Drum Roll Please

I got an 89 on my exam. My second highest grade in nursing school so far. This is a solid B, so solid in fact that I was only 3 pts shy of an A. So solid that I can essentially get an 80 on the next two exams and get a B in the class. And so solid that I can get a 65 on the next two exams to pass. I do need an average of a 94 on the next two exams for an A, which may be a little difficult, but hey, I'll still try.

Yay, I am so excited :)

Today's The Day

OB Exam 1.

I think I am ready. But there is always so much I don't know that it's hard to tell.

Tune in later for the results.

I feel good so we'll see :)

My Day in L&D

Labor and delivery. For as long as I can remember, this area has been number one in areas of nursing I am interested in. A close second is ER/Trauma and Peds as third. Maybe it's because I feel like I am making more of a difference in people's lives in these departments. Maybe it's because I find these areas so intriguing. Maybe it's neither of those things and something entirely different, but those areas have always remained on the forefront of my mind.

When I first started nursing school, I told myself I would keep an open mind, that I wouldn't close myself off to just L&D, or ER, or anything else. I would go through the rotations and see if maybe something else would surprise me. I went through three rotations on med surg floors so far. This is the area where everyone tells you to work a year or two in order to hone your skills as a nurse and then transfer to wherever you like after. My first two of the three med surg floors I was on I absolutely HATED. I'm not a big fan of adult poop or adult urine. I'm not a big fan of 1:6-8 patient ratios. I'm not a fan of doing nothing but passing meds all day. Or being yelled at by older patients. Or anything else really med surg-like. I don't feel like I am making a difference, I don't feel like I am helping anyone. The third of those three med surg floors I had a better experience, and ended up feeling a little more like what I was doing mattered. But still. It didn't feel like home.

Then came Peds. I felt more comfortable, but it wasn't how I envisioned it at all. I thought I would go in there and be super nurse, and make all these sick kids magically smile and feel better. I was naive, and my expectations caused me to be disappointed. My Peds rotation was just yet another med surg floor, this time the patients were smaller, and I had to deal with moms and dads on top of it, which can be intimidating. I know that there is a whole lot more to the Peds world than what I experienced and I did like it more than the other rotations, but it still just didn't feel quite.........right.

Then there was Psych. Definitely NOT for me. Charting non-stop all day in the nursing station, and passing out meds- not my cup of tea. I can be a secretary any day of the week if I want right now without a license. Nurses chart- sure, but not like this. This was just insane (no pun intended).

Then came OB.

The excitement of it alone almost overwhelms me.

I've only had one day on the floor and while I didn't experience much, something just feels......right. It's hard, because I am an emotional person, so I don't know how long it will take me to stop crying after every birth, after every loss. I fought back tears several times yesterday. Most happy ones, but there was a sad set of tears in there, too. In talking to the nurse I was working with, I was told it's OK to cry. We're human. If there's a loss, just be there for the patient, cry with them, and if I need to step out, then do it. I will be able to find a way to block things when I need to. I can do it. It might take some practice, but I think I can.

I really feel like this might be my home. And the realization of that kind of overwhelms me as well.

There are so many awesomely fascinating aspects of OB. It is really such a specialized area and I feel like while there is a lot that I know, and a lot that I am still learning, there is still SO much more to learn. There's also other aspects of OB, too- like postpartum nurses, baby nurses, NICU. I will be experiencing all of these during this rotation. Maybe I will like those, too.

There's just something about L&D.

So for my first day, I had a patient, who just so happened to be an RN herself. First time mom, didn't know the sex of the baby yet. I was so excited to be able to experience this time with her and her husband. Unfortunately, she didn't deliver before I left. In fact there was not one vaginal delivery then entire time were we there, yet the floor was crazy busy. By the time we left, all 12 beds were full and all 3 triage beds as well. There was about 4 c-sections earlier in the day, and I was able to see one of them. It was pretty cool to be able to see things from the other side of the table for once, and holy cow, the stitching involved is amazing! Way cool. So many layers......which I am sure I knew in the back of my head but just didn't realize until it was there in my face to see. Doctors and nurses all seemed very nice. My nurse even told me about the new grad program their L&D has about once a year.

I saw two epidurals given, I saw one spinal given (for the c-section I watched), I watched a foley cath being done, which I had asked to do myself because I know how to do them and can do, them, but my nurse thought it would be a better idea for me not to do it since my patient was a nurse. I saw the baby nurse and the pediatrician doing their thing with the newborn, suctioning out the mucous the c-section babies often have, doing the gestational age tests, APGAR scores, foot prints, etc. I saw everything BUT a vaginal delivery.

Right before we went home, a young lady came in who was 21 weeks pregnant with her water broken and in a lot of pain. The nurses were saying she was probably going to deliver soon. This was tough for me, because as I learned, with a baby that small, there is nothing that can be done. Nothing. Too small. Usually after 24 weeks there is a chance, and at 22 weeks they may evaluate to see if there is a shot but 21 is not enough. Sad, very sad. Apparently, the patient was a drug mom in a drug program at the hospital. Even sadder.

But not all the cases are like this. I can't express the coolness of witnessing the birth of a little life into the world. Watching them take their first breath and seeing the happy moms and dads, so proud. I got to take a picture of a dad cutting the cord off his little girl (was a c-section baby and they were doing it in the little newborn room, oh and the picture was for the dad with his camera, not mine!). So cool. So very, very cool.

There's just something about L&D.

My Labor

Being in OB with all the talk of pregnancy, labor, and babies, it has me thinking a lot about the times I was pregnant, and the time I had Grace especially. Although I had started getting contractions with Nate a whole THREE weeks early and before my scheduled C-section, I obviously didn't get to experience full labor with him. But since I have been thinking about my experience with Grace so much, and her 8th birthday coming up in just 2 weeks (oh my!), I thought I would share that experience here.

WARNING: This blog is extremely long. It is probably my longest blog, ever. Heck, it's probably anyone's longest blog, ever. It's that long. You are hereby warned.

Flashback to September 5th, 2002.

It's a hot Friday afternoon. Ray and I just closed on our condo, our first together since we got married. I was due on September 10th, a Tuesday ,and no signs of my little girl were showing yet. My next appointment was at 4pm on my due date and as of my last one, things didn't seem to be anywhere near getting started. I was scheduled for an induction on September 21st if needed (which I am glad I wasn't still pregnant that much longer than I was). There was a lot to do at the condo, and I remember we had to wait a little bit to get the keys to the place. There was some issue with the seller's realtor or something. My memory fails me as to what it was exactly but I just remember having to wait until evening before I could start cleaning. Over the weekend, we cleaned and moved and I probably didn't rest much at all. I wanted to get Grace's room as ready as I could for her and get things as ready as I could in the rest of the house for us before she came. So that weekend, I was a busy little bee. I think we got a lot accomplished.

It's Monday, September 9th. Ray goes to work, and I'm home. I go out to run some errands in the afternoon, and this is where I begin to remember feeling very uncomfortable. I was in the parking lot of Doris' Italian Market. I am there to pick up some thinly sliced steak of some sort to make steak sandwiches for dinner and as I walk through the parking lot, I remember having to stop because I had a moment of being extremely uncomfortable. I can't say it was a contract because it didn't feel like the contractions I had later on, but I kept having these uncomfortable moments every so often while walking.

I get home from my errands, and I feel as though I need to use the bathroom badly, urgently, all out of no where. I am almost literally running in the door of the bathroom when all of a sudden, my pants are soaked. "Did I really just pee my pants?" I think to myself. I can't even believe it. I am perplexed by how this could have happened and have a fleeting thought that maybe my water broke. So, I call Ray's mom and ask her if my water were to break, would I start my contractions. I don't know the exact wording of my question, but it was vague. Vague enough to where she answered, "Yes," and vague enough that I just continued to think I peed my pants. (Make note for later that this was probably in the neighborhood of 3pm)

I would later realize that this even was my water breaking. And I would later realized that I had several "stupid" moments where I should have done totally different things but did very air-headed things instead. This was one of them. I should have totally called the dr's office and told them what happened. They would have had me drive over and see what happened. They would have then admitted me into the hospital and by Tuesday I would have me a baby girl.

Instead, I just cleaned up and changed and made dinner and went to bed. This would be the last time I would be able to sleep before having Grace 2 days later.

It's 7am-ish Tuesday morning, September 10th. Ray wakes up for work, and I wake up, too. He leaves, and I am hanging out at the house, and I start to realize I am having these pains coming and going, so I start to keep track of them. I can't recall what they were now, but they were pretty far apart still, and they are coming and coming and coming. The pain is noticeable but completely bearable and I remember thinking to myself, "I wonder what all the fuss is about? These are NOT that bad at all. I can totally do this." My original plan was to have a baby without medicine. I had went through years of extremely horrid menstrual cramps. I would be in unbearable pain for hours on end and medicine would never help once they started. They would get so bad, I would literally vomit, which is something I don't ever do, except in that situation. Years I went through this. These contractions- nothing compared to that. I could totally go through with my "no meds" plan. Or so I thought.

It's Tuesday evening/bedtime. Ray goes to sleep. I toss and turn. The contractions had gotten stronger and a little closer together. Earlier that evening, I went to my friend's house who was also a neighbor at the time, to heat up my rice sock I got from childbirth class in their microwave because we didn't have one to give me a little relief. I couldn't sleep. Not a wink. Stronger and closer my contractions came, when finally at about 4am (it is now Wednesday, Sept 11th) I told Ray I think I needed to go to the hospital. We got ready, called his parents and my mom and headed down. Around 5am I get triaged and they are asking me a million questions and I remember I can't answer them because I am in pain. They exam me and tell me I am only 1-2cm dilated and that I should leave and go walk for 2 hours and come back. Two hours? That's like an eternity when you're in pain. Ray and I go downstairs and try to walk. I decide that it hurts too much to walk and that we should go try to eat instead (yeah, not the best idea when you are in labor, I realize now but that's what I did). We finish breakfast and I walk some more. At 7:30am we head up so I can get checked out again. Still 1-2cm. Dang it. It hurts bad enough, you'd think I was ready to push. I can't remember if they told me to go walk for another couple of hours or what, but I think they did. At some point they told me to go to the mall and walk. I told Ray to just take me home instead., and granted, the hospital was over 25 miles and 35 mins highway driving from my house. but I wanted to go there anyway (another non-smart decision). I was tired and I wanted to try to sleep, as I have already been awake for over 24 hours now, and have been in labor for the same amount of time.

At home, I couldn't sleep, the pain was just too much. Finally we decided to go to Sawgrass, since it was about half way between our house and the hospital. We walked around Target, and I was trying my best to put on my poker face and try not to look like a pregnant lady in labor because I didn't want people freaking out and calling me an ambulance or something. I had an appt with my doctor at 4pm and I contemplated either keeping my appt or going back to the hospital (the office was in the bldg right next to the hospital, so I would essentially park in the same spot for either place). For some reason, I decided to go to the hospital instead and when I got checked again, I was told I am finally at 3 cm and they would admit me. After I am admitted, I am told to go walking around the halls. So I try to walk but it's really hard with the pain. I ask for pain meds, but was told that I had to be in a labor room for an epidural where I could be monitored and there were no rooms. It was so busy that day, they had beds in the hallway with partitions around them so patients had some sort of privacy. I was lucky to be sharing a small closet like room with 1 or 2 other patients so at least I wasn't in the hall.

Around 6pm or so, my doctor comes to see me after she finished up with her office patients. She tells me they are going to break my water and that she wasn't on call that night, instead the Nurse Midwife from the office was and she would tend to my delivery. There was another OB doc who was on call if I were to need a C-section.

A little while later, Midwife lady comes in to break my water and when she goes to do it, she asks me, "When did your water break? Why didn't you tell us?" I tell her that I have no idea when it broke and if I knew, I would have told them that. I don't think she believes me....something in her attitude and tone. Something blocks my brain and doesn't allow me to recall my peeing my pants 2 days prior (Yes it is now over 48 hours from when that happened, which is not good because anything over 24 hrs increases the risk of infection and we are now at double that). I am in the neighborhood of 5cm at this point. I REALLY REALLY want an epidural but I am told the same reason as earlier that I cannot have one. I don't remember at what point they gave me an IV med called Nubain (boy does that stuff make you loopy!!!!), but I think it was earlier because I remember it wearing off and I had asked for more and got some. I had about 30 second cat naps in between my excruciating contractions that I must say, were about a zillion times worse than my horrible menstrual cramps. Bad. Very bad. So bad in fact, that I think I might enjoy getting shot or something more than having contractions. Apparently, I was told that I was doing extremely well because there were people screaming all over the place, and I was not yelling or screaming or anything. Maybe moaning, but I was quiet. I was certainly screaming and yelling enough in my head. I do remember moving and squirming around in my bed and grabbing the bed rail as hard as I could squeeze it during my contractions.

During this time, I am extremely cold. Too cold, like something isn't right cold. I am shivering. I feel my forehead and it feels warm. I ask others to feel it and they agree. I tell the nurse that I have a fever. She leaves and comes back and takes my temp, and yes, I have a fever. My water has been broken for 2 days. Fever + 2 day broken water= possible infection. The nurse leaves and comes back with some IV antibiotics and I think some blankets.

At 11:30 pm, I am checked again and I am told that I am now at 8cm. All of a sudden, for the first time, I am in full blown freak out mode. I remembered in child birth class they talked about the transitional phase. This is where you go from 8-10 cm in a relatively quick time. Usually too fast to get an epidural at that point. I tell the midwife that I am very sorry, but if she doesn't find me a room and get me an epidural right then and there, that I would not push and have my baby. She needed to do something if she wanted me to do anything for her. Not 5 minutes later, she tells me that a room (magically) opened up and I would be going there right now. A few minutes after that, the anesthesiologist comes in. I am in the middle of a contraction when he wants me to sit on the edge of the bed and lean forward so he can get this epidural party started. I ask for a minute, and to my recollection, he tells me kind of rudely that if I don't do it now, I won't get one because he has other patients waiting for him. Now maybe he was sweet as pie, but for some reason I am remembering him to be not so nice and needing a little course in Bedside Manner 101.

They say that the epidural can take 15-20 mins before you start to feel it, but I swear to you as soon as he was done injecting my epidural space with the medicine, I no longer felt one single iota of pain from then on out. Immediately I went to sleep. I know I said earlier that Monday night was my last sleep until I had Grace. I won't really count this sleeping because I had to constantly be checked and it only lasted a little less than 3 hours, but I was out cold every time I had the chance to be in between all the poking and prodding they were doing.

At 2:30 am, the midwife comes in and tells me that I am no longer progressing. My cervix, which was at one point 100% effaced, is now swelling. I am still at 8cm and have no moved one bit (when I went from 3-8 in about 6 hrs time earlier and now I am not progressing at all). She says what I thought was that she "thinks" I should have a C-section. Because I thought she said "thinks" I try to convince her that I should try a little longer. Just give me another half an hour to see what happens. She tells me that I'm really not going to change anymore. I'm swelling, and that's not good for delivering a baby. It's best if we just proceed with a C-section.

I say Ok. I am calm. I just want to be done with this. It has now been 43 hours since my contractions have started and 43 hours since I have been able to have a solid rest. Let's go have a baby! Ray, I think, was a little concerned that I was about to have major surgery. Me, I was still loopy from all my meds. I am wheeled immediately into the OR and surgery is begun at almost the speed of light. I've never seen people move so quickly. Within like 20 mins of being told I need to have a C-section I was wheeled in, prepped, cut open, and Grace was born, which is now 2:49am. I think within 25 mins getting into the OR, I was totally stitched up and heading back to my room to recover.

Now here is where I look back and question things.

1. From what I was told from my mom and Ray's mom, while I was in the room, sleeping, not feeling my contractions, they were waiting and watching my monitor. From what they could tell, each time I had a contraction, Grace's heart rate when down. I was never advised of any sort of problems with my labor. If she was having this decelerations in her heart rate, why wasn't I told?
2. From what they thought, Ray's mom and my mom said there was another lady who had already been wheeled into the OR and apparently they got her out and brought me in so that I could be done first. Why not just do her and have me wait another 45 mins? I've been waiting 43 hours, what's another really? This just reinforces the fact to me that maybe there was an issue (see #1).
3. I can't recall now, but I vaguely remember something being not so good with Grace's APGAR scores.
   
4. I remember the nurse telling me they would take Grace for a bit bring her in about a half an hour to my room. After I got in my room, I fell asleep and didn't wake up for nearly 3 hours. When i woke up, I realized they never brought Grace in, so I had Ray go get the nurse (don't know why I didn't just use the call button) and they finally brought Grace in.
5. Apparently, while I was sleeping, Ray's mom and my mom could see them, a small team of docs and nurses, maybe 4ish or so, working with Grace. Slapping the bottom of her foot, a long wire going into her nose (which I am thinking it was this suctioning type thing and not an intubation type thing, by the sound of it). This went on for a good 20 mins or so. So what was going? And why didn't they tell me?

For all I know, maybe everything was fine. It just seems a little strange.

At any rate, that is the story of Grace Elisabeth and her grand entrance to Earth (and I how I managed 40 out of 43 hours of labor with no epidural.)

Odds and Ends

A few things to talk about.

1. I have orientation in the hospital next week. Its a new hospital that I haven't been to yet. In my Peds class, this hospital was one of the options to go to, however, I ended up getting the one that was closer to my house. It works out well because I can pick the kids up on my way home and I won't have to go out of the way at all.
2. I am finding this class extremely interesting and I really just can't wait for clinicals to start. I am still nervous about them, but I'm more excited.
3. My teacher has said that on numerous occasions students have been the only person in the room with a patient and have had to basically deliver the baby- because we are NOT allowed to leave the patient to go get help- all we can do is call for help and they don't always get there in time. This is so awesome. Ok, so I am not really expecting this to actually happen to me or anyone I know, but man if it did...................
4. I found out yesterday I won a scholarship I applied for. They will pay all of my tuition, give me extra money for books, supplies, and other costs, and I will also get a monthly stipend. All they ask is that I work for 2 years in a hospital, clinic, etc. that has a critical shortage of nurses. It can be anywhere in the U.S. and just about every place is critically short of nurses. Unofficial word is that there were 6400 applicants and 500 scholarships. Whoa! I'll keep you posted if I get more of an official word on those numbers. I'm so excited!

That's it for now. It's been a very busy, intense week of nothing but lectures (she wants to get as much info in about normal pregnancy, normal labor and delivery and normal newborn stuff before we start in the hospitals next week). I'm so glad I will have my 2 days off each week again starting next week.

OB Begins

Tomorrow, Monday, begins the first day of OB. I can't tell you how excited I am for this rotation because this has been the area I have felt was of most interest to me. I have envisioned working on the floor for a while, getting my Bachelor's degree and then eventually making my way into a Master's level Certified Nurse Midwife (CNM) program with a dual degree as a Women's Health Nurse Practitioner (WHNP). Of course, this was all subject to change, and I could be a trauma nurse in the ER for the rest of my life. But if I had to guess, this is where I would end up. Now, I could love floor nursing and be there forever and never have to go another day of school again after graduation. I could possibly be forced to get my Bachelor's later on because of hospital politics and never see the light of day in a Master's program. Who knows. But tomorrow begins my journey of finding out whether this particular road is one I still want to possibly venture down in the future.

We'll see.

I am scared, nervous, and excited all rolled into one. This semester I will be doing tons of new things. The instructors will expect more of me. I will be starting IVs later this semester. I have to start thinking like a nurse and proving I can do so. This is my second to last semester. The game is officially stepping up.

It's funny. I get all nervous and afraid of clinicals sometimes, until I am actually IN clinical. Then, somehow, I have this barrier that shuts out the nervousness and I just do my thing. Like the time I had to do my first and only foley. I was sooooo scared. I was literally freaking out inside my head. Then it was time and I had to go and I just pretended like I knew what I was doing, (Ok so I knew what I was supposed to do, but actually doing it was a different story) and I just played it cool. Don't know how, but I did. And I hope to continue that throughout the rest of the program.

Anyway, off to finish some reading for tomorrow and get to bed.

Finally the class I have been looking forward to since I decided to start this journey. Can't wait!

Wrapping Up Pysch

After my psych final, I left nearly right away to go on vacation. I just got back Saturday so I figured I would give a little update on things.

I was hoping for an 85, but I ended up with an 81 instead. It didn't earn me the B that I thought would be no problem to earn, but I passed. I passed another nursing course. I have passed five so far. Five more than I thought I would pass when I first started the program nearly a year ago. Four courses left. I am amazed, to say the least.

But now, the hard part begins. Well, first is the part I have waited for since the beginning. I had always had an interest, a main interest, in Labor and Delivery. My next rotation is OB. I am BEYOND excited. It is my last specialty course, my sixth nursing course, the beginning of my fourth semester. I am excited and I am nervous. There is a lot of information (although that can be said for any of the courses, really). I am always overwhelmed by the amount of information I need to know at the beginning. It's overwhelming to look at, but as I progress through the course, I learn, my confidence grows, and I get through it. At any rate, I more excited than anything else.

August 23rd begins the beginning of the end. The homeward stretch. A little over eight months until graduation. Wow. It seemed like just yesterday I was still taking my pre-reqs and had two years to go, at least. I'm getting closer, and that's really strange.

So after OB, which will be from August-October, it's Ortho/Neuro which is October-December. After my three week winter break, I will begin my final semester taking Cardio. I will have Spring Break for one-two weeks and then I will have my final course we call Trends (it's basically my preceptorship).

So now, I am on summer break. I am taking a non-nursing class that I need to graduate online. I am hoping to get everything done soon so that I can focus on spending all my time with the kids. I have some things I need to do around the house and I also would like to start reading ahead for OB.

So that's all for now. I won't be posting anything until after August 23rd since there really isn't anything to post about with school on break. See you soon!