Sunday, April 11, 2010

Life in the balance

I attended a neonatal conference this past week that was amazing. I learned a LOT of new things. A couple of things that will stick with me... I have learned a few new things that I will use to hone my cardiac assessment! It was exciting information and I will definitely put it into practice. (It also solidified my absolute NEED to get a GOOD neonatal stethoscope. If someone would just buy the camera lens I have listed THREE times on Craigslist, I could get a stethoscope. I have wanted one for awhile, but haven't been able to justify the money, especially as I have been getting cut at work so often lately and my latest pay check was severely short. If there are any interested buyers, you can find the lens listed here!) I also learned some good information about HIE (hypoxic ischemic encephalopathy) that has me really wanting to review my NRP skills and putting them into practice more. Overall an excellent conference. This one was only $70. In the world of nursing conferences, that's pretty cheap, especially considering they fed us a nice breakfast, snacks, and lunch. Plus, I got 6.5 CEU credits! We had an excellent showing from our birth center (I believe I counted 9 of us, which is a LOT considering the size of our birth center!)

I left the conference and headed south to pick up my children. (THANK YOU SO MUCH RICH AND NANCY FOR TAKING OUR BOYS THAT AFTERNOON!!!) As I neared Federal Way, my phone rang. It was my charge nurse. I assumed she was cutting me, since we have been overstaffed lately. Imagine my surprise when she said, "Is there any way you could come early to help us? We've had a crisis with a baby and all my nursery nurses are tied up and I have no one now." Wow... wasn't expecting that... at all. I was taken so far off guard that I didn't know what to say. So I called Mike and asked him to find out if Nancy could keep our boys just a little longer until he got home. I'm so grateful she could. So I didn't even go home... I went straight to work. I arrived a little after 5pm and didn't leave until 7:30 the following morning! It was busy and I don't think I stopped for very long at all.

I arrived and indeed there was a crisis going on with a baby*. Thankfully the nurse practitioner had arrived and the transport team was there, but it was chaotic. I played gopher for little while, getting things copied and running back and forth relaying messages and obtaining things. The nurse practitioner asked me to come with her while she updated the mother and act as a witness for the consent to transfer the baby. I obliged. I must say, it took all my efforts not to cry as she stood there and explained to this shocked mother just how critically sick her baby was. (This was a situation that was completely unexpected prior to the birth.) There was so much that I could read in this mother's eyes... horror, shock, sadness, worry, and fear. Her own mother had to get up and walk out because she was so emotional. Shortly thereafter, I ran back to the labor unit to attend a baby delivery. And shortly after that, I ran back to attend yet another. The night continued this way... baby after baby after baby...

Around 3:30am, I was having a hard time keeping my eyes open and hadn't had a break at all since arriving some 10 hours previously (and having been awake for roughly 22 hours by that time.) So I told the charge nurse I was going to take a break in one of our empty rooms. My plan was to sleep until 4:30am and use my entire hour to catch some zzzz's. I should not have been surprised when the door flew open about 30 minutes later and one of my labor nurses said, "Sorry, you have to get up. Someone just came in completely dilated, the doc is on the way but probably won't make it and she is premature." UGH... so I jumped up and was in a total daze and fog and had to get myself together really fast... throw all my stuff back in my pockets and run down the hall. The baby was early, but probably not quite as early as the dates put it. Nevertheless, until we knew, we had to treat the baby as though it was earlier. This meant going straight to the nursery, obtaining labs, and putting an IV in and starting IV fluids.

All in all, it was a nice birth and transfer. It only took us an hour to do it all AND get it shipped out the door to another hospital where the baby could receive a higher level of care.

I believe we had 7 babies that night and there was 8th getting ready to deliver as I walked out, exhausted beyond belief. Despite being totally sapped, I sat and had breakfast with my boys in the cafeteria (we do this about once a week or so when Mike has to leave for work) and I was in a very reflective mood, just thinking about everything that had happened.

We had all kinds of births that night (thankfully only one of the seven was a c-section). We had term deliveries, one premature delivery, one critically sick baby, one baby that we thought was going to be VERY compromised at birth and thus had a whole team ready... imagine our joy when this beautiful baby came out screaming and healthy! We dealt with different types of families... some spoke English, some did not. Some were happy families, some were not. One family in particular was facing a crisis so big and so enormous that I could barely wrap my head around the fact that they were, in the same breath, feeling joy over the birth of their baby.

I am so thankful to be a part of it all. I feel so blessed to be given the opportunity to get to know these birthing families and be allowed into their most private circle of emotions. I feel blessed to work in a place where I can sometimes nearly see the veil parting before me... to see births and know that I am so close to heaven I can feel it. Despite how stressful things may get, it is this part of the job that buoys me up and makes me so grateful that heaven and earth are not as far apart as they sometimes seem.

And I must say thank you again... twice. Firstly... to the incredible team of nurses that I work with. It IS not easy to work at the community level. In fact, it sort of felt good at the conference I attended when the nurse who was lecturing (a nurse who has a doctoral level of training and works at Dartmouth University) said, "You nurses who work at community hospitals have the hardest job of all!" WOW... she is right though. I've worked at a hospital with much sicker infants, but there is also a lot more back-up help available. At the community level, there is just your team of nurses. You can call in back-up in the form of a skilled nurse practitioner, but he or she can't always get there very quickly. So you must rely on each other and your skills to see you through until help arrives.

Secondly... thank you again to Rich and Nancy. You see, I sent the kids to school that morning and when I got home, I was so deliriously exhausted that I collapsed into my bed. I honestly can't remember if I set the alarm and turned it off or just didn't set it at all. I was horrified when my phone rang at 3:45pm, nearly a half hour after school let out, and heard Nancy on the other end saying, "We have your boys." Oh my heavens... so I bolted out of bed and headed over to her house. I am so thankful that we have friends who look out for us! Thank you again!

*I know it sounds weird, but you may notice that I refer to all babies as "the baby" or "it". I'd prefer to say "he" or "she" but keep things gender neutral in order to protect people's privacy. I also may change the details of things slightly in order to keep things anonymous.

Thursday, April 1, 2010

Fort Nisqually

We hit Fort Nisqually at Point Defiance today. We met up with Nancy, Garret, Kira and Cameron and had a great time. We got to learn a lot about the history of Fort Nisqually, which I believe was started around the 1830's. The kids liked seeing things like an old outhouse, a wash house, the blacksmith shop, and one of the fort's corner towers, which they got to climb up. If you are in the area and haven't been here, I highly recommend it.

Evan got to feel some beaver and badger pelts:

Inside a real outhouse. They had no idea what it was used for until Nancy explained it to them!

Checking out a laborer house:

The boys. (Kira is hiding there on the left):

The gang having a little time out:

Playing in barrels of water outside the wash house:

Learning about a curiously odd pair of scissors that is meant to snuff candles and subsequently trim the wicks:

A sad Evan. He was not in a great mood today and is having a little personal time out here after being naughty (but I'm posting the picture because he's so darned cute anyway):

When we were done at the Fort, we headed up to a cupcake shop in the Proctor district called Sweet Things Cupcakes. Evan had a lemon cupcake but dug in before I could get a photo. I had a cookies & cream variety and Ethan had one called The Elvis... banana cupcake with peanut butter buttercream frosting and chocolate shavings. He said it was really good!

Thanks Nancy for joining us today!