Wednesday, May 26, 2010
Hello Sun
The long awaited promise of Spring is here. After rains and cold days and nights and wonder if we would ever put away the down comforters, it is here. It is here in the jubilant colors that overflow flower beds, in many seen digging in the dirt and the intermittent hum of gas powered machines cutting, trimming and shaping. Bright screaming pinks, cheerful happy daisies, garden centers popping up at the market. The magnolia blooms have come and gone. The corn is in the ground. Wildflowers are growing and the black-eyed susans are well on their way to making their July showcase. There is green everywhere, the leaves whooshing as the wind blows. Hello Sun.
Tuesday, May 11, 2010
Hat
Charlotte was telling me tonight after her bath that a girl made fun of her hat at school today. A cute, funky pink cowboy hat. I was so reminded about Ella the Elephant story! So we had a talk about how people can feel however they want, but hurting another person's feelings is not okay. She teared up a bit and said that she didnt tell her teacher and that she walked away before she started to cry. In the end though, she said she'll wear the hat tomorrow.
Sunday, May 9, 2010
Anatomy of a crash
A friend at work Facebooked that they saved a life today. I'll find out more details when I get back to work this week, but it made me consider that part of my job--one folks may not nomrally associate with being a labor and delivery nurse. The job is often coaching, giving pain medication and teaching. It is reassurance, explanation, hand holding, leg holding and breathing. And sometimes it is panic, and running and praying.
A crash is a name used by nurses ( and others) to denote the emergent c-section of a patient. They happen at any stage of pregnancy after 24 weeks. In my experience, they are the reaction to the sudden and unresolving (lasting several minutes) decrease in fetal heart rate, below 100 (often much lower) that do not repond to position change, oxygen administration or IV fluids. I have been a part of two that were the result of a maternal seizure and one from a respiratory arrest of the mother. They happen in the delivery rooms when a patient is in labor and in the triage area where a patient might just come in for some vague pain. I have cut the clothes off of one patient to get an IV in. They involve a massive influx of staff into a patient room, each doing a single task--starting an IV, disconnecting plugs, putting in a foley catheter, explaining to family and patient and pulling the patient in there bed to the OR--all in less than a minute. The flurry extends to the nurses station where staff are tring to reach the attending, respiratory therapist, and most of all, anesthesia. In a true crash, the patient is put to sleep and intubated. There is no incision until the anesthesiologist says "Cut". The usual symphony of movement in surgery is replaced by a hastily splashed antimicrobial wash over the abdoemn, two disposable scalpals thrown on the field, a surgeon (usually the resident) and a tech helping as first assist. Cut, tear, cut, tear, cut, tear. One hand cuts, four hands pull tissue apart. Minutes count. Seconds count. The fastest crash was skin to baby out in a minute. The baby cries and someone in the room says "Okay folks, we can slow down." And the entire room (except the infant resuscitation team) releases its pent up breath. The rest of the crew dons hair covers and masks--items usually left in the hurry. The nurse and tech do a count--though an x-ray will be taken at the end to make sure nothing is left in the patient. The stitching begins and the circulating nurse goes to band the father of the baby and tell him about mom and baby. The pace comes down to normal.The staff will relive it through the night and it will be discussed as one of many "war stories" on slow nights at the nurses station.
I often wonder what patients think of this, if there is lasting trauma--like post traumatic stress. It is not the delivery women envision. It is so very fast. It helps if the baby is stabile enough for mom to see in recovery--then it's real. She's a mom. Her baby is safe.
A crash is a name used by nurses ( and others) to denote the emergent c-section of a patient. They happen at any stage of pregnancy after 24 weeks. In my experience, they are the reaction to the sudden and unresolving (lasting several minutes) decrease in fetal heart rate, below 100 (often much lower) that do not repond to position change, oxygen administration or IV fluids. I have been a part of two that were the result of a maternal seizure and one from a respiratory arrest of the mother. They happen in the delivery rooms when a patient is in labor and in the triage area where a patient might just come in for some vague pain. I have cut the clothes off of one patient to get an IV in. They involve a massive influx of staff into a patient room, each doing a single task--starting an IV, disconnecting plugs, putting in a foley catheter, explaining to family and patient and pulling the patient in there bed to the OR--all in less than a minute. The flurry extends to the nurses station where staff are tring to reach the attending, respiratory therapist, and most of all, anesthesia. In a true crash, the patient is put to sleep and intubated. There is no incision until the anesthesiologist says "Cut". The usual symphony of movement in surgery is replaced by a hastily splashed antimicrobial wash over the abdoemn, two disposable scalpals thrown on the field, a surgeon (usually the resident) and a tech helping as first assist. Cut, tear, cut, tear, cut, tear. One hand cuts, four hands pull tissue apart. Minutes count. Seconds count. The fastest crash was skin to baby out in a minute. The baby cries and someone in the room says "Okay folks, we can slow down." And the entire room (except the infant resuscitation team) releases its pent up breath. The rest of the crew dons hair covers and masks--items usually left in the hurry. The nurse and tech do a count--though an x-ray will be taken at the end to make sure nothing is left in the patient. The stitching begins and the circulating nurse goes to band the father of the baby and tell him about mom and baby. The pace comes down to normal.The staff will relive it through the night and it will be discussed as one of many "war stories" on slow nights at the nurses station.
I often wonder what patients think of this, if there is lasting trauma--like post traumatic stress. It is not the delivery women envision. It is so very fast. It helps if the baby is stabile enough for mom to see in recovery--then it's real. She's a mom. Her baby is safe.
Monday, May 3, 2010
Crafts
Two tubs of stuff, two tubs of material and three bags of trash have been removed from my craft area. I have no fewer than a dozen projects to finish--more if you count quilting. Unfinished sewing projects, unfinished cross-stitch and I found 4 different "teach yourself how to knit" books. Perhaps I will finally sit down and venture past straight knit and purl! However, i also came to the realization that I will not be able to take up another hobby for awhile--so most of my scrapbooking paper went to the garage sale. I bought a "Project 365" kit from Charlotte last year. That may just be my speed. I am eager to read about the possibilities. My Charlotte's cape is nearly finished. I may never work with satin again! Need to take another class and learn more about my machine, and sewing in general. I think more cards with different stitch decorations will be the next thing.
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