Month: September 2008 (Page 1 of 2)

Swoon.

Yes, I’m very distractable when I should be studying for my final test. But when you’re reading sentences like “Lochia rubra lasting longer than 2 weeks postpartum is highly suggestive of sub involution. Some women report scant brown lochia or irregular heavy bleeding. Leukorrhea, backache, and foul smelling lochia may occur if infection is a cause,” you need to take some time to not think about vaginal bleeding.

Sometimes putting on a big sweatshirt and fresh socks can make you feel a lot better about the world.

Toward the end of September is the time to start thinking about Halloween costumes. Why so early? Because inevitably I go all cosplay crazy and need lots of time to A. Make it happen or B. Talk myself out of it. Luckily this year I have it all figured out:

Ah ha hah aha ha. Right. But I do like her hat. And I entertained the notion of being a tired/dead nurse with copious body fluids on her but Brian informed me that that would be “The Lamest Costume Ever.” Here are some other characters that have crossed my mind as cosplay-making goldmines. First those that must be done in pairs:

Amanda and me as the red and white queens. Oh, how I would love to be Carol Channing. NOT AFRAID OF MARMALADE!!! Then there’s sweeney todd and Mrs. Lovett, particularly the beach scene. Can you imagine making that though? I would have to wear it to the beach one day. And we can’t forget the Doctor and Donna Noble, again with Ben filling in the partnership. But where am I going to find a brown pinstripe suit and trench coat in his size for under 10 bucks? Next we have some solo costumes.

Jem, Lindsay Funke, or Patty O’Green. Eh. I feel like these have all been played and/or they would be too difficult. I need something fresher, funnier, and simpler. Time and money just do not allow for much creativity this year. I’ll probably be a ghost. Sigh.

I was assigned to the NICU Wednesday. It was pretty boring because for the most part you just let the kids sleep so they can rest and grow. We do assessments every two hours, alternating doing a hands-on assessment and just taking vitals off the monitors. You want to disturb them as little as possible because it’s stressful. We had a little girl born at 27 weeks (her mother was getting sick fast with high blood pressures) who was on her second day in the NICU. She was under 1 pound. She looked more like a fetus than a baby since she hasn’t put any fat on. Just a large head and skeletal body with frail muscles you can see under her skin. She was getting her nutrition through a central line in her umbilical vein and was breathing on a ventilator. We had to suction her trachea a few times for fluid build-up. She was also hooked up to an ECG, had a pulse oximeter on her foot (that you have to switch feet each day because the little light can burn their thin skin), and a temperature probe stuck to her belly. It must be frightening for parents to see their kid like this. She was on a bed under a radiant warmer and pumped in moist air to keep her from drying out. They use saran wrap over the bed to keep the air in. I guess the fancy “giraffe isolette” was being used by another preemie who was not so badly off but was born first. I loved taking care of the little girl. She was so completely helpless. When she cried it was soundless because of the intubator. Kind of surreal.

Thursday I was assigned to Labor and Delivery. First I did a transition for a newborn c-section just before I started my shift. I gave the baby its first bath and took vitals every 15 minutes. I also gave it the vitamin K shot and put in the eye ointment – those little guys can screw their eyes shut really tight! I saw a beautifully easy birth at 10 am. It was the second in the family. The mom had an epidural and just breathed out her boy in less than 5 minutes once she started pushing. The umbilical cord was crazy long. The midwife was so impressed that she had someone get a tape measure. 44 inches! They’re usually 14-18 inches. I helped a spanish-speaking only (SSO) patient who was having a natural birth. Nooooo thank you. Compared to that gorgeous epidural earlier it was clear which way I should have my first. I really have no motivation to try natural. I hoped to stay through her birth but it was taking much longer than planned (she was already fully dilated) and I wanted to see the c-section at noon. I heard it took another hour and a half after I left before the birth. The c-section was great. I love watching surgery. When they take the uterus out to sew it up I thought it looked just like a roast chicken with its neck sewn full of stuffing, with drumsticks/fallopian tubes on either side. Like I said before, I spoke with the first assistant RN who assisted with the surgery. She told me all about the surgery, the tools, the healing, and her education to get to that role. I tooled around after lunch following a nurse on an antepartum patient. I dropped in for another vaginal delivery, seeing just the end of it up to stitching up the mom. I have to admit by that point I was getting kind of bored with deliveries. I feel the same about c-sections. It was a cool experience, but you’ve seen one you’ve seen them all.

One week to go and I’m done with OB.

Ben has taken up his blogging pen. That’s a link to his new site and I updated the link on the right side of this side as well. Please add him to your usual internet browsing!

This week in clinicals was great but I’m pooped and don’t want to get all worked up writing about it on this here blog. My legs are moaning with ache – I’m not sure if it’s because I couldn’t find my compression socks this morning or because it’s the end of two 12 hour days. I was ravenous and exhausted when I got home a couple hours ago. Now my tummy is full of tacos and my veins are coursing with happy diet coke, my legs up propped up on pillows and I’m catching up on two days of internet hoo ha (whoa, 700 BILLION?). I hope to write up my experiences tomorrow, but I may not get to it. Then the weekend will be here and I won’t every get around to it. That happens. Basically I’m writing now to at least say hello, so I don’t feel too bad about myself for not writing later. If you’re a bored passer-by on my blog, entertain yourself by figuring out what this is – I talked to a Certified First Assistant RN today (she was so cool!) and she talked about this:

Did you know that fish, stage make-up latex, and dog butt musk share the same unpleasant scent?

My hoodie stank so I washed it. It still stinks. It smells like alkaline chemical, like the stuff I used in darkroom. I haven’t been in a darkroom in 8 years.

Question posed on another blog: What are your most re-watched movies? In no particular order:

The Princess Bride
Star Wars Return of the Jedi
The Lord of the Rings (all three, plus bonus features when I’m sick)
Singin’ in the Rain
Rushmore

TV shows?
Arrested Development
Seinfeld
Friends
Family Guy
Spaced

LD was very slow today with only 4 laboring patients, and mine was the only one who looked like she would deliver during our shift. The other student and I faced off with rock-paper-scissors to win the patient – I was lucky to get her. She was very sweet and pregnant with her first child. Supportive family was there the whole time. She delivered vaginally with an epidural and episiotomy. The pushing was only 20 minutes long and not nearly as gross as I expected. I followed her the rest of the day until she went to the post-partum unit.

I got to check her cervix (or attempt to – it’s very gooshy and confusing in there), remove her foley catheter, and assess the newborn after an hour. I helped her get the baby latch in order to breastfeed. I even got to put in a straight catheter to empty her bladder just before she left the unit. So even though it was a super slow morning and I sat around waiting for a long time I got to do a lot of fun things in the end. (Yes, inserting catheters is fun!).

The birth was totally exciting and happy. We were a little worried about the fetal heart rate, lots of decelerations during contractions. My nurse surmised that the cord was wrapped around the baby’s neck and she was right. We worried that having all that trouble would exhaust the baby before she could be pushed out. But pushing labor went fast enough (20 minutes) so there weren’t any real problems. The placenta came sliding out quickly with a waterfall of blood behind it. The placenta had a marginal cord insertion site so that was cool to see. I would have liked to look at it closer with better lights, but I decided it might be inappropriate for me to sneak off with the tub and poke and play with it. They might think that was weird 🙂