask myself why I am living here! I have my family and friends here. People love this state so much that the houses are mostly being purchased by people out of state. This is a problem in the long term. Our schools are being paid for by people who only live here in the summer. Their children don't attend our schools and now they don't want to pay taxes for that particular reason. Not to mention that taxes in this state are at a national high. Let me also include that as a nurse, RI is the 48th in the country for medical reimbursement costs. That means that 47 other states are reimbursed more money for the same procedure. This country has some interesting ways of doing things!!
Deep breath. We also found out that I may need to take fertility drugs in order to get pregnant, which means that we could have twins right off the bat. That's a lot to digest, we decided to wait a month or two.
This is why my labor and delivery stories have been few and far between lately. I am working for the next 3 nights so..im sure more stories will come.
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May 12, 2004

I love establishing a relationship with a girl who needs help and seeing it through to the end. Today was 25year old Tina's fourth c/s and tubal ligation (tubes tied). Different father with all babies and cocaine positive with this one two months ago. He was healthy...the poor new daddy needed the attention. I taught him everything I knew about newborns..and he was afraid...21. I cant wait to watch him over the next few days. She has already raised three..she's practicly a pro..and that makes him even more nervous. I remind her to teach him how. I walked in one hour later and together they had changed her pads, got her back to bed and changed her dressing. Keep in mind this was a sterile dressing that they put plain guaze and tape in place of...I laughed a bit as I pointed this out to her. Her eyes widened.."shut up"..(we had that kind of relationship). Im not lying tina..but your not going to die...its ok. She smiles. "Will you change it back to sterile dressing?" She is doing wonderful and really loves the little guy..I have faith in her.
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May 11, 2004

How to breath for a baby....101..We call it NALS...aka neonatal artificial life support. It is very serious and we are recertified every 2 years along with a whole heck of a lot of other certifications. Today was my recertification....I dont mess around anymore. The days of being the giddy little graduate nurse are over. I know what im doing and I can go through the ropes. Now?..Now I perfect my style. I tested with sam, I do all my codes with sam. We are known as the dynamic duo...frick and frack. I am the "bad girl" if you haven't guessed. Sam tends to be very textbook and this is important, but I tend to be the critical care nurse. I always answer the ER calls...no one else does. I go down and start an IV on toddlers, and help with codes. I went to nursing school for that shit..I thrive on it!! Other nurses are more comfortable doing only what they know, labor and delivery or surgical patients. I love the hard stuff.
I suppose this is what makes the world of nursing go around. I dont mind taking care of a 3.5lb baby, others wouldnt go near that with a 10foot pole. I hate dialysis, my friend scott loves it.
I am not getting what I want from my current job and so I have applied for other postions. The only one I really wanted was not given to me and infact given to someone with much less experience than me..no labor and delivery experience to be exact. But you need to hear this wonderful rationalization..ok..here I go....
I believe in Kharma..and I know that this happened for a reason. I was going to take a big chance by leaving but it was going to be in the same field but second shift. (Im growing tired of third). I will now work perdiem for the new hospital and get my feet in the door. My mission is to show them what a good nurse I am and slip me in to the next second shift position. I also have some seniority at my current hospital. I am trying to get pregnant myself and also trying to buy a house. I may try to eliminate some of my goals. It seems to be a bit overwhelming. Until then...babies will still come at my hospital.
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