Me trying to coax a patient to walk (around the unit) and rock (love those rocking chairs) and roll around (on a birthing ball) trying to get some effacement –
Then I hear through the grapevine that the doctor is tied up in the office and wont be by ’til later
The patient says her pain scale is a 10 out of 10…as she watches t.v. and doesn’t seem to realize when she’s contracting…
An hour later she’s crying and kind of like this
But I’m secretly excited because I know she has to be progressing.
It’s lunchtime and I know the doctor will make a pit stop to check on his patient …. whoop! whoop! she’s 4/50/-2 and contracting regularly, every 3 minutes.
The doctor tells me to increase the Pit…I’m reminded that the order is written for a max dose of 42 milliunits. I do not bother telling them that the oxytocin receptors get saturated and I can’t blow a baby out of a uterus.
She’s contracting regularly, so I don’t increase the pit and just keep encouraging her to move around.
The race begins to get her delivered in a timely manner — preferably before the doctor leaves his office at 5 o’clock
I scramble to eat lunch while watching her strip from the breakroom. I’ve never gotten to sit with my back to that monitor, whether or not I have a patient in labor. I’m halfway through when she decides she wants an epidural.
I go get the epidural cart and place it in the patient’s room (to make it easier for the anesthesiologist) and make sure her labs are printed out and on the front of the patient’s chart (to make it easier for the anesthesiologist). I get the fentanyl, set it up in the pump (to make it easier for the anesthesiologist)…just ready for him to review before pressing ‘start’ (to make it easier for the anesthesiologist). I get the patient in the correct position (to make it easier for the anesthesiologist). I’m helping the patient breathe through her contractions. I put a mask on (hallatosis – to make it easier for me). Everything’s ready. I rock.
And then the anesthesiologist tells me they have to check on a cardiac patient first. They’ll be back in 5.
Epidural is in! Working on both sides! I clean up the room while the family is out in the hall (even though I said to wait in the waiting room). 45 minutes later I try to go finish my lunch. I pray that I can finish before anyone decels, decides to get hypotensive, or tells me they feel pressure. The doctor calls. They want an updated vag exam and I need to call them back…STAT (their words, not mine). My food will wait.
Yessss. My pre-epidural-patient-workout-epidural-foley catheter-cocktail worked. The patient is complete!
I reposition the patient left lateral. Call the physician and say the patient’s 8cm. They ask what the pit’s at and I whoops! gotta go! the patient is calling! …and then go to try to finish my lunch ;)
I’ve finally eaten half a sandwich and the patient calls. She feels pressure. I don’t have to check her. I can see she’s complete and crowning.
We talk about pushing one last time…
I play my mood music (Diana Ross’s I’m Coming Out) and call the doctor, the NTN and my scrub tech. I’m ready to rock and roll. The doctor comes in and gowns up. The patient pushes. And her mother does this
and her husband does this
the baby is born! and I do this
And that’s a typical day in the life of an L&D nurse, according to Oprah :)
Ha! My favorite charge nurse would probably say I never miss lunch :) And man, do I love Oprah!!
God knows there are some anesthesiologists that make me groan when I see their name on the board, but the majority of them are amazing and deserve a Nobel Peace Prize (spoken like a true labor and delivery nurse). And in real life, I know that a cardiac patient is higher on the food chain, but when you have a patient crying and screaming and her family is glaring at you because you can’t abracadabra an epidural at will, you don’t care about anyone but your patient and their pain.
Shout out to all my favorite anesthesiologists…especially the one that likes cupcakes as much as I do :)