DS vs NS (this is a vent)

lovemyjoblandd · Feb 2, 2013

Okay, this is a perfect example of why people shouldnt take ambien around a computer. Sorry guys.... I had a horrible night when i wrote this. I was slightly (very) irrate. At 645, with 2 nurses on nightshift and 5 dayshifters on the clock in the breakroom, my induction in active labor and requesting an epidural, 3Other active labors on the floor, we get a call from the ed. 38 weeker c/o "something falling out of her." Thats the only report we recieved. I think " oh her mucus plug. Big deal." I go start the bolus for my induction for her epidural and show her husband some ways to comfort her until MDA gets there. I walk out and see the new patient had been placed in a room and changed, but not put on efm or anything. She appears to be in labor and very uncomfortable. By now its about 7am and dayshift is still sitting in the breakroom while myself and coworker and running around like crazy. I think to myself " oh geeze, ill just get her on the monitors, grab some vitals, and then go report and get home to my own sick baby." So i say a quick hi to the new patient and quickly explain efm. Plop on the US and cannot find tones.... I look for about 15 seconds and ask mom " where do they usually find tones?" She said she didnt know. So then i asked if she has been feeling fetal movement. She tells me hes been active all morning. I search for about 5 more seconds and she then tells me "oh hes breech" a wave of relief comes over me and i move the US up. Find tones at 110. Stick the pulse ox on and yup, u guessed it.... Maternal. My heart sinks as i roll her to her side and call for assistance. My nightshift coworker ( who has 3 patients of her on, 2 in active labor and 1 srom'd breech r c/s waiting for doc to get there... With FIVE dayshifters on the clock in the breakroom) comes to assist me and has the ultasound machine. No cardiac activity seen. Finally a dayshifter comes strolling at about 710. Off i run to my other patient to do epidural. Not until the MDA is in the room did someone finally come to relief me. As i finally clocked out at 0800 i overheard that the new patient was indeed iufd at 38 weeks confirmed by the "real" ultrasound tech and she was 4/100/-1. I cried all the way home and when i finally got there i held my sweet sick baby boy tighter than i prolly should have and cried into his lil baby hair.

Fyreflie · Feb 2, 2013

Honestly it sounds like you have had terrible luck with staff and nursing culture. I've worked LD at three different hospitals now and had the exact opposite. We're all required to rotate days/nights and I've never felt alone. The worst staffed hospital I worked at had the best teamwork I'd ever experienced. Someone is almost always available to second/help/do baby. Last night we were slow so we tag-teamed all the baby assessments and got them done super fast.

I'm really sorry you're having that experience because it can be so much better. Is there someone you can talk to about changing unit culture? Barring that, the most direct way you can impact that culture is to train student nurses to help others.

lovemyjoblandd · Feb 2, 2013

Well my coworkers on nights are awesome and we all work together. If u r in trouble someone will come running without even having to ask. The dayshift is a whole nother story. They r every man for themselves. Thats one of the main reasons i wony work days. And these particular dayshifters can be quite nasty. There is no changing that. They have ran off more than 1 new employee. I love my nightshift crew and love working with them. I just hate dealing with the next shift. And as a nightshifter, we dont get student nurses i love to teach and did a lot of it at the military hospital i came from.

gaonsi · Feb 2, 2013

I haven't had it as bad but twice I can think of there has been an admission at 0730a and night shift has helped the day shift nurse get the patient in bed, on the monitor(i work ICU), helped draw labs etc etc while day shift sits in the breakroom drinking coffee. I wonder how anyone could function without teamwork, especially during the day! Sorry you had a rough night. I hope you're feeling better and your baby is too.

lovemyjoblandd · Feb 2, 2013

My poor lil man has been battling sickness for 3 weeks. Started with pink eye, then an ear infection now ear infection in both ears. And he had a hives like rash. Back to the doc for the third time yesterday. Started on omnicef and prednisone. I shoulda asked for that instead of aumentin to begin with. Thanks!

PediatricRNTX · Feb 2, 2013

I LOVE that you "warned" that this is a vent!!! Now days people want to rip u up for venting on this site....vent away, if it makes u feel better!!

lovemyjoblandd · Feb 2, 2013

Thank. You pediatricrntx. I honestly dont have anywhere else to let it out. I can talk to my husband but he has no idea what i am talkin about and just dont "get" it. I feel like im talkin to a brick wall when i tell him about my nights lol. He tries to be supportive, but it is not the same as someone who has been there. The thing is, while our job is stressful, its not the job per se that stresses me out, its the other bs. Staffing, mean lazy dayshifters, and to top it off we have construction goin on and had to give 4 of our birthing rooms up to postpartum. Its just chaos. And when my environment is chaotic, i feel my mind is chaotic. Of course at work i am cool calm and collect so when i get him i just fall apart for a lil while until my mind can settle. As an update on the term demise, i was able to help prepare the baby boy's body, take pics, take foot impressions, etc last night and it was very healing for me.

babyktchr, BSN, RN · Feb 2, 2013

Ambien vents are the bestest ever!!! Although it sucks, its nice to hear that this goes on in other places and not just in my neck of the woods. Sounds to me like your staffing needs a bit of tweaking. 2 nurses and all that going on is just plain unsafe. As a manager, my question would be this....IF YOU ARE ON THE CLOCK why are you sitting here?? I think it would've been prudent to take 5 seconds and go back there and say, umm, we are dying out here, come out and help. We (as peers, coworkers, fellow worker bees) need to step up and speak up instead of marinating in our own frustrations and hold each other accountable for bad behavior that has obviously been allowed to thrive. While venting is a fabulous thing, it hog ties any forward progression. Vent, but act. And hold management accountable. This behavior should NOT be tolerated on any shift. Period. Go to those people and speak your mind and if that gets no action, then take it right up the food chain. I would also be talking to management about your night time staffing. It sucks. Royally.

Falling apart is necessary. As nurses, we learn to suck it up and move on. But its human to react, and the moment you don't react would be the time to worry. I am so very sorry that your night ended with such a heartbreaking outcome. I am glad you got to heal your soul later by working with the baby. I totally get where you are coming from.

You are a rockstar....ambien and all. Never forget that.

dariah · Feb 5, 2013

I have a similar problem sometimes. I've had to stand for an epidural 30 minutes passed change of shift because no one came in to relieve me. And when we come on for night shift the charge nurse always says "Can someone go cover so and so in the OR?" before we even do sign out. We also have to go searching for the day shifter to give them report, and usually they are in the break room eating breakfast. (We never start our shift with dinner. We sometimes can't even eat.) Once an OB even asked me to stay late to start his induction because he even knew it would be another hour before the day nurse started the pit.

Nights are hard for my body and my social life but I like my coworkers way more than the day shift so for now I'm staying.

lovemyjoblandd · Feb 5, 2013

Dariah, its very frustrating. It makes me want to wait til the very last minute to walk in and clock in, but my military mind goes into panic mode if im not at least 15 minutes early lol. It really is a double standard. It irks me real good.... But like u, i like my coworkers and ability to practice autonomy at night so i will continue with it until something changes. Babykatcher. I love reading ur posts, and want to thank u for ur words of encouragement. I have mentioned these things to management but they r part of the problem. I just keep these things to myself so as to not cause myself further drama

meanmaryjean, DNP, RN · Feb 5, 2013

NO SNARK INTENDED: You've told US - but have you told THEM? If they are sitting around on the clock and you are running around, take a minute and go in the break room and ask for help. No - demand help in the name of patient safety.

I'm a night person, and I know how this is. Sometimes you just have to be blunt.

You really want to change the culture? Suggest changing work hours to 6a-6p to 'balance out the workload'. THAT usually gets their attention.