burning_moon117: (Default)
 A lot has been going on at work. Our old boss Kathy didn't give 2 fucks about night shift, so even though at the time she left, night shift had lost 7 or 8 nurses, she never hired anyone for us, saying that we were well staffed. And now we have all these people out on maternity leave and medical leave, and more will go out on leave soon. Almost every night I am off, I get a call and/or text asking me to work extra. One week I worked an extra 8 hours on a night off and then another night, came in 2 hours early for a shift. It's exhausting. Supposedly new people have been hired, but most are new grads, so they still have 12+ weeks of orientation to go through.

One reason I haven't posted much lately is that last month, we had a maternal death while I was working. We haven't lost a mom on my floor in 8 or 9 years, so it was very shocking. Yes, we have babies die, but it's something that is known ahead of time usually, due to defects or being very early.

The woman was an antepartum (someone who is pregnant and being monitored closely), 35 weeks pregnant with twins, there to be monitored for hypertension (high blood pressures). She was set to go home that day.

It happened around 12:15am or so. One or both babies came off the monitor, so the nurse, Arlene, went to go in the patient's room and adjust  the tocometers. The mom was on the floor, unresponsive; no heart beat, not breathing. A code was called, everyone rushed up to our floor from the rest of the hospital. Apparently, an ER doctor took over the code, and was so set on bringing the mom back (I believe that she was immediately dead). The L&D supervisor, Alaina, was trying to get him to stop so they could do a c-section in the room and get the babies out. He didn't listen. Finally, they took her to our OR and coded her throughout the section. From the time the mom was found, to the time the babies were out was 20 minutes. Twenty minutes without oxygen, so then both babies were being coded. They coded mom fro 3 hours. At one point she went into DIC, meaning the clotting factors in her blood were used up. Finally, they let her go. The family got there about the time the county coroner did, so the coroner waited an hour for the family to say goodbye.

The room this woman had been in was across the hallway from our nurses' station, so we saw the whole thing up until they took her to the OR. It was very traumatic for all of us there. And the whole family was out in the hallway crying.

The doctors thought maybe she had had an amniotic fluid embolism, but wouldn't know for sure until the autopsy came back.

Later that day, the twins were sent out to another hospital to go on cooling measures for neuro protection. I believe they went to Children's Hospital LA and then later to Cottage. They are still alive, but may have deficits from lack of oxygen.

Turns out the mom had a large clot in her pelvis, and something knocked it loose. It was good that it happened in the hospital, instead of happening at hope. Her man is in jail, so her children probably would have found her and the twins dead in the morning. She had a 16 year old set of twins and a 9 year old.

Shit Shows

May. 24th, 2017 01:46 am
burning_moon117: (Default)
 The Sunday night shift turned into a complete shit show.

I started with a gyn patient (gynecology; she'd had a hysterectomy), and a couplet, a mother baby pair, we'll call then Couplet A. The gyn pt was fine, it was the third night I had taken care of her. The mom of couplet was a post op day 1 c-section. She was getting antibiotics for an infection (she had had a temperature after the section of 37.9*C or about 100.2*F I think). Baby was a shitty eater, he was super sleepy and wasn't doing well at breastfeeding. He didn't even do well at formula feeding. At most I got him to take 5ml (1/6oz). He was on phototherapy for jaundice, in the high risk zone (high intermediate and high risk bilirubin level babies go on phototherapy). Phototherapy can be dehydrating, so it's important for the baby to get nutrition.

Around 8:30pm, I got Couplet B. The mom had had surgery to remove a cyst on the right nipple and the left nipple was inverted, so she didn't even want to try breastfeeding. That baby also was a shitty eater. He took 1ml around 9pm, and another around 6am. His mom and I tried multiuple times during the night to get him to take more. He just played around with the nipple and then got gaggy. Well. He clearly swallowed a shit ton of amniotic fluid; they suctioned 14ml of fluid out of him after the delivery. I think he still had fluid in him making him gaggy. In addition to that, his breathing at birth was so bad they almost took him to NICU. I think they should have; it was fast and very shallow.

Around midnight, mom of Couplet A got another temperature of 37.9*C, and had no plain tylenol, so I had to give her 2 tablets of norco 10/325 to give her enough tylenol. It brought her temperature down to 37.1*C at least.

At 3:30, I was told I was going to get Couplet C, a mom who was post hemorrhage and also post mag (magnesium to treat pre-eclampsia).

She actually didn't come until 5:15am, thank goodness. She had been on mag 24 hours from the delivery, and her blood pressures had been good, however, she had a headache, which is not a good thing with pre-eclampsia, but no stomach pain and or blurred vision, and her reflexes were fine. And baby was fine as well.

However, she had lost 400ml of blood during delivery, and then another 350ml after delivery, and then some during the day, so her total blood loss was 970ml.

Around that time I got the results of Couplet A baby's bilirubin draw from 3am. Another high risk result, and it had gone way up. Our policy is if a baby has 2 high risk results, they should go to NICU for triple phototherapy, if the hospitalist pediatrician agrees. So I call the on call hospitalist ped... and his phone was off, went straight to voice mail, which is apparently a common thing. I was running around, so I got Halie to feed that baby, and she got him to take 20ml, miracle of miracles.

Then I had to take staples out of my gyn patient, because that particular doctor likes staples out at the crack of dawn. However he was already there check on her and decided to have her shower before the staples were taken out. Fine with me.

Finally my supervisor got ahold of the hospitalist ped and the baby from Couplet A went to NICU. Then a doctor pops up from nowhere and checked on Couplet C mom, fresh off mag and a hemorrhage, and decided she could go home.

So I am giving all this info during report to Lauren, the day nurse, when Lab calls with a critical hemoglobin level from the mom of Couplet A. Ugh.

So then I asked later, and it was a shit show for her as well. Couplet A mom had to receive 3 units of blood, and Couplet C mom had an epidural headache, so they had to do some procedure for that. At least Couplet A baby stayed in NICU. But then she discharged the gyn patient and got a fresh c-section. Man, I felt bad. It was just a shitty assignment.
burning_moon117: (Default)
 First of all, I should start with Mother's Day.

My parents decided to do a BBQ on Mother's Day that was part for Mother's Day and part for my dad's birthday. I figured my Aunt Terra would be sad this year since my cousin is married to a guy in the Air Force and they are out in Texas right now, so I got her a pretty good Mother's Day gift: quite a few bath things from Bath & Body Works. I also got my mom bath things from there. After we BBQ'd and ate, I passed out the Mother's Day gift and my dad's birthday gift.

My aunt looked down at the bag I gave her, before she opened it, and said, "How'd you know my mail box was empty??" As in, my cousin didn't send her anything for Mother's Day, didn't even call of text her. My aunt was almost in tears. Needless to say, I was very glad I got her something more than a card.

My Statistics and Sociology classes were done Thursday. I didn't have time to celebrate, since I worked all weekend, and then my first BSN class started yesterday! But I am excited, because work-wise, I am off from Friday to Wednesday, with a 4 hour work class on Tuesday. A whole weekend off, and a holiday weekend at that!

I plan to go eat Thai food with Alyse and Halie on Friday, and we'll possibly also go to Solvang for all the delicious baked goods there. My parents and I might BBQ again Monday, so I will have Saturday and Sunday to do whatever, relax a bit, plus do some classwork.
burning_moon117: (Default)
I feel like I have so much to do.
  • today is my dad's birthday
  • I work Friday and Saturday
  • Sunday is Mother's Day
  • I can get extra credit for my Sociology final (which is an essay) if I turn it in Monday by 1pm; have not started yet
  • take home test for Statistics is due Tuesday
  • welcome call to Grand Canyon University is Wednesday
  • Sociology final is due by 1pm Thursday
  • Statistics homework is due Thursday by 2pm (online)
  • Statistics final is Thursday at 2pm
  • I work next Friday, Saturday, and Sunday
  • I start my bachelor's program Monday May 22nd
I am so exhausted. I have no caffeinated beverages in my house. It's !:30am and I am so hungry.

Burned Out

Apr. 10th, 2017 01:14 pm
burning_moon117: (Default)
Lately I feel as though I am doing a millions things at once. I am working full time nights, and I was being oriented to shift lead; now I actually can shift lead. I am taking a semester long statistics class in person, as well as an 8 week online sociology class. Plus there are shows and movies I'd like to watch and books I would like to read. About 75% of my DVR is full and I am behind on The Expanse and Call The Midwife. And I still haven't watched the latest season of Sherlock (I'm afraid that I will be disapointed).


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