Saturday, May 8, 2010

Day as Circulator... Happy Nurses Week everyone!

I was not super thrilled to find out that I was circulating yesterday. I was missing laboring patients! It had been a few weeks since I had a day with a couple of nice births. BUT, I had a GREAT day as circulator!

First case was a primary section of a 5/3 for transverse lie. She was SROM'ed and that baby's head was stuck up in her rib cage. The CNM tried to see if the baby could be versioned, but no luck (probably because of too little fluid). Off to the OR, and shortly thereafter a beautiful baby. Mom seemed okay with everything. She understood the need for a section and understood that she could have a VBAC with her next pregnancy (at my hospital anyhow) if she liked.

Second case was a scheduled section. This would be her 3rd section and her previous two sections were done overseas and both had negative outcomes. I was really hopeful that she would be able to be awake for this birth (for the first time) and that she would be very happy with the outcome. Unfortunately, her spinal was placed by a RRNA ( a student nurse anesthetist) and it was not a good one. Was it the student's fault or just a failed spinal? I really don't know. Anesthesia had to basically put her into a twilight sleep for the birth because she felt a lot of pressure when her muscles were moved (but not when the doc was doing the incision). I didn't get a chance to talk to her in PACU once she was more alert, but I was sad that her experience was not the excellent one that I had hoped for.

Third case was a twin vaginal delivery! Yes, we take all of our twins back to the OR (eye roll). She was a gravida one with PIH who was being induced at 30 weeks. She had received two doses of betamethasone (for fetal lung development) and MULTIPLE doses of antibiotics because she was chorio at this point. She was also morbidly obese and we were very worried about having to move her to the OR table if something went wrong. The big issue (according to my hospital) with twin deliveries is that the second baby can prolapse a cord... Bleh. Guess what? She ROCKED! She pushed that first baby out with no problem, second baby was born a mere 16 minutes later! Both babies ended up in NICU, but with everything said and done this was a fantastic outcome of a not so favorable situation.

Fourth case (some tired feet at this point), was a section of a 35 weeker for severe PIH. Sitting that mom up for her spinal I saw multiple blood pressures of 200+/ 115+. I was ready for her to seize. Seriously. This baby was as little as my 30 week twins earlier. So little in fact that the NICU nurses rolled a scale into the OR to see if s/he was big enough to even go to the newborn nursery, which s/he was not. Another baby to NICU. Sigh. At least I was keeping the NI nurses in a job.

I work tomorrow and cannot wait to see what Mother's Day will bring. I am sad to be away from my kidlets on Mother's Day, but helping other mothers makes the separation bearable :).


  1. You sound like you work at a hospital very similar to mine!

  2. If you work at a county hospital with not enough nurses, than YES! I love it though, although my dogs are really tired at the end of some days.