markm739

You will soon find out that being big means that you will constantly be called upon to help turn patients to the point that it will be hard to get your own work done! I had a preceptor who was a strong guy, and they would call him down from our unit to help move huge patient in the ED....well, this guy wound up with a HERNIA! Please be careful; you will automatically be expected to go above and beyond the call of duty in moving heavy patients, and there won't be much you can do about it, so PLEASE watch out for your back, and use good mechanics as much as you are able, or you may wind up with a back problem. :pumpiron:

I don't have any great words of wisdom for you, but can sympathize.....these patients can change quickly, and tend to be resistant to treatment. I had one last night who jumped out of the back of a rolling pickup truck....huge epidural hematoma with a 3 cm midline shift, pupils fixed and dilated....family made him a DNR and were going to deescalate in the morning. About 4 this morning his temp went up to 105.7.....Dantrolene didn't touch him. He had been a 3T, but started responding to pain, even with his pupils like they were. Anyway, I read an article back a few months ago which you might find helpful, if you get Critical Care Nurse; here's the info. Sympathetic Storming After Severe Traumatic Brain Injury Crit. Care Nurse, Feb 2007 I am in a combined MICU/SICU/Neuro/Trauma unit, and would love to read more of other people's particular experiences with neuro patients.

Here's a good one I observed on my unit today regarding OCD behavior. I had to give report to a nurse who is particularly unpleasant ALL the time; I have had patients complain about her, and have been told by other nurses that she has been written up numerous times.....she is still here, so evidently all the writing up in the world won't get rid of this gal (henceforth referred to as G.) After I gave report, I was waiting for my night shift cohorts to finish so we could leave to go to a meeting together, and I happened to notice that G. had obtained a couple of our antiseptic wipes, and was wiping down the telephone in a very detailed fashion. I thought to myself, "Probably not a bad idea." She then began to wipe down the counter space where she would be camping out during her shift....again, a good idea. She then, after finishing with the counter, started cleaning the telephone AGAIN!!! Uh, hmm.......didn't you just do this, G.? My word, is this actual OCD behavior I am observing, characterized by the ritualism and repetitive task stuff? We cannot assess our patient until we have cleaned the telephone multiple times? Amusing......

With 4 years of prior experience, you are going in with a leg up on me! I went in completely cold with only school clinical experiences under my belt. Does your ICU have a series of orientation classes they will put you through? The one disadvantage you may have is being 4 years from school. Did you have a critical care course in your LPN coursework? If not, I can recommend the book I have from school as an excellent one to have. If you need some comic relief, I can relate a little of my experience starting out in the ICU. I went back to school in my forties. I gained a great deal of personal satisfaction from having a 4.0 average, graduating summa cum laude, and winning the annual nursing award for the dept. that year. I spent many late hours at the school library to achieve this, and it sort of left me with the sense that I was not a total idiot (ah, the things we assume in life!) This all changed when I hit the floor! I had a guy for a preceptor who was really hard on me (verified by whispered comments from other nurses who watched us together.) Here is a sample of my typical inner thought pattern on any given day during my orientation: "This guy is treating me like I am an idiot. Somehow, I know I am not an idiot. But if that is the case, why am I being treated like this? Maybe it's true!!! Maybe I really am too slow and dense to get all this......maybe I am truly not cut out for this, and all I can do in life is take tests and write care plans. Maybe I should just admit defeat, tuck my tail between my legs and quietly make my exit...." Two things kept me from folding in those early weeks. One was the conviction, somewhere down in the recesses of my soul, that I actually was NOT an idiot; the other was a life changing day when I visited this board, and read these words: "NEVER let ANYONE treat you as if you were incompetent!" I can't remember who posted that, but it struck a chord with me; I said to myself, "That guy will NOT treat me like an idiot!" Something rose up in me that day which was a determination to survive, and I can say today that I am now thriving and am quite content on my unit. Keep posting, and let us know how it is going. We care, and there are a lot of great folks on this board. If you believe in yourself, you will make it!!!

Are you still on orientation? Do you have any previous nursing experience, or are you starting fresh in the ICU from nursing school? I started straight out of school in the ICU 18 months ago. I really didn't start to gain any feelings of competency until I got off orientation and didn't have someone breathing down my neck all the time. I would say it took about 9 months to a year or so to start feeling significantly more confident. A young nurse on my unit who has been there a few years told me it takes a good 2 years to really feel as if you've got it, so be patient. Remember this also: people often wind up treating you according to how you carry yourself, which often has nothing to do with how much you know or how well you do your job. My preceptor told me to act as if I knew what I was doing, even if I didn't! I have also noticed that the people who carry themselves with a certain amount of poise are treated as more competent by the others. Watch out about asking questions, also. It is officially encouraged, and should be, but in practice, can create an appearance of dependency to any mean spirited people on the unit. Try to find out the answer yourself without asking whenever possible, and save the question asking for the stuff you absolutely have to do it for. I am blessed to have a German lady close to retirement in her 60's who has sort of taken me under her wing; I am completely safe with her, am treated with respect by her, and can go to her with anything.....she watches out for me when we are together, I return the favor when possible, and am learning a lot from her years of experience. I hope you can strike up a relationship with someone such as this lady, but pick carefully, as people can be very 2 faced. Remember that you are trying to learn a bunch of complex stuff all at once, and are often expected to remember things weeks and months after having only been shown one time! Remember also that you have chosen to invest your life in something that matters, contrary to many young people your age. If you made it through the hell of nursing school, you can make it through this! I personally found orientation harder than nursing school. Please email me privately if you have any questions or need to vent, as I have just recently been in the spot in which you find yourself, am still alive, and am actually quite happy with where I find myself now!

All the advice I have read in this thread is great, and on target. Having completed my first year in ICU straight out of nursing school, a couple more things come to mind. The ICU tends to attract a certain kind of personality. ICU nurses can often be strong-minded, dominant (or sometimes domineering!), opinionated types. Unfortunately, since they have learned their job well, so many parts are so automatic for them that they forget just how complex it all is to a newcomer, and often can't understand why it takes us a while to remember it all and put it together. My first piece of advice, therefore, is a rather curious one, and is straight from the mouth of my preceptor soon after I got on the unit. He said that I should act as if I know what I am doing, even when I don't!! He warned me to phrase my responses so as to reflect to people, especially physicians, that I know what I am doing. If I started a phrase with "I think...", or anything which reflected uncertainty, he would interrupt me and have me rephrase it to reflect that I either knew it or didn't. I think what he means here is that how one carries themselves influences the perceptions of others, and if you can carry yourself confidently and act like you know what you are doing, it will convey a subliminal impression of competence which will be beneficial; it is a fact of life that people go by impressions and outward appearances more than the substance of things at times. So, what is the best way to accomplish this when you are feeling overwhelmed, having a bad day, etc. and maybe just feel like having a good cry? Let me relate a day I had involving this board. My preceptor was in my face quite a bit, and often over things which I felt were just his opinion as opposed to absolute fact. I was told by others who watched us that he was being hard on me (one nurse even mentioned it to our unit educator), so this led to some bleak days, as I had never even been on a medsurg floor before, and was learning both basic nursing and ICU at the same time. It seemed at times that he harped on a couple of things I hadn't done, and that all the good and right things that I knew I had done were not noticed. One week I sank rather low from his being "in my face" all the time; I dreaded seeing him coming around the corner. I began to feel as if I would never catch on, and was wondering if I should ship out. I got on this board, and read a note of encouragement someone had written to an orientee which said, "NEVER let ANYONE make you feel incompetent!!" I was at such a low point, having been made to feel like a blooming idiot by this guy, that these words resonated, and I walked away with a new resolve to not let him do this to me; this was a turning point, I wound up surviving orientation, and am happy as a lark now on the night shift! So, the net out is this: Watch appearances and how you carry yourself and communicate, believe in yourself when it seems no one else does, and hang in there! Also, keep smiling, even when you don't feel like it, and save your tears for the privacy of your car or home; it may convey an image of weakness to one of the hard nosed types who are ready to look for something wrong, and you will be talked about in a condescending way in little groups when not around; I have heard this done. One more thing: make sure you understand the general workflow of the unit, as in when things should be done by, etc. Always aim to do everything as early as possible, cause you'll then be ahead of the game when things fall apart, and it will be easier to regroup and be out the door on time. Best Wishes!

If you want to find a positive side to this horrifying incident, it is that you found out what those people are like before going to work there! Imagine having found out their lack of caring and compassion after having been hired! I have not had it happen, but I have flowed so heavily in the past that I worried about sitting down at someone's house, and wound up sort of sitting cata-wompus on one leg so I wouldn't stain a couch. With bleeding that heavy, is your MD checking your hgb? They say a lot of premenopausal women are borderline anemic; I'd keep tabs on it. I hope you find a great place to work! ICU Newbie

I began my prerequisites in 2001 at the ripe old age of 43. I had a previous degree, so all I had to do was take the science courses before starting our BSN program in 2003 full time. I was not the oldest one in our class - the oldest one was 50. I graduated summa cum laude this year, and won the nursing award for the year for our department. Incidentally, the student who won the nursing award last year also was older, she was 50 when she got it. I am on orientation in the ICU; it is tough, as the others my age in the dept. have been there forever, have all their relationships established, and do not necessarily welcome you with open arms. They don't care if you did well in nursing school.....the playing ground is leveled once you get out there. The bottom line is this: I think age is an advantage in school, as we are able to synthesize thought a little better at this age and relate pieces of the whole in a more comprehensive way than the younger ones, but it seems to be a disadvantage once you start work, as you wind up being out of step with your contemporaries. Regarding your wife, I remember some quotes from my instructors in nursing school. On a particularly bad day, when my own normally supportive spouse was not very supportive, and I was almost in tears, I came to class and she said, "You are the only one who can do this for yourself!" The same lady also said, "Find something in life which is your passion and DO IT!!" It is apparently common to have a lack of support at times....also, remember that a lack of support comes with older ages. I found that the younger people in our class tended to have people be proud of them, iron their uniforms for them, buy them things pertaining to nursing, and generally dote on them....at our age, people look askance at things we do, and simply seek at times to criticize. As much as we may love our spouses, they may be dead in a car wreck next month!! We will then have ourselves and our abilities and the things we have built up through our lives left. Investing in yourself is always a good idea, as you are the one person who will definitely be there in your old age, remembering what you did and didn't do. No one else will be there to commend you for missing an opportunity; at our age, we have to get on with things, as we don't have time 20 years from now to go back for a second degree. All in all, I found going back to school in midlife a very rewarding experience; if I can survive orientation, I think I will have many happy memories in my old age of the people I helped. I hope things go well for you; this board can be a great source of encouragement, so check in frequently!! ICU Newbie Graduated May 2005 Survived NCLEX July 2005

To Pricklypear - What you said about families hardly ever reversing DNRs makes sense. I'm sure the wife wouldn't reverse this guy's, as bad off as he is. "But you must ALWAYS function within your scope of practice" I am glad to find out that there are others in this world who don't consider that a mere nursing school habit. It is encouraging to know that others would question what is going on out there, and would actually care about doing what is right. Thanks. With regard to ethical reasoning, I think it really hit me what was happening with him when I realized it violated the "do unto others as you'd want done to your own family" rule, and also that all that was drilled into us in nursing school about informed consent and the volitional rights of patients. Of course, I really wonder if he considered that what he was doing was in the realm of euthanasia. One more strange thing happened with this guy. He started out the conversation where he discussed the rationale for the morphine by saying that he wanted to see how I felt before giving it, because another preceptor/orientee pair on the floor had an incident where the preceptor did something, and the orientee felt it to be an ethical problem; the preceptor said that the orientee went to someone else without even talking to the preceptor about it and lodged a complaint; my preceptor didn't think the orientee handled it properly, so I think he was preempting a similar occurrence by attempting to raise the issue with me. Two things come up about this. First of all, this shows he was aware that what he was doing was morally debatable. Secondly, I would guess that the other orientee who did this was probably too intimidated by her own preceptor to directly address it with them. This can be a problem on this unit; we have 15 orientees, and the types who are preceptors are not exactly touchy feely friendly types, they are kind of hard driving individuals who are very certain of their own ideas and practice because of the vast experience they have. It is harder to correct someone who is the primary source of job performance data about you to management. This makes orientee's positions in these kind of situations more precarious. To all who have encouraged me to go to ethics boards or management: I guess it is true that one would need to be prepared to be branded as a do-gooder or whistle-blower if they did this. I wonder how much management goes along with this kind of thing; I mean, if they are presented with it, they obviously have to respond to the outward significance of it, but are they really thinking inside, "I wish she hadn't done this, we know it goes on, but prefer to look the other way?" Any charge nurses or nurse managers out there able to comment? Have any NMs had whistle blowers on their staff? Is there anyone out there who blew the whistle, and would like to tell us how it went? ICU Newbie

"You are in a position right now to be victimized by association." You really have me thinking about this one. My spouse and I were discussing the meaning of this, and it could be 1) guilt by association with this unit 2) Being in a position to be influenced by nurses who think this way 3) Being ridiculed for being so naive as to think that anyone in the ICU would actually think that the 5 medication rights were something to be adhered to...primarily speaking of right dose here. I actually have thought about transferring out of this unit.....this may add to my rationale for doing so. It is true that it could become a "he said, she said" thing, as this nurse is very much respected by management. ICU Newbie

Greetings to all! I am amazed at, and grateful for, the insight, wisdom, and even courage which can come from a collective effort such as this! I really appreciate your thoughtful and comprehensive replies more than you know. I was off for 2 days after this incident, and go back tomorrow (Saturday.) I may check to see if the pt. is still on our census. One thing I need to check is what dose of morphine was actually given to the patient when my preceptor walked in there, as he didn't tell me. I say that because of an odd conversation he had with me a couple of weeks ago. We had a patient who was breathing over her vent, and he said she needed to slow down, and that it probably meant she was in pain. That was reasonable, and her order was for 2 mg of morphine prn. This didn't help her, and when it didn't, he said that I needed to learn how things really work up there, and proceeded to say - not exactly in these words, but this is what it amounted to - that the nurses up there pretty much use the drugs available in the Diebold as they felt was needed - in other words, titrating to effect rather than sticking to the dose written on the MAR. He did say this verbatim: "For example, you'll have someone come back for more of a drug out of the Diebold.....ooops, they dropped the last dose!" ...giving me the eye to indicate that the nurse was lying about the reason for overriding the Diebold and that she was actually giving the amount of the drug she felt necessary.....he then proceeded to say, "But on the MAR, they just cross off the dose as written." When I asked a question, he looked at me and said, "You know, I think you'd better forget what I just said." I said, "But you just said it!" He said, "Well, forget I said it." The first day that I had the aforementioned COPD patient in my original post, he was extremely agitated in the a.m. He was pulling his vent tubing off his mask for the BIPAP constantly (we had to restrain him, finally), and was moving around in bed enough that he was in danger of falling. We did not have any sedation orders, so I thought I would call the md for some, but he was so agitated that I was wishing I could give him some Ativan immediately, so I went up to my preceptor, and, based on his previous little "unspoken protocol" conversation he told me to forget, asked him, "That guy need some sedation NOW; do we have an unspoken protocol to go ahead and give him some Ativan?" He proceeded to look at me and act as if the conversation of the other day didn't happen, and acted all self-righteous about it..."We don't HAVE unspoken protocols! That is a controlled substance....." He later reiterated, saying that I could lose my license over that....yet, I was just trying to respond in kind with how he tried to describe to me how things "really work" on the unit. Another incident happened where we had a terminal pt. - 92 year old stroke pt. w/brain hemorrhage who came in the night before and would soon die - who had initially been put on a vent. It was decided by the family, since the bleed on CT was showing up in fully half her brain, and she would not recover, to take her off the vent and let her go naturally. We started our unit's formalized deescalation protocol; it stated that a morphine drip would be started which would run anywhere from 2-10 mg/hr. Well, my preceptor said it should be started at 10 mg/hr. We did this. The daughter came out and kept asking us about every little movement her mother made, such as when her mouth moved a little - "Why is she moving her mouth like that?" I didn't mind this, as I knew it was a s/s of emotional distress on the daughter's part, and that she mainly needed reassurance; when she did this, I would go in and assess if anything was really wrong (there was usually no change), and then just give them both a little concerned TLC and a hug, as this was what I felt the daughter needed. My preceptor later came and told me he turned the morphine drip up to 15 mg/hr so that the the mother would quit the movements which were upsetting the daughter (and there really weren't many, she was out of it), to create the impression to the daughter that everything was ok. Now, the argument could be made that the slight movements she made might indicate some discomfort, and that we were titrating to pain.....but, they seemed to me just to be reflexive, mainly consisting of occasional mouth movements where the ETT tube was touching her mouth (she was on a T-piece at this time.) I say all this to say that this preceptor has a history of giving drugs as he pleases, and saying that this is how everyone on the unit does it; his backpeddling on the "nurses are walking around on this unit with extra drugs stored in their pockets that they use when they think they need them" was a little strange to me. So, I really don't KNOW how much he gave the pt. because of his history exhibited in both statement and practice! He may never tell me, as he may smell a rat if I come back and ask him how much morphine he gave that guy. NrsKaren, I appreciate the resources you posted, and have looked them up; this is a great way for us to learn from each other. I am interested in hospice nursing, so this may be in my future. Siri, I understand your reaction, as it is possible that his motives amounted to what you said, although one may argue that euthanasia may be the correct term (which can be argued to be synonymous with murder anyway.) I certainly wouldn't want my own spouse to be subject to this without my knowledge. I think the idea of this preceptor needing some inservice has hit the nail on the head. His ideas and practices have me totally confused on how far actual practice, in the ICU at least, differs from what we were taught in school - esp. pharmacology!! I really had medication administration drilled into me in clinical, and it became an area I was precise and competent in; to get out here and find out that ICU nurses do what they feel is best and carry drugs around in their pocket to use the amounts they feel appropriate despite orders, makes me wonder how safe this place and its patients are (and the whole hospital, for that matter.) I appreciate the encouragement to question things and even approach ethics committees. I think, after hearing from you all, I will be more vocal in my questionings and objections. Thanks! ICU Newbie

A post which discussed end of life issues over on the long term care forum got me thinking about something which occurred yesterday in the ICU unit where I am on orientation. I have reposted it here to see what you all think. My preceptor and I cared for an end-stage COPD pt. 2 days this week. He was on BIPAP with terrible labored breathing, and I saw his LOC decline significantly during the day on Day 1. Day 2 a.m. he was unresponsive most of the morning; about noon, he was able to squeeze my hand weakly upon command, but had no other response to anything except pain at any other time. My preceptor went in and talked to the wife about his code status and the potential use of a ventilator, which he might never come off of; this all resulted in her saying that the pt. had previously stated that he didn't want to be put on machines. When the doctor came in about 1300, he was officially made a DNR. Now, I know this is a commonplace and commonsense scenario taking place regularly throughout this country, and that the wife needed guidance as to what to do so as to not prolong the suffering of her spouse of 51 years. It was the next thing which happened which I am looking at with a critical eye in light of the discussion of end of life care issues. When the md wrote the DNR order, we also revamped his entire med list to reflect the new approach; again, common sense. Our unit has a formal deescalation protocol, but this was not being implemented, as this man had not been on a vent. The new med list included morphine, of course...it was 2-4 mg, can't remember the frequency, probably q 1-4 hours. It was not the morphine drip at 10 mg/hr that's on our deescalation protocol. At 1700, my preceptor came up to me and asked me how I felt about giving this guy morphine. The pt. was resting quietly in bed with no agitation or signs of pain or increased vitals. I asked him why, since there seemed to be no immediate indication for the morphine; he said that if this guy were to hang on too long, let's say, 3 or 4 days, the wife may start to doubt her DNR decision, and that would just add to her misery. I said, "You mean, give him morphine to slow down his breathing so he won't hang on 3 or 4 days?" My preceptor nodded. This was a new concept for me, as there seems to be quite a difference between not engaging in futile treatment and actively giving drugs to hasten the end. No one would want this COPD guy to suffer any longer than necessary, but actively giving him morphine for RR effect is a little on the proactive side, it seems. My preceptor walked over and indicated he was giving the morphine; when I left at 1900, the gentleman's RR was down to 8. I was thinking about this last night, and suddenly thought to myself, "How would I feel if I knew my own husband's end in this ICU was hastened by possibly a couple of days by a nurse who felt it would be detrimental to my mental well-being to let my spouse 'hang on' (in other words, die without intervention), and that this decision to consciously slow down his breathing to hasten his end was done without my consent or knowledge?" I am becoming increasingly more uncomfortable throughout the day as I contemplate what happened. I know that what happened makes absolutely no difference to the pt.'s long term welfare; it's just that the wife had no say in this, it is dangerously close to euthansia (if not equivalent), and is the stuff lawsuits are made of. Also, when I apply the "do unto others" rule, it falls a little short. Since I am new on the scene, I am wondering if the problem is that this is a common practice that no one talks about, and that I am just naive about what really goes on. My preceptor's motives were not bad (the euthanasia movement's aren't either), but this really blows away the idea of informed consent to medical treatment. I imagine that all sorts of things go on in ICUs across the country that no one would admit to, but I would really like to get some reactions from seasoned ICU nurses and nurse ethicists as to whether this is common practice, this guy is unusual, or I am naive enough to still be hanging on to nursing school habits and ideas, and am too "black and white" in my thinking. ICU Newbie BSN May 2005 NCLEX survivor July 2005

This thread has me thinking about a situation which occurred yesterday in the ICU unit where I am on orientation. My preceptor and I cared for an end-stage COPD pt. 2 days this week. He was on BIPAP with terrible labored breathing, and I saw his LOC decline significantly during the day on Day 1. Day 2 a.m. he was unresponsive most of the morning; about noon, he was able to squeeze my hand weakly upon command, but had no other response to anything except pain at any other time. My preceptor went in and talked to the wife about his code status and the potential use of a ventilator, which he might never come off of; this all resulted in her saying that the pt. had previously stated that he didn't want to be put on machines. When the doctor came in about 1300, he was officially made a DNR. Now, I know this is a commonplace and commonsense scenario taking place regularly throughout this country, and that the wife needed guidance as to what to do so as to not prolong the suffering of her spouse of 51 years. It was the next thing which happened which I am looking at with a critical eye in light of what is being discussed here. When the md wrote the DNR order, we also revamped his entire med list to reflect the new approach; again, common sense. Our unit has a formal deescalation protocol, but this was not being implemented, as this man had not been on a vent. The new med list included morphine, of course...I think it was 2-4 mg, can't remember the frequency, probably q 1-4 hours. It was not the morphine drip starting at 10 mg/hr on our deescalation protocol. At 1700, my preceptor came up to me and asked me how I felt about giving this guy morphine. The pt. was resting quietly in bed with no agitation or signs of pain or increased vitals. I asked him why, since there seemed to be no immediate indication for the morphine; he said that if this guy were to hang on too long, let's say, 3 or 4 days, the wife may start to doubt her DNR decision, and that would just add to her misery. I said, "You mean, give him morphine to slow down his breathing so he won't hang on 3 or 4 days?" My preceptor nodded. This was a new concept for me, as there seems to be quite a difference between not engaging in futile treatment and actively giving drugs to hasten the end. No one would want this COPD guy to suffer any longer than necessary, but actively giving him morphine for RR effect is a little on the proactive side, it seems. My preceptor walked over and indicated he was giving the morphine; when I left at 1900, the gentleman's RR was down to 8. I was thinking about this last night, and suddenly thought to myself, "How would I feel if I knew my own husband's end in this ICU was hastened by possibly a couple of days by a nurse who felt it would be detrimental to my mental well-being to let my spouse 'hang on' (in other words, die without intervention), and that this decision to consciously slow down his breathing to hasten his end was done without my consent or knowledge?" I am becoming increasingly more uncomfortable throughout the day as I contemplate what happened. I know there is probably a euthanasia/ethics thread that this might fit under more appropriately, but you all really have me thinking here. Should I post this also under any other thread? (I am relatively new to posting.) And believe me, I know that what happened makes absolutely no difference to the pt.'s long term welfare; it's just that the wife had no say in this, it is dangerously close to euthansia (if not equivalent), and is the stuff lawsuits are made of. Since I am new on the scene, I am wondering if the problem is that this is a common practice that no one talks about, and that I am just naive about what really goes on. My preceptor's motives were not bad (the euthanasia movement's aren't either), but this really blows away the idea of informed consent to medical treatment. I imagine that all sorts of things go on in ICUs across the country that no one would admit to, but I would really like to get some reactions from seasoned ICU nurses and nurse ethicists as to whether this is common practice, this guy is unusual, or I am naive enough to still be hanging on to nursing school habits and ideas, and am too "black and white" in my thinking. ICU Newbie BSN May 2005 NCLEX survivor July 2005

I had a question which asked, "Tell me about a time you exhibited leadership." This was the one question I had not prepared for; floundered a little, muddled my way through it, got the job anyway and am now orienting in the ICU. Good luck! Try to relax. Sheree

How quickly have you gained the 7 lbs.? I don't mean to be alarmist, but I would suggest checking your blood pressure to make sure it isn't going up if the weight gain was in a short period of time. If your blood pressure is up, I would suggest calling your md. If your blood pressure is ok, I believe that a pound a week in the last few weeks may ring a bell from my OB class. The baby gains a lot in the last few weeks. Just make sure to rule out preeclampsia if your weight gain has been sudden and quick. I hope you have an easy delivery and a healthy baby! Sheree Graduated May 14, 2005, passed NCLEX July 2005, orienting in the ICU.