Published Feb 21, 2006
sweetcheekers
75 Posts
This weekend was ugly! I work in OB and this was my weekend to work. We had 3 moms and 3 babes and one in labor. I had the 3 couplets and the other RN had the labor patient. It was just after midnight and a labor Pt shows up looking really painful, is checked and dilated to 2cm. We call for another labor nurse so in the meantime the labor nurse is going back and forth between the 2 laboring moms. I open up the room for the new admit, get her IV going and then the labor nurse hooks her back up to the monitor. (She had been on one in our exam room prior to moving to her room.) Anyway, long story short the other labor nurse arrives and takes over on the other patient and the nurse I had been working with takes over the new labor Pt. Her strip looked good except the heart rate was in the low hundreds, but had variability. She requests an intrathecal and the RN calls the doc and says her Pt wants and intrathecal but she doesn't like the heart rate. Doc says, "I'll be right there." He arrives in a few minutes, breaks her water and all hell breaks loose. There is meconium and it is not just stained fluid. It is all meconium. He says he's never seen anything like it. It was thicker than pea soup and the amount was unreal. Within a minute of AROM we lose the heart rate on the monitor. He calls for a second fetal scalp electrode thinking its junk, the second one isn't picking up anything either. The strip just shows searching marks. He calls for a stat c-section which where I'm at is a good 20-30 minutes away. Then the baby comes so fast we cancel that. (literally she was crowning within 5 minutes of calling for the section.) The babe pops out before he can even get gloved, the warmer isn't on yet and her we have a totally limp babe. From the patients admit to delivery was 90 minutes. We lost heart tones 8 minutes before she delivered. Rescusitation was started and continued for 30 minutes with intubation, PPV, compressions, epi x2 down ET, epi x2 per umbilical cath. Nothing. Never had a heart beat. Perfect full term babe. How can you have 3 docs and 3 nurses available with full knowledge of what to do, implement it and have such a disastrous outcome? What a night from hell. I was reminded again that we are not in control. We do what we know, we do what we can, but ultimately we do not decide what is to be.
Larry77, RN
1,158 Posts
How terrible...so sorry for that experience. I always enjoyed OB but not when things go wrong...
I took care of a Pt who had a fetal demise but the baby was only 20 weeks and had prob died at 16 weeks per the doc. OB can be such a happy place but when things go wrong they really go wrong and the whole hospital seems to feel it.
LoveTheNICU
57 Posts
I am so sorry to hear about your weekend....... Mine was right up there too. My NICU was at capacity when I arrived on Saturday, and we literally had 4 calls to L/D for admissions in 20 minutes. We didn't even have the transport beds cleaned and back up to their unit to bring the kids down. They just kept coming. One little guy just had no chance- I don't know the story on him, but I do know that immediately after admission they took him off support and brought him back up to postpartum so the parents could be with him while he passed on. To top it off, we had a 23 weeker code (not unexpected, but still no fun in the midst of everything) and one of my primary kids for the weekend was anencephalic and had already been made a DNR..... I love what I do, the majority of the time it is immensly rewarding and wonderful, but this weekend was physically and emotionally exhausting Hang in there, and know the good days will keep outnumbering the bad...
jillyk*rn
859 Posts
:icon_hug: hugs to you!!!:icon_hug:
Kim O'Therapy, BSN, RN
773 Posts
Thanks for being there for the bad times.....as well as the good. The bad times is when the patients need you the most.