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whitewriterMy Sunday afternoon shift starts with me getting excited because I'm asked to care for a lady with severe pre-eclampsia and severe I trailering growth restriction (IUGR) and to run a magnesium infusion (never done that before but I read the policy recently). To then be less excited because they're planning and emergency c section instead at 34 weeks and can i go be the stopgap until the senior RM arrives.
Oh and she's only 17.
Shes a sweet young bogan thing in the bed crying. I had just passed a random Indian guy in the wait room who looked much older than her. I put 2 and 2 together and think hey whatever works.
Baby comes out 1880g and crying. Not bad for 34 weeks.
I leave the case with the senior.
After some education and dinner (where by the time.i get back from theaters literally 5 baby's have been born normally) i get a p1 at 6cm.
I ask her what pain relief she would like and she's like an epidural. Now. And I'm like urrr okay then.
I barely did my assessment and had only just ascertained she didn't need a CTG only now to that yeah, she's gonna need one.
Theres a delay for anaesthetics so I offer her morphine.
Mini mistake. It means I gotta do a VE to make sure 6cm hasn't become 10 In the last 2 hours.
My VE sucks ass. I thought fully with a really thin anterior lip.
Head at spines. How can it be at spines and fully?I think. Shes not acting like shes fully. The incharge redoes my VE cause I'm so unsure
Its 7cm. But thicker at the top and not really at all near the bottom and she averaged that out to mean 7cm.
Whilst I try not to feel so shit about my horrid VE result (fail, essentially). We determine she needs an IDC and pop one in.
That the bigger drama is that when anaesthetics comes to do the epidural just right when she's sitting and he's about to wash his hands, he gets a phone call to an emergency in ED and has to rush off.
My woman is sans epidural so we get out some morphine. I give it so nicely and so quickly shes shocked it doesn't hurt (8 yrs of ICU baby my subcut injections are the best).
1 hour later shes basically almost anuric. For someone who hasn't peed for 3 hours the amount in the bag is depressingly close to 5mls if any.
The CTG also looks weird. Decreased baseline but great features so I'm not entirely concerned. The sound of the HR doesn't sound great. Lowest hr is 120 so technically still normal.
I leave her with the night staff
As I was preparing to leave, one of the MUMs from MSH was there a little early to get a feel for the place before the first nightshift I imagine she has done for the last 10 yrs. Technically, she was my direct manager for the entire time I was at MSH as a student midwife (so now shes my ex-boss): but the longest conversation I ever had with her was on my last week when I was sorting out my annual leave to cover the gap before registration since the district so kindly decided not to employ us as RNs until our RMs came through (for the first time ever, what bitches. We aren't 21 yr old students anymore, we have mortgages and families to care for).
Some of the managers (including my ex boss) are doing extra to support the large gap left by an increase for staffing that occured prior to the hiring of more staff (which is still in the works).
Her first words to me were "are you still on nurse bank?" to which I replied I quit and went direct casual with SSH on Dec 27. And she just nodded.
I still don't know how I managed that considering I'm not independent as a midwife by any means.
I get excited when I have a clinically interesting case. I've been telling them all the crazy drain stuff and trisomy
28 stuff and they think its gross. Apparently the other midwives think that's weird.
Oh and she's only 17.
Shes a sweet young bogan thing in the bed crying. I had just passed a random Indian guy in the wait room who looked much older than her. I put 2 and 2 together and think hey whatever works.
Baby comes out 1880g and crying. Not bad for 34 weeks.
I leave the case with the senior.
After some education and dinner (where by the time.i get back from theaters literally 5 baby's have been born normally) i get a p1 at 6cm.
I ask her what pain relief she would like and she's like an epidural. Now. And I'm like urrr okay then.
I barely did my assessment and had only just ascertained she didn't need a CTG only now to that yeah, she's gonna need one.
Theres a delay for anaesthetics so I offer her morphine.
Mini mistake. It means I gotta do a VE to make sure 6cm hasn't become 10 In the last 2 hours.
My VE sucks ass. I thought fully with a really thin anterior lip.
Head at spines. How can it be at spines and fully?I think. Shes not acting like shes fully. The incharge redoes my VE cause I'm so unsure
Its 7cm. But thicker at the top and not really at all near the bottom and she averaged that out to mean 7cm.
Whilst I try not to feel so shit about my horrid VE result (fail, essentially). We determine she needs an IDC and pop one in.
That the bigger drama is that when anaesthetics comes to do the epidural just right when she's sitting and he's about to wash his hands, he gets a phone call to an emergency in ED and has to rush off.
My woman is sans epidural so we get out some morphine. I give it so nicely and so quickly shes shocked it doesn't hurt (8 yrs of ICU baby my subcut injections are the best).
1 hour later shes basically almost anuric. For someone who hasn't peed for 3 hours the amount in the bag is depressingly close to 5mls if any.
The CTG also looks weird. Decreased baseline but great features so I'm not entirely concerned. The sound of the HR doesn't sound great. Lowest hr is 120 so technically still normal.
I leave her with the night staff
As I was preparing to leave, one of the MUMs from MSH was there a little early to get a feel for the place before the first nightshift I imagine she has done for the last 10 yrs. Technically, she was my direct manager for the entire time I was at MSH as a student midwife (so now shes my ex-boss): but the longest conversation I ever had with her was on my last week when I was sorting out my annual leave to cover the gap before registration since the district so kindly decided not to employ us as RNs until our RMs came through (for the first time ever, what bitches. We aren't 21 yr old students anymore, we have mortgages and families to care for).
Some of the managers (including my ex boss) are doing extra to support the large gap left by an increase for staffing that occured prior to the hiring of more staff (which is still in the works).
Her first words to me were "are you still on nurse bank?" to which I replied I quit and went direct casual with SSH on Dec 27. And she just nodded.
I still don't know how I managed that considering I'm not independent as a midwife by any means.
I get excited when I have a clinically interesting case. I've been telling them all the crazy drain stuff and trisomy
28 stuff and they think its gross. Apparently the other midwives think that's weird.
