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monkeybug

Public Health, L&D, NICU
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monkeybug has 15 years experience and specializes in Public Health, L&D, NICU.

monkeybug's Latest Activity

  1. monkeybug

    The most ridiculous birth plans you've had the pleasure of reading

    One of the first things we did on our unit was to teach the laboring woman how to unplug her monitors and go to the bathroom without help. We were always happy to come assist with the IV pole, but if they needed to go immediately (as is often the case when pregnant) they were welcome to proceed without having to wait on us. Bedpan? No way, unless they were laboring without an epidural but with a fetal scalp electrode. We didn't want that yanked and pulled on accidentally. And I seriously doubt anyone would get upset about a little poo in the bed. It's just part of L&D. The only time I ever got irritated about bathroom issues in bed was when I had a patient who could get up and go to the bathroom but chose not to. Instead she'd just pee all in the bed and then call us to come change the linen. And lest anyone think I'm unfairly assigning intentions to her that didn't exist, she told us what she was doing and why. She had few fans among the nursing staff. I've had some lazy moments in my life, but never to that point.
  2. monkeybug

    Personal fertility issues a detriment in OB Nursing?

    First of all, best wishes for you. I'll say a prayer for you. I worked in L&D all during my infertility escapades. I would go in for ultrasounds and blood draws before my 3-11 shifts. Looking back, I really think it would have been better for me to have been somewhere else. I don't know where, as I could never stand the thought of med surg. Maybe Walmart. It was tough, really, really tough. I dealt with a lot of anger and bitterness. Every time a teen mom would mouth off at me, or say something inappropriate about their baby, every time someone would come in high on crack and deliver, every time someone failed to appreciate the miracle they'd just been bestowed, I'd inwardly rage. Why them, and not me? Why did they get a baby when they were doing everything wrong, and I couldn't get pregnant, despite doing it all the "right" way? I was a walking tornado of anger. The other nurses that got pregnant on the unit tended to tiptoe around me, but I appreciated that they recognized my anguish. And my coworkers rejoiced with me when I got pregnant. My fertility specialist finally refused to proceed until I went to counseling, and I utilized our hospital's EAP. It really helped to talk about it. I should have done it long before I did, but my attitude towards counseling was "you're never going to make me happy that I'm barren!" (I tended towards the dramatic while hopped up on all those hormones.) Most L&D nurses will, at some point in their career, question the choices of the universe, or God, or fate, when it comes to who gets to be a mom. We just see too many unpleasant things. When the nurse is also trying to conceive, it can escalate these feelings. I don't want to discourage you from a career choice, because quite possibly you are a much more logical, kind person than I, and therefore won't feel the way I did. It was 4 years of hell for me, though, going to work every day and going home to a room that was supposed to be a nursery but was instead empty. I'm sure I wasn't the best nurse through it all. I still got great patient comments on surveys, and I still even taught childbirth class through it all, but I was a very angry, unhappy person on the inside.
  3. monkeybug

    Can a woman refuse an emergency csection ?

    I have seen a bedside committal. It actually happened pretty quickly. In small towns, the doctors and judges may be friends, and it might not take more than a phone call. At least that's the way it happened in what I witnessed. And in the end, the patient was grateful. She was hypoxic and therefore not thinking at all clearly. The idea still makes me squirm though, as I very much believe in autonomy.
  4. monkeybug

    The most ridiculous birth plans you've had the pleasure of reading

    I'm also a labor nurse who seriously considered homebirth. If we're so great, why did I consider it? Much as I love my coworkers, I was embarrassed about the idea of delivering in front of them. Also, due to some medical issues, I cannot have an epidural or spinal, and I thought a midwife could help me with natural childbirth. The vast majority of the patients where I worked had epidurals, so natural labor was a rarity. Not that it was pushed on them, on the contrary, this was the demand of the patients. I sought out a midwife who would assist me, but I changed my mind. Part of it was the iffy legalities, I live in a state where homebirth is a risky proposition legally speaking. When the midwife told me that if something went wrong she would, in her words, "dump you at the doors of the ER and never acknowledge that I knew you" I had some serious doubts. Don't get me wrong, I didn't have a problem with her attitude, because I knew if she attended me at home (or at a hotel, as was her usual practice) and it was found out, she could go to jail. So I stuck with my favorite OB at the hospital, and my birth was definitely a nightmare. He and my nurses did everything I asked of them. I was able to sit, walk, rock, get on a birthing ball, and reposition at will. But my baby had other ideas about my plans for a calm, natural, vaginal delivery. My nurse had dimmed the lights, I had music, she massaged my back until I'm sure her arms were about to fall off. She fetched ice, she put cold cloths on my forehead, she encouraged me. My OB suggested a cesarean around 2am. I refused, and he said, "Ok, great, I'll be back in an hour and we'll see what's happening." By the time the hour was up, I was begging for a cesarean. I had that awful bone-on-bone pain of CPD. The baby was also having huge decels. My fears about being shy and embarrassed flew out the window. I'd have walked down the halls of the hospital naked if that was what it took to get that baby out of me. I was in agony. I hopped onto the OR table under my own power, while being gently scolded for not waiting on help. My precious child coded at delivery, and luckily, because I was at my hospital, he had a nurse practitioner, a nurse, and a respiratory therapist all to himself. Good thing, because I hemorrhaged due to uterine atony, so my nurse and OB were a bit busy dealing with me. My husband was brought into the OR even though I was under general (very unusual) because things were getting serious. We were both fine, thankfully. I don't know how my delivery would have gone if I had chosen to do it outside the hospital. No one will ever know. But I feel like I got amazing care, and, though I sometimes feel like a failure for having a cesarean, I never blame my OB because he was happy to let me decide. I'm sure if the decels had gotten deeper and more persistent he would have urged me in that direction, but it didn't come to that. I'm just glad that I had the option of the section, and the team there for the both of us.
  5. monkeybug

    The most ridiculous birth plans you've had the pleasure of reading

    The very fact that Ina May has a maneuver named after her proves that dystocias can happen anywhere, even at home. I support the right of women to deliver at home, safely and legally. But we have come so far in medical advancements that we have forgotten that birth can kill mothers and babies. I've got several antique obstetrics textbooks that describe what it was like before C-sections were an option, when birth primarily occurred in one's home. Hooks to decapitate and remove dead babies, how to break a symphasis pubis to assist with the delivery of a huge baby (and how to construct a sling bed for the woman to lay in for weeks on end while she recovered). Yes, absolutely, there are way too many cesareans in this country, but sometimes they can save lives. The inventors of forceps were lauded because they saved lives. The guy that came up with a way to repair fistulas following birth revolutionized life for many women who were basically homebound forever after they delivered because of the odor and embarrassment from unrepaired fistulas. Birth seems so safe and benign now because few of us (outside L&D nurses) know anyone that died in childbirth. Yes, there is too much Pitocin. Maybe there are too many epidurals, but I bet the women who were burned at the stake for even having the audacity to ask for pain relief in labor would think we were nuts for even debating it (on that note, I highly recommend Get Me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank, it's a very informative read).
  6. monkeybug

    The most ridiculous birth plans you've had the pleasure of reading

    The hospital where I delivered and worked for years did use LPNs in L&D! They were scrub techs primarily, but could also recover patients. We adored our LPNs!
  7. monkeybug

    The most ridiculous birth plans you've had the pleasure of reading

    If you are a nurse, I'm sure that at some point you've practiced some defensive nursing. We all know the risk of lawsuit, and in OB it's worse than anywhere else. I've seen a crunchy couple that refused monitoring and interventions have a bad outcome, and then turn to the nurse and doctor and say "But why didn't you tell me? YOU are the professional!" So it's all fine and good to say that it should be perfectly fine for the baby to go unmonitored because mama doesn't want to cooperate for whatever reason, comfort, idealism, etc., but how do you explain to a lawyer, jury, and now grieving mom that you missed those repetitive lates because the you were trying to make the patient happy. I believe home birth should be an option for low risk women who don't want to be monitored. But when you come to the hospital to deliver, you should expect monitoring. Yes, I know the statistics don't show that monitoring does much but increase the rate of C-sections, but I know for a fact it will be used against the nurse and doctor in a lawsuit. Every little gap in tracing will be pointed out to the jury and the nurse will be questioned about why the baby wasn't being monitored. It's like going to the ER with chest pain and refusing an EKG. Why even go? Stay home, and then you can be as comfortable as you want, and if something goes wrong you have only yourself to blame.
  8. monkeybug

    The most ridiculous birth plans you've had the pleasure of reading

    I can promise you that laughing at a birth plan with things like "ask me before you circumcise my child" has NOTHING to do with the C-section rate. The decision to proceed to the OR is made by the baby, the doctor, the mother, or some combination of the three. This forum is supposed to be a safe place to vent and laugh. And I don't know any nurse with more than 2 years of experience without a gallows sense of humor. It's the only way to survive. I could either snicker inwardly at the ignorance, or I could bang my head against the wall and then quit. I adored intelligent questions and input when I was a labor nurse. I wanted patients who cared about themselves and their babies. What I didn't need was someone who got a canned birth plan off the internet and then went no further. They read somewhere about how the nurses and doctors were going to try to kill them and their babies, and they believed it. Did they go to the free childbirth class offered by the hospital (that I usually taught)? Of course not, that would take time and effort, and involve acquiring knowledge. Much easier to assume things and print something they found on a blog.
  9. monkeybug

    Medical terminology according to patients

    My dear grandmother was truly from the backwoods. Think Deliverance. She had some interesting terms. Deaf was pronounced "deef" with a long E. Vomit was always vomick. One I hear a lot (from nurses and patients, it's definitely a regional thing) is "eat up with" as in "He is just eat up with poison ivy." It means he has a very, very bad case of it. "They opened her up and then just closed her right back because she was just eat up with the cancer." A daddy had a question about his baby's umbilical cord, but he kept calling it his "unbiblical" cord. I wondered what heretical ideas that poor cord stump had espoused. Epidural is another word that is absolutely mangled. The absolute best, though is "happydural". I've also heard "opadural" "empadural" and "spinal tap".
  10. monkeybug

    Everything is our responsibility. Rant.

    I would have a very difficult time biting my tongue and taking that. I feel for you!
  11. I'm from the Deep South, and have lived here my entire life (except for travel gigs) and I have NEVER heard it pronounced that way. Maybe she was eccentric.
  12. monkeybug

    Medical terminology according to patients

    Oh, man, I used to have an exhaustive list of terminology for the female reproductive organs, collected over many years. Some of the ones I remember: Pocket book Rose Cat Monkey Angina (I guess their vagina hurt) My Business My Stuff
  13. In nursing school I did clinicals in a small hospital that had some interesting charting I've never seen anywhere else. I wonder if anyone else has heard of it? At the end of the shift, say 3-11, you'd chart, "2200 Stable hrs.-----A Nurse, RN" to indicate, I suppose, that the patient was still breathing at 10pm. I even witnessed someone from medical records bring a chart to a nurse and tell her to finish out her shift. She'd made an end of shift note, but because it didn't say "Stable hrs (hours)" it wasn't complete. I've worked in many hospitals across the country, and never again have I run into this notation.
  14. monkeybug

    Any new changes working in your hospital?

    When our employee surveys indicated incredibly low morale and extreme dissatisfaction with management, we were forced to attend meetings where we (the staff nurses) had to come up with ideas about how we could improve things. I think they missed the whole point. I've left the hospital, but from what I hear from my friends still there, things are going down hill fast.
  15. monkeybug

    Unions protest 100m hospital donation

    But again, how is THIS ambulatory care center preventing anyone from abortion? Or birth control? Is every health care operation supposed to take care of this? Do you expect an orthopedic surgeon's office to provide murder on demand too? I know it's a crazy thought, but maybe this huge donation of money to health care is a good thing, even if you don't care for their beliefs.
  16. monkeybug

    The coveted Monday thru Friday job

    I've been working M-F for almost 2 years, and I'm still undecided. I love having weekends and holidays off. Knowing I'll be off every single Christmas Eve and Christmas Day is awesome. (Thanksgiving I could do without, I spend that with the in laws:cheeky:) I do miss having days off to get things done. I have to take time for doctors appointments and hair appointments and vet appointments when I used to just schedule them on my day off. On the whole, I'm a fan of M-F. Nothing is perfect, but it beats calling home on Christmas Day from work to tell everyone Merry Christmas.