burning_moon117: (Default)
Did you know that the World Help Organization had designated 2020 as the International Year of the Nurse and Midwife? That was something that happened before COVID-19. But instead of celebrating us, this year has been beyond anything I could ever imagine.

I haven't posted since April, it's been too stressful. For awhile, our policies regarding COVID-19 were changing almost daily. Though over the past few months, things have stabilized a bit. And living in California, so many things are still closed or restricted.

At the hospital, my floor (NICU, Mother Baby, and L&D) plus Pediatrics are the only places allowing visitors in the hospital, though in special cases (end of life), visitors might be allowed. All patients admitted to the hospital are getting swabbed for COVID-19. However, at first the testing was taking awhile, then we had reagents (I think?) that allowed the lab in the hospital to process the test in 24 hours, then 4 hours, then 1 hour. However, now we only have a few 1 hour tests left, and those are usually used for stat (emergency) surgeries. Now results usually take 4-8 hours.

Lately, we have 1-2 COVID positive moms on L&D/Mother Baby every day. Though a few times we haven't had any, and our max was 10 positive moms! Our usually patient ratio is 4 couplets (mother-baby pairs) to one nurse. With COVID positive moms, we get a maximum of 2 couplets, and both would be positive, we don't mix positive and non-positive patients. Luckily, most of our positive moms have been asymptomatic. And we are swabbing the babies of positive moms and 24 hours of age, and then some of our hospitalist Pediatricians also want them swabbed at 48 hours of age, if they are still there. We aren't separating COVID positive moms from their babies unless the mom have to go to ICU (from a bad postpartum hemorrhage or from COVID symptoms) or baby has to go to NICU for some reason (cardiac issues, preterm, respiratory distress, etc).

Patients have to wear masks when staff (nurses, doctors, etc) are in the room, and if they are visiting baby in NICU. Us nurses have to wear masks and goggles in patient rooms. In COVID positive rooms, we wear a procedure/surgical mask over a N-95 mask, goggles or face shield, shoe covers, gown, and gloves. Most of us have also gotten our own scrub caps or hair covers. Plus we wear hospital-provided scrubs that we change into and out of at the hospital, and leave them in a hamper in the locker room.

Last month we started to see a lot of moms who had a history of testing positive for COVID, but had been cleared by Public Health and we are to treat them as if they are negative.


We have had moms come in sicker. A lot of patients are having telehealth appointments with their OB, or have stopped receiving prenatal care, so things have been missed. Plus it does seem like our COVID positive moms are more likely to have clotting issues. One mom straight up didn't seek any prenatal care and had 2 eclamptic seizures, which is just so uncommon to see here.

Since I shift lead a lot, I have barely been on the floor. I was on the floor July 4th and had COVID patients, and I was on the floor Thursday, and since it had been 2 months, it was my turn again to take COVID patients. Plus I had an orientee. And then one of our moms tried to hemorrhage at the end of the shift. I was fucking stressed.

One of my coworkers had to quarantine because her husband got COVID from his work. He was sympaotic only a few days after exposure and quarantined himself early, and luckily neither her nor their 6 children got it. Another coworker had to quarantine because her boyfriend got it at his work, though she actually got very sick as well. Public Health cleared finally cleared her to come back, even though she was still swabbing positive, so I am sure it's fine *eye-roll* but finally she swabbed negative a few weeks ago.

I feel bad for other floors. Most COVID patients are going to Med/Surg, Tele, or ICU, depending on how sick they are. And our plan has always been, if we have a mom sick enough, we will send her to the ICU. Pediatrics has even had a few kids with COVID. One night I was working, the ICU had 2 patients die from COVID within a few hours of each other.

At work, we are all burned out/on edge. I can't even imagine how the staff on those other floors feel. I am sure they actually have PTSD from this.

For 2 months, I didn't even go see my parents. In May, I had minor surgery. I had a hysteroscopy, D&C, uterine biopsy, and I had a Mirena IUD placed. The day before surgery, I was swabbed for COVID, and I had antibodies drawn. Both negative. My mom drove me to and from surgery, and stayed over the first night. I figured since I was negative, I wouldn't pass anything on to her. Now, I see them every once in awhile, now that work is providing us with proper PPE. Let me tell you, the cramping from surgery/the IUD has been brutal. And here I am, 4 months later, STILL bleeding. But at least I wont get endometrial cancer, yay I guess.

Most of my friends are nurses, and carry the same amount of risk/possible exposure, so we hang out outside of work. Restaurants in California are closed except for take-out, so we hang out at someone's house. One of Alyse's cats had 3 kittens and they are so cute and fuzzy. Unfortunately, I have been using Door Dash/Grub Hub and cooking less. I just overall have less motivation to cook/clean/go shopping. I do laundry every week though, I have to so I can have clean scrubs.

And now we are in fire season again in California. To the parents who started a fire with a gender reveal party, fuck you. I can't wait until we start getting rain, hopefully next month. Air quality has been shit. A few weeks ago, we had a weird thunder and lightening storm, and the lightening caused dozens of fires all over the state. Cal Fire told Californians to be ready to evacuate. To where? The whole state was on fire. Where I live, it would take me almost 9 hours to get to Oregon, 6 hours to get to Nevada, 6.5 hours to get to Arizona, and 5 hours to get to Mexico. Where am I going to go? The ocean? Though there are multiple beaches within 30 minutes of where I live.
burning_moon117: (Default)
I had 9 days off work, since I was supposed to take 2 classes for work, though they got canceled.

When I finally went back to work on Friday, basically every policy regarding COVID-19 had changed.

Everyone is now wearing masks, patients, care partners, nurses, doctors, aides, RTs, etc in all patient care areas.

Do know how uncomfortable it is? To be breathing in your own moist, hot air for 12 hours? And you can only really take it off for lunch. Well. We take our masks off halfway to drink. But the first night of that, my heart was racing, I checked and it was 144bpm. My face is now super broken out, my nose had a bunch of dried blood after night 2. And the masks give us scratchy throats.

Best part is these are single use masks that are at most good for 2 hours. And we are wearing them 12 hours a day and we are supposed to reuse the same mask for a week. And then we "recycle it" and our hospital will somehow sanitize these masks even though the manufacturer says there is no way to safely sanitize them.

So you could say we're having a really great time at work.
burning_moon117: (Default)
Last week, I worked Tuesday, Wednesday, and Thursday. Friday I went to the grocery store, came back home coughing, sniffling, and I was really itchy, so I am sure it was allergies and not COVID-19. But any time I cough, I wonder, you know?

This week I worked Sunday, Monday, and Tuesday. We had 2 potential COVID-19 patients, both in isolation. I heard one of the local labs is going to start doing their own COVID-19 test? Or processing them closer to home? Not sure. Anyway, supposedly it will go from 5-7 days for results to come back to 24-48 hours, which is much better.

We have been having nightly conference calls at work, each department is supposed to get on, as well as our CNO (Chief Nursing Officer). Plus a few nights, an infectious disease doctor was also on the call. Right now, our protocol for COVID-19 is changing nearly daily. Currently, we have enough PPE. Tuesday night on the conference call they told us we are allowed to wear masks at all times if it makes us feel more comfortable, and we wont get in trouble for it, though they don't want us wearing homemade masks. I heard today that now it is mandatory to wear a mask in all patient care areas.

My county has 99 positive COVID-19 patients, the county to the north, which my city borders, has 88. My hospital is the biggest local hospital and we have 12 positive patients, on ventilators, and 21 potentials, most of whom are on Tele, with the exception on the 2 on my floor. Thursday, the first death in the county was at my hospital.

My floor (Labor & Delivery, Mother Baby, and NICU) and Pediatrics are the only units allowing a care partner/visitor now, and only one. On our floor, it is whoever is banded to match mom and baby, so usually the father of the baby or the mom's mom.

As if that wasn't scary enough, since nearly all my shifts I am shift lead/charge nurse, we had a bad maternal hemorrhage on our side Tuesday night.

The mom's original blood loss from delivery was 275ml I think? She had a clot out that weighed 160ml, but her fundus (top of the uterus) was firm, vitals normal. Then she had another clot come out that was 250ml. For a vaginal delivery, 500-999ml is a stage 1 hemorrhage. I told the nurse that had her to call the doctor while we did more vitals and restarted her fluids. Plus I told the L&D supervisor.

The doctor came and did a bimanual exam to check for clots and 660ml worth of clots came out, so at this point she was now a stage 2 hemorrhage. The doctor decided the patient had to go back to L&D (since they have a lower patient ratio). Then her blood pressure dropped to 81/66 and she got this look, like she was extremely unwell and terrified and like shit was about to hit the fan. They rushed her across the hall, and I kept the baby since the boyfriend/husband was at home with their other children. She ended up being a stage 3 hemorrhage and they put in a Bakri balloon, which is a special balloon placed in the uterus and filled with sterile water. The weight of the water is supposed to stop the uterine arteries from bleeding. An hour or so after she went over, she was stable enough for the baby to go back in the room, thankfully.
burning_moon117: (Default)
I haven't really posted in awhile.

I imagine most people are staying at home, because of what is going on with the novel corona virus. I'm a nurse so I am still going to work and because of that, my normal routine doesn't feel too different? But at the same time it does because on some of my days off, I go see movies or get fast food or hang out with friends. The main thing that has changed at work is that patients can only have one visitor/care partner, and it has to be that one person the whole time the patient is there, and that person can't be sick. So it's been very quiet, even with working night shift, our patients usually have a bunch of visitors.

My hospital doesn't currently have anyone with novel corona virus, though there are 3 people with it in the community who are not seriously ill and are recovering at home. The county to the north of me is going to shelter-in-place as off 5pm this afternoon. And LA and the Bay area have already been doing that. I figure it's only a matter of time until my county also does it.

I hope everyone is doing okay.

Hi guys!

Dec. 8th, 2018 08:31 pm
burning_moon117: (Default)
 Um so..... I haven't posted since September? Really? I could have sworn I posted in March. 

And my New Year's resolution was to post more. Whoops! 

My other resolution was to read more. I actually have done that. After nursing school, I was so over any and all reading of books, even for pleasure. I still read fanfic online though. But this year I have read 16 books and I am currently reading 2 more, so I am very proud of myself. Part of it was I went back to the local library. Basically my card was inactive because I hadnt gone in so long, so I got a new card and have been checking out ebooks from the library, plus reading books I have bought in the past few years and not read, and re-reading a few books. 

Work... is work I guess. Kathy was our boss in my old post lol. She left. Candice and Chris J took over us as interim directors: Candice was our director before Kathy but had ascended to being the CNO (Chief Nursing Officer) of the hospital, and Chris J was in charge of Peds and NICU. After that, our new director was Leila, with Sue from Lompoc Hospital becoming our director under Leila (Leila was senior director, over all the departments- Peds, NICU, L&D, and Mother Baby; Sue was director over L&D and Mother Baby; Chris J was director of Peds and NICU). Well Leila left. It's good she left because we were already going to the union about her. She came from a state without nursing unions and thought she could do whatever and that the CONTRACT the union has with the hospital was just a "suggestion."

So now Sue is our director, and I think she is very much struggling. she came from an incredibly small hospital. She was the director of Perinatal Services over there as well. But. They have 6 LDRP beds  (you stay in a labor bed your whole stay basically, in one room) plus 2 triage and 2 overflow rooms. Whereas my hospital in 28 postpartum beds plus 14 L&D beds and 6 triage beds. And we take a lot of high risk cases while that hospital cannot handle that and sends them out. She is definitely struggling. 

So far I have been there 4 years and we have had 6 directors: Ria, Candice, Kathy, Candice and Chris, Leila, and now Sue. No wonder our dpartments are so shitty.

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).

Profile

burning_moon117: (Default)
burning_moon117

September 2020

S M T W T F S
  12345
6789101112
13141516171819
20212223242526
27282930   

Syndicate

RSS Atom

Most Popular Tags

Style Credit

Expand Cut Tags

No cut tags
Page generated Jul. 17th, 2025 11:58 am
Powered by Dreamwidth Studios