aren't there any uncomplicated births anymore??

[MIA-RN1]

I can't understand what is going on! There is a joke that I have a 'black cloud' around me!

This past two days, I have had a patient with about a 500cc hemorrhage, a pt that spiked fever, chest pain, body aches (turned out to be endometritis) the night before discharge, a PP patient who had earned a stay in ICU d/t not being able to breathe and being intubated, babies with jaundice needing the lights, a PP who's discharge was held up to r/o pneumonia, an antpartum w/ pyelo, another antepartum r/o PE who ended up having gallbladder surgery...what is going on? Where are all the uncomplicated patients?? Have they all decided to stay home for the winter???

I am feeling the strain as a relatively new nurse. And to note, these are only the ones I've cared for. We've also had several antepartums, lots of TAH floats to our floor, some of which I've had the last week or so, and a PP mag pt also.

They say they trust me and that's why they give me these patients. They say that I can handle it. And of course I do. But I still get cold sweats when I see my assignments. I've been doing real well and progressing nicely and I feel like I am comfortable in my role as nurse. But lately, there has been at least one patient a night that makes me question my career choice. Not because I don't like it but because I am scared of it. When I found out the ICU patient was coming last night, I almost cried. If it was just her, okay maybe it would be easier. But I had three other couplets as well, and two of them needed to be discharged home at 7pm. So it was tough and tight.

We are not the largest facility and we are not the one for high-risk, acute moms or babies. It just seems like TPTB are trying to make us that way. We have moved many of our special-care babies to the regular nursery; that is scary in and of itself. We are too small to handle the demands that I think they are putting on us.

I am questioning my choice to work there. With all the experience I have been getting in surgical patients, maybe I will just find a women's surgical floor to go work on and then at least I won't have to deal with the babies. There is rumor that we will go to 6 couplets per nurse. That will be the day I leave.

I just feel that they expect too much out of us, and myself personally I feel like I have been having just really heavy shifts. I am sure I am not the only one but it feels like it today.

Thanks for letting me vent.

[MIA-RN1, RN]

I hear ya, Blue Eyes.

I am glad that allnurses is here because its really helped me open my eyes to corporate stuff that I;d probably be naive to otherwise, and helps me see the deeper picture as to what fuels our floor operations.

We are taking the 'magnet journey' and maybe...just maybe...there is a chance that things will go straight. The thing is, its like this everywhere. We all have to deal with poor ratios, sicker and sicker patients (thank you HMO's) and TPTB who don't work the floor don't see the real thing. I WISH my NM would come and work with us on a day like the ones we've been having. Can you believe we had a CODE on a mother the other day?? It was handled expertly by the nurses involved, and the outcome will likely be allright but c'mon...why did we have that sick a patient on the PP floor to begin with?? Aside from the fact she was PP, which of course is the kicker. Antepartum, postpartum--if they are sick, bring em on. No matter if its gallstones or PIH, if they have an upcoming or recent birth they come to us. Thats how it goes. Most of the time it is okay but we are NOT the high-level hospital in the neighborhood. I had one PP freshly extubated from ICU. Ok, so maybe she was stable when I got her but I was shaking in my nursemates all night, kept thinking what if. Can I handle it? I do LOVE nursing and I LOVE my patients and it sounds convoluted to say I love my job but I want it better, I want it safer and I want us to work at the acuity level we are capable of caring for. And if we have higher-acuity patients then I want more nurses on the floor. No nurse should have three couplets and a high-risk patient with or without a baby. Maybe I am too new a nurse and its just my comfort level isn't there but its bad enough with 4 couplets and one is a fresh c-sect who needs HOURLY checks for 12h.

Good grief I am almost late for work; off the soapbox I go.

[magz53]

Doesn't it boggle the mind of all of us that variations of this same thread continue to be a concern to caring intelligent nurses ?? Is there a hospital anywhere that has adequate staffing ?? Why are we so powerless to change things ?? Why can't we command the respect that our work deserves ?? Is there anyone in management out there lurking on these boards who could possibly give us some insight ? Nurses are leaving hospitals for all of these reasons. We are unable to give the care we know we are capable of giving and that the patients deserve. Rare is the evening I go home feeling satisfied with the care I gave............so stretched to the limit are we all. Some of us are working in small hospitals and the "city" hospitals are too far of a drive to be feasible to work. From what I see on these boards, they may be no better staffed. We keep sharing horror stories and while it may comfort us to know we are not alone, nothing changes. I would never encourage anyone to enter into the field as patient care seems to be management's lowest priority under cost containment and 100 other things. Grrrrrrrrrrrrrrrrrrrrr

[allpcn]

re:aren't there any uncomplicated births any more??

I've been doing L&D for several years. I love it. I've had nights with ruptured uterus, home birth of 25 wk and Mom is bleeding out, a stat c/s in ER as they are performing cpr on mom, I personally have delivered many babies because they walk in the door with thick mec and crowning. It's exciting to bring a baby back from deaths door. The thing you have to remember is L&D is almost always an emergency situation. If you don't like the adrenaline go to a floor that has separate L&D, PP, an Nursery. There is nothing wrong with not liking the stat situations. Find a place that works for you. For me Ilove the the stats. PP and well baby are too dull. Keep in mind though it takes years to feel even a little comfortable in a L&D and even then no one that is any good feels totally comfortable because there is always something new.

Uncomplicated births are treats we all wait for, but in reality no birth is totally uncomplicated.

[Ado Annie, ASN, RN]

I have to say "Thank God for those interventions when they are needed."

I honestly don't think that all 3 of us would have survived if I'd had my babies before the advent of modern medical science. (hypertension, baby A was breech, postpartum hemorrhage)....

[SmilingBluEyes]

Interventions when needed are good. But I see too many that are not needed and simply elective. And this concerns me. Obviously, there are high risk cases or problems that require urgent intervention. This is not what I and others are venting about, however.

[MIA-RN1, RN]

re:aren't there any uncomplicated births any more??

I've been doing L&D for several years. I love it. I've had nights with ruptured uterus, home birth of 25 wk and Mom is bleeding out, a stat c/s in ER as they are performing cpr on mom, I personally have delivered many babies because they walk in the door with thick mec and crowning. It's exciting to bring a baby back from deaths door. The thing you have to remember is L&D is almost always an emergency situation. If you don't like the adrenaline go to a floor that has separate L&D, PP, an Nursery. There is nothing wrong with not liking the stat situations. Find a place that works for you. For me Ilove the the stats. PP and well baby are too dull. Keep in mind though it takes years to feel even a little comfortable in a L&D and even then no one that is any good feels totally comfortable because there is always something new.

Uncomplicated births are treats we all wait for, but in reality no birth is totally uncomplicated.

I hear you, but I DO work PostPartum!!