L&D

This week I was assigned to L&D, that is Labor and Delivery. I participated in helping with two births on Wednesday. The first came very fast when it came, the second not so much. They were both spanish speaking pt's which made for somewhat of a barrier. Mi espanol is muy picito y muy mal. (I speak very little spanish and it is bad.)

The first pt was having her fourth child. They had given her pitocin and she went from a 4 at 70% to a 10 at 100% very quickly. We went in the room and tell her not to push and she doesn't, but she kind of sighs and the baby falls out. It was one of the oddest things I have ever witnessed. Sigh, then baby. It was a beautiful baby and the mother and father was so excited. The fathers aunt had died roughly an hour or so before and so they named the babe after her.

The second pt was having her first baby. The had her on pitocin for a long time and she was progressing very slowly. She stayed at 8 and 90% for a long time and then 9 and 90% for a long time. She presented full at 10:50 am and we helped her push for four hours. She was working so hard and trying so hard. She was truly exhausted. The baby's head was not going to come through it was presenting at a bad angle and positioned such that it was not coming through. The next thing I now I was in the L&D OR prepping the pt for a c-section. Once it got going I stood at the foot of her bed and observed the birth of her baby. The pt had been pushing so long that the baby was in the vaginal canal, so at the appropriate time, the circulating nurse had to crawl under the operating table open a trapped door, reach in with a sterile glove and manually push the baby out of the vaginal canal. So the pt had two hands in her at one time - weird. Moments later a beautiful baby girl (with an oddly shaped head) was born. She responded slowly to the world due to the drugs she had received, but eventually she came around.

Life is truly amazing. This morning my little friend Haydn is staying with us and Christa and Dewayne are off to Baptist to have my newest little friend Ava. I'm excited to meet her today. Funny how it's different when it is one of your own as opposed to one you just help with. May God bless them.

Yesterday and Today

I suppose I should say a little more about why I don't like pediatric medicine. It is not that I don't like children. In fact it is quite the opposite. The truth is that I have always loved children; their innocence, their purity.

Seeing people with illness, disease, and other difficult situations is hard but, unfortunately, it's just a part of life. Seeing children with illness, disease, and other difficult situations is hard but that is in no way a part of life. People live their lives, get older, get sick and die. When that happens to children it is devastating because they are cheated - they haven't gotten to live their lives yet. I've spent the last 3 years working with a population who often die. I've learned to understand it, to accept it, and at times appreciate it. I don't want to spend my life watching the pediatric population suffer. That's not to say that all health care situations end in death, because they don't, but I wasn't build to watch children suffer.

But, there is one beautiful aspect of pediatric medicine, maybe the most beautiful aspect of all medicine - that would have to be birth. That moment when one begins their journey.

I spent yesterday in the newborn nursery. My task was simple - hold whichever baby was crying, comfort it, wash my hands, and then pick up the next. It was truly a moving task. I held one baby and looked over at the name card on their crib and realized they weren't even 12 hours old yet. I acknowledged at that moment the sovereignty of life. What an honor to spend the first few moments of life with this child. As I held the different blessings in my arms I wanted and wished so much for them. I said small prayers to God for them. What an amazing gift it was. I then realized as I hoped so much for them how insignificant I am. As I stood there holding them and wanting so much for them I realized how truly powerless I was. As much as I wanted, there was truly nothing I could do to enhance or encourage these little people and their lives. All I can do is pray for them.

Today a lot of things occurred. I shall only focus on the afternoon though. This afternoon I gave a presentation, ironically on pediatric nutrition. Today I got to be a Registered Dietitian and give an hour long lecture to my peers and faculty. This was not an assignment, it was a request from a previous instructor I had. I had the most fun - something I have greatly needed for many weeks. I cracked jokes, fielded questions, and I was just overall awesome. One day, in some capacity, at some university, when the time is right, I will teach. I will be an amazing teacher and I will love it.

I've become one of those people

So yesterday was my first day of OB and it was incredibly uneventful. I pretty much stood around all day. Oh no, I did forget one exciting thing - I got to look at 2 postpartum rectums to see if the pt's had hemorrhoids. 1 did, 1 didn't. Very exciting!!

It also happened to be my plan of care week. We have to do plans of care for a grade at least once every rotation. A plan of care consists of a nursing diagnosis and two interventions for 7 systems (neuro, skin, cardiac, respiratory, GI, genital-urinary, and musculoskeletal), signs and symptoms for each nursing diagnosis, and a lenghty analysis statement for each nursing diagnosis. Usually a plan of care takes me anywhere from 4-8 hours depending on the pt and depending on how much I can copy from a previous plan of care I've done. This week however I had to do one for the mother and the baby, so that's 2. This rotation we go all day on Wednesday and then half the day on Thursday or we get lucky and get the whole day off on Thursday. Luckily I got the whole day off today. So, I started working on my double plan of care at approxiamately 9:30 this morning and finished it about 5:00 this afternoon, this is 7 1/2 hours. On one hand I'm glad I'm done, on the other I wish I could have done something fun on my day off, on the other hand I have the whole night free to watch my two shows (survivor and Lost), on the other hand I won't have to do it this weekend (which is good because I have an excessive amount of other homework). So I have four hands.

As I have indicated in previous blog posts I am also working to prepare for next year. One requirement of next year is that we have a PDA. The PDA will pretty much have to be on our person at all times so that we can consult all the multimedia we get to buy as well as document on pt's and send reports in to faculty when we are at the hospitals and various clinical sites. It may initially sound very exciting but really it is just a ploy to give us more work. So anyway, my contract came up with Verizon in March. I've been with Verizon for 6 years and have greatly appreciated their business and professionalism. I wasn't sure what I wanted to do, which PDA to buy, etc. I did a lot of research (this is an understatement coming from a person who spent 6 months researching before buying my 1st real car). I spoke with my advisor and got the basic requirements for the PDA. Looked at phones. Went to 5 different stores and spoke at length with tech people and got all the positives and negatives, the good the bad, the prices, the specs, the perks, the quirks. In the end I finally made a decision (yes, it is shocking). I got a Blackberry. I really do like it. I have become one of those people. I've had it about 5 weeks and I'm really enjoying it. I've downloaded some applications that have come in quite handy - the Bible (I can read at lunch), epocrates (a complete drug reference guide), and my personal favorite - disco bowling (I'm awesome).

Unfortunately, two weeks after I got my Blackberry, we had a specialty year meeting. At which they told us not to buy a PDA yet because they were working some kinks out of some programs and we may only be able to use a certain PDA. I'm fearful that brand will most likely not be Blackberry.

Summer School

So summer school started last Monday. It's amazing that so much time has already passed. It's hard to believe that I am already 1/3 of the way done with school. When they presented the syllabus in class last Monday, they said this semester was going to fly by and that if we turned around twice it would be over (I tried this and it didn't work).

So, tomorrow I start my OB rotation at Nashville General Hospital. I'm excited and looking forward to this new experience. Hopefully it will be uplifting in comparison to other rotations I've had since having a baby is usually a positive thing. At this point though, I'm not exactly sure how to get to Nashville General, but I'm sure I'll figure all this out before 6:45 in the morning. Nashville General Hospital serves much of the lower income population of Nashville and a lot of the Hispanic population are served there. My Spanish is incredibly rusty, but then again, it is really bad anyway. Anyway, I'm assigned to the postpartum unit tomorrow, so no live births for me - that'll have to be another week. I'm looking forward to this rotation though and have been all year.

This week through different lectures and a growing familiarity with my new classes has enabled me to begin to see the light. You know, the one at the end of the tunnel. I'm begining to realize the end, of this year anyway, is in sight. The days are numbered and I'm happy for that. That's not to say that this tunnel doesn't still have a lot of hurdles.