Friday, March 20, 2009

Needle Stick, Limbo and Stuff

That just about sums it up. All done. The End. I wish I could just re-title the next month's worth of blog as "Interim Permittee", but now the name reaches back to the beginning. It will change again because everything is in flux even as I sit here doing nothing waiting to learn when I can take the boards. Here I am in limbo; not a student nurse, not a Student Nurse, not a nurse. I'm an Interim Permittee. That's a person who occupies the time and space between finishing school and passing the boards. So my last week of nursing school went something like this:

No one could start the IV on the former heroin addict (I was able to draw blood from the IV start, but couldn't thread the catheter) and so an anesthesiologist was called in and s/he re-capped the needle on the lidocaine after using it on the pt (Double bad practice = re-using the needle in case another site needs to be used plus re-capping the needle. Hey, all the cool kids do it. Heck, I had done both earlier.). The needle curled under and went right through the cap and into the anesthesiologist's finger. Blood in the finger of the glove: it was a really bad stick. I had to tell the Dr the pt had a blood-borne disease.

So, kids, the lesson here is Don't Re-Cap Your Needles. Yeah, I know you just learned it in school, too, and you said to yourself at the time, "Why would I ever re-cap a needle?", but it's common practice and it's a major cause of needlesticks. I saw it happen.

My very last day I picked a pt who was at 9 cm thinking that we'd have a baby and she stayed at 9 all night and then came the ugly late decels and the trip down the hall to the OR where I said goodbye to the pt right after shaving her abdomen. Who knows how the story ended. And with that I walked out of the hospital and into the night and out of nursing school without so much as a round of applause or a handshake or... well, anything. I was just finished.

Monday, March 02, 2009

The Velamentous Insertion

This is not really about a velamentous insertion. I just like the sound of the words and I saw an umbilical cord recently that had one (fine outcome; velamentariness not discovered until the placenta was delivered). You can read all about cord troubles here.

Last night, with two patients, one an antepartum patient and one a patient being induced for a low amount of amniotic fluid, I ran into my patients (that'd be mom and baby) and FOB (father of baby) from the night before. They were in the hallway in front of their labor room, babe in plastic wheelie bassinet and mom in double hospital gowns, taking pictures. They called me over and wanted a picture with their cutest little one. I picked the little swaddled fella up and I'm sure I had the world's biggest smile in the picture; mom had scooted next to me, and also had a huge smile.

I love L and D. It's the drama, the blood (it looks like the scene of a crime sometimes after a birth), the family hovering and worried then ecstatic with tears flowing, the cute babies (and even the not so cute ones), being on the verge of life (and death; that happens, too), the tedium of a long labor, the terror of a fast one, the fetal monitor with that quick as nervous baby heart beat in the background when you're starting the IV

which, by the way, I finally did successfully. Yes, last night. There was something about last night wherein everything seemed to come together. I did more things right than wrong, I had patients who deserve a framed picture on the wall in some sort of patient-of-the-month montage and then the happy family from the previous night so excited for me to be in a picture holding their baby and so sweet and thanking me.

The patient actually *fell asleep* while I was starting the IV. I'm all about using a little intradermal lidocaine bleb now! I told her, "This was the easiest IV I've ever started!" which, when translated meant, "This was my first successful IV!"

I just feel like The Nurse now. Somehow. And, more than that, I feel like The L and D Nurse. I have only two weeks of nursing school left and then, who knows. The word on the street is that there are no jobs for new nurses. I'm not going to worry about it. Things will work out, but,

Here's My Question For You:

Should I change the name of my blog when I'm no longer a student?

I'd like some opinions. I'd like to call it The Velamentous Insertion, but then my readership would, likely, drop from three to one (Thanks mom for your loyal readership!).

That is a portrait of me drawn by my daughter. I'm wearing my scrubs (as you can see). No. I don't actually have problems with my liver.