Wow! So "Not Me! Monday" turned out to be more fun than I ever anticipated! I got over 800 hits to my blog, which I certainly know is due to the traffic from MckMama's blog my fantastic creative writing abilities. Um, yeah...so, anyway, thought I'd throw a blog out there related to my moonlighting practice as a labor and delivery nurse! (Quick little disclaimer: Do not take this as medical advice. Please contact your health care provider...or something like that, right?)
I love the calls that go something like this:
Patient: Um, this is my first baby, I'm due tomorrow and I just had two contractions in the last hour. They didn't really hurt, but I'm afraid of making it there on time. Do you think I should come in?
Here's what I'd like to say:
Well, do you live two days away? 'Cuz if you do, then certainly, you might want to think about maybe getting packed and possibly starting your drive. But take your time.
Patient: But I lost my mucous plug!
Here's what I'd like to say:
Oh, no! You better find it! You do know that you can't be admitted unless you find it?
In contrast, here's what the clinic triage nurse would say about lost mucous plugs:
You better call 911 and take an ambulance to the hospital!
Here's what a clinic triage nurse once told a patient who reported having 3 BM's in an hour:
You better call 911 and take an ambulance to the hospital!
And guess what the clinic triage nurse would tell the first timer above?
You better call 911 and take an ambulance to the hospital!
I think maybe the clinic triage is just automated, "Please press one if you think you are in labor, two if you have the runs, three if you've lost your mucous plug--but it doesn't really matter what you press because we'll just tell you to call 911 anyway."
Thankfully (most) people are smart enough to just drive themselves in in non-emergency cases, but not all!!
Then there's the fine folks who come in (notoriously) at 11:30pm on a Saturday night, saying:
I haven't felt my baby move for two days. (Yikes!)
Now, this is truly a scary situation to me, the last thing a labor nurse wants is to put on the monitors and not have baby's heart tones. But, come on! Really, two days?!! And instead of calling after an hour or two of no movement you wait until Saturday night?! After 48 hours of no movement?! Wow. No you're lookin' at a good two hour hospital stay (and it's not just in and out...you get admitted and the whole 9 yards!) when you could've been in and out at the clinic.
9 out of 10 of these turn out to be "false alarms" (thank goodness!). Inadvertently, you put the monitors on and the baby moves like crazy...but that my friends, is AWESOME!! Then the mom feels embarrassed and we gently remind her to wait much less if she is concerned about her baby's well being (yeah, like 46 hours less!) and, perhaps, then she could see her own doctor in the clinic.
What I'd like to do is write a book called "Frankly, You're Pregnant", and it would be all about the in's and out's of pregnancy. 38 weeks and back pain? Well, "Frankly, You're Pregnant". Terrible acne and bacne (back acne)? Well, "Frankly, You're Pregnant". Hips ache, boobs ache, belly aches? Well, "Frankly, You're Pregnant". You get the picture!
Here's the other thing...Birth Plans? The unofficial word on the street amongst labor nurses is, the longer the birth plan, the more labor and delivery complications. And I don't say this to be mean, not at all! I myself am an "au naturale" kinda gal, but it really seems like these poor ladies come with their laminated birth plans and grand ideas, and it never fails that they are the ones who end up tethered to the monitor 'cuz they have meconium in their amniotic fluid, crappy heart tones, pre-eclampsia, big babies that get stuck, and c-sections. Which, inevitably, afterwards they'll end up with an infection, bowel impaction, seizures, morphine PCA's, jaundiced babies...etc. I also feel like the bad guy in some of these cases. I don't think the general public is aware of the consequences of some decision making in regards to birth plans. Our goal, as hospital nurses is to have a healthy mom and a healthy baby. Unfortunately, that sometimes means an induced labor, an episiotomy, cutting the baby's cord before it is done pulsing (I don't really get that one anyway), and, egads!!, sometimes a c-section. A 42 week baby is at just as great a risk, if not more, than a pre-term baby. Did you know that beyond 40 weeks, you're baby is likely to poop inside? This creates a whole new set of circumstances at delivery. So, I guess what I'm saying is, listen to your doctor or nurse. Advocate for yourself and your baby, but keep in mind that we are not out to get you or derail your beautiful birth experience. A very experienced nurse once told her labor class, "We are not here for a beautiful birth experience. Our goal is a healthy mom and a healthy baby." Very well said!
Wow! That was a long post! I kinda went off on a tangent, didn't I?! I'm sorry, next time, I'll try to keep it light and fun! I meant for this post to be humorous and tongue in cheek, but I guess my passion for healthy babies came through in the end. Oh, wait! Here's my favorite:
Nurse to patient: You're urine tox screen came back positive for amphetamines.
Patient: Oh, I was just around people who were smoking it. (Really? Do you think we're that stupid?)
Or alternate response:
Patient: Oh, I had a bad cold so I took some Sudafed. (Wow...I guess you really do think we're that stupid!)
I love the calls that go something like this:
Patient: Um, this is my first baby, I'm due tomorrow and I just had two contractions in the last hour. They didn't really hurt, but I'm afraid of making it there on time. Do you think I should come in?
Here's what I'd like to say:
Well, do you live two days away? 'Cuz if you do, then certainly, you might want to think about maybe getting packed and possibly starting your drive. But take your time.
Patient: But I lost my mucous plug!
Here's what I'd like to say:
Oh, no! You better find it! You do know that you can't be admitted unless you find it?
In contrast, here's what the clinic triage nurse would say about lost mucous plugs:
You better call 911 and take an ambulance to the hospital!
Here's what a clinic triage nurse once told a patient who reported having 3 BM's in an hour:
You better call 911 and take an ambulance to the hospital!
And guess what the clinic triage nurse would tell the first timer above?
You better call 911 and take an ambulance to the hospital!
I think maybe the clinic triage is just automated, "Please press one if you think you are in labor, two if you have the runs, three if you've lost your mucous plug--but it doesn't really matter what you press because we'll just tell you to call 911 anyway."
Thankfully (most) people are smart enough to just drive themselves in in non-emergency cases, but not all!!
Then there's the fine folks who come in (notoriously) at 11:30pm on a Saturday night, saying:
I haven't felt my baby move for two days. (Yikes!)
Now, this is truly a scary situation to me, the last thing a labor nurse wants is to put on the monitors and not have baby's heart tones. But, come on! Really, two days?!! And instead of calling after an hour or two of no movement you wait until Saturday night?! After 48 hours of no movement?! Wow. No you're lookin' at a good two hour hospital stay (and it's not just in and out...you get admitted and the whole 9 yards!) when you could've been in and out at the clinic.
9 out of 10 of these turn out to be "false alarms" (thank goodness!). Inadvertently, you put the monitors on and the baby moves like crazy...but that my friends, is AWESOME!! Then the mom feels embarrassed and we gently remind her to wait much less if she is concerned about her baby's well being (yeah, like 46 hours less!) and, perhaps, then she could see her own doctor in the clinic.
What I'd like to do is write a book called "Frankly, You're Pregnant", and it would be all about the in's and out's of pregnancy. 38 weeks and back pain? Well, "Frankly, You're Pregnant". Terrible acne and bacne (back acne)? Well, "Frankly, You're Pregnant". Hips ache, boobs ache, belly aches? Well, "Frankly, You're Pregnant". You get the picture!
Here's the other thing...Birth Plans? The unofficial word on the street amongst labor nurses is, the longer the birth plan, the more labor and delivery complications. And I don't say this to be mean, not at all! I myself am an "au naturale" kinda gal, but it really seems like these poor ladies come with their laminated birth plans and grand ideas, and it never fails that they are the ones who end up tethered to the monitor 'cuz they have meconium in their amniotic fluid, crappy heart tones, pre-eclampsia, big babies that get stuck, and c-sections. Which, inevitably, afterwards they'll end up with an infection, bowel impaction, seizures, morphine PCA's, jaundiced babies...etc. I also feel like the bad guy in some of these cases. I don't think the general public is aware of the consequences of some decision making in regards to birth plans. Our goal, as hospital nurses is to have a healthy mom and a healthy baby. Unfortunately, that sometimes means an induced labor, an episiotomy, cutting the baby's cord before it is done pulsing (I don't really get that one anyway), and, egads!!, sometimes a c-section. A 42 week baby is at just as great a risk, if not more, than a pre-term baby. Did you know that beyond 40 weeks, you're baby is likely to poop inside? This creates a whole new set of circumstances at delivery. So, I guess what I'm saying is, listen to your doctor or nurse. Advocate for yourself and your baby, but keep in mind that we are not out to get you or derail your beautiful birth experience. A very experienced nurse once told her labor class, "We are not here for a beautiful birth experience. Our goal is a healthy mom and a healthy baby." Very well said!
Wow! That was a long post! I kinda went off on a tangent, didn't I?! I'm sorry, next time, I'll try to keep it light and fun! I meant for this post to be humorous and tongue in cheek, but I guess my passion for healthy babies came through in the end. Oh, wait! Here's my favorite:
Nurse to patient: You're urine tox screen came back positive for amphetamines.
Patient: Oh, I was just around people who were smoking it. (Really? Do you think we're that stupid?)
Or alternate response:
Patient: Oh, I had a bad cold so I took some Sudafed. (Wow...I guess you really do think we're that stupid!)
You've touched here on the one issue that I'm really not sure about in all this (at least as much as you can be SURE of anything): post-dates. Of course I'm not talking 40-41 weeks. I'm talking, what happens past 41 weeks? Until I started researching, I was terrified of going past my EDD because of "what might happen to the baby." However, stuff I've read suggests this can be less of an issue than I previously thought.
ReplyDeleteBut what you've said goes back and backs up my original ideas.
How can I find out more about how to handle a post-dates pregnancy? I realize that will ultimately be between me and my care provider (whom I have not yet seen since I just changed, eek), but where can I look to become more informed about the risks and how I or my midwife can recognize them? Any suggestions?
Thanks! :)