The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Silence Is Not Always Golden

Posted by isntshelovlei on May 3, 2010

Our last OB clinical was yesterday—there really was a light at the end of that long, dark tunnel. I really didn’t think I could take another day on the postpartum floor so I was glad when my instructor said I could go to the NICU. But it’s never a good sign when you get there and the charge nurse presents you to the nurse she’s assigning you to and tells her, “I’m sorry, I have to give you a student today.” WTF?!? And like I wasn’t even standing right there! The nurse kept a straight face but you could tell she was less than pleased. So there I was, only there for about 60 seconds, and I was already turned off to the whole situation and ready to leave. You have TWO whole patients who sleep 98% of the day anyway, what is the big damn deal? Lord forbid I keep you from your sticky buns and trash mags…  

But I took a deep breath and kept it moving. It was the last day, and I was determined not to feed the trolls. I did the eternal scrub up to my elbows just to be able to enter the unit but was not allowed to touch anything—not  a chart, not an isolette, and certainly not a baby—for five-and-a-half painful hours. I should have brought a crossword puzzle or something. I’m really starting to rethink my desire to be a NICU nurse. Not because of the less than stellar experience I had (because the nurses in the NICU where I volunteer are great), but because I’m starting to think it’s just not enough excitement (patient care/interaction) for me. I know that some people like relaxed jobs where they sit around and don’t do much, but if that’s all I wanted to do I could have went to school for envelope stuffing or something. The most interesting thing that happened all day was two incidents where fentanyl (big time pain med—100 times more potent than morphine) syringes came up to the unit completely empty. But they weren’t just empty syringes. They were actually drawn up to the dose that was supposed to be in them but there was nothing in those chumpies but air. Gone unnoticed, that would have been one hell of an air bubble… Freak pharmacy thing or…you fill in the blank…

Though it’s no secret that maternity wasn’t my favorite rotation, our last moments in OB will forever leave a footprint on my heart. As we walked through L&D we could hear a woman in the actual pushing stage of labor. And she was a-hollering—totally to be expected when you’re pushing something the size of a watermelon out of a hole the size of a lemon. She had the nulliparous students in the hallway cringing at how much pain she apparently was in. So she’s in there screaming and you can hear the nurses encouraging her to push. There was a climax of activity/noise and then all of a sudden it was quiet. Since we were not actually in the room and able to see what was going on, at first when you hear the woman stop screaming you figure okay—the baby is out. But then you slowly start to realize that it’s too quiet. The critical thinking wheels start to turn and you ask yourself why isn’t the baby crying? Next thing I know they were calling for a neonatal crash cart… 

…dystocia…nuchal cord x 2…baby completely blue…umbilical cord separated from the placenta…blood everywhere…

When you work in health care you will sometimes see how even in a beautiful situation such as a new life being brought into the world, things do not always go as planned. Always count your blessings.

5 Responses to “Silence Is Not Always Golden”

  1. I’m sorry that you have had bad experiences lately. That was crazy how they treated you in the NICU. My heart would have broken to be there for that birth. When I hear about things like that I wonder if I am going to make it.

    You’re all done though right? Breathe and put it behind you. 🙂 What’s your next rotation?

    • isntshelovlei said

      Yup–maternity final tonight and then I get a whole week and a half off before it starts all over again. Summer we’re taking “Care of Older Adults” (oh boy…) and Pharmacology. Fall I believe is Peds and Mental Health…

  2. nurseXY said

    My OB clinical is in a small regional hospital. My day in “NICU”, we had 1 baby, who had been recently extubated–5 days ago, (intubated and extubated the same day–think maybe someone jumped the gun?). Can you say feeder/grower? I actually went to Bed Control and the charge nurse meetings because it was so boring. I had finished my assessment at 0800, and the next intervention was at 1300, the next assessment.

  3. A Nurse said

    Hey, too bad you got a cranky NICU nurse. They tend to be on the cranky side anyway… pay them no mind. 😉
    I like students….I think it is good to encourage the new nurses-to-be since old ones like me aren’t gonna be around much longer.
    And by the way, more than likely, the NICU nurse that “had” to take you….probably wasn’t a good nurse anyway….because the good nurses I know that are worth hanging with are the ones that are willing to “teach”.
    Sometimes if it is really busy it is often a little more difficult to get the teaching in….but, really. I have worked NICU and there is always something a student nurse can learn or do.
    And about L&D…..I have been in on approx 10K (yup, you read that number right!) deliveries since I started in that area and I will tell you that most of the time deliveries are fairly normal and happy. But there is no predicting when something will go wrong and when it goes wrong, it can go really really wrong…and quite fast. It would be interesting to see that strip……..
    Don’t write off OB entirely. It was the LAST area of nursing that I wanted to do when I started out my career….. and I ended up doing it for 15 yrs – and ended up being my favorite area!….. keep an open mind! 🙂 …and don’t let anyone quash your goals!!

    • isntshelovlei said

      10K deliveries?!? Wow… But yeah, I’m trying to keep an open mind…it’s probably way too early in the game for me to decide where I want to end up anyway…

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