Thursday, March 27, 2008

Who's your daddy.....

Okay, here's a new one on me.

Gal comes in to have a baby, which she is giving up for adoption (the baby is going to a couple that are somehow distantly related to her). Her husband is with her, only two weeks ago he had kicked her out of his house but is letting her stay with him now. This man is so eager to sign away his rights, his lawyer comes to the hospital within hours of the baby's birth. Except, he wants a DNA test.

Why the DNA test? The gal says it is because they were at a party one night with some friends, got really drunk and passed out. Only, she woke up later with her panties around her ankles and her husband still passed out. She says that a friend of theirs at the party raped her.
Okay, makes sense but then who shows up at the hospital.........the supposed rapist. Demanding a DNA test as well.

Okay, if he's a rapist why is he walking around town and not in a jail cell? And why is he demanding a DNA test? Because according to him they had consentual sex and if that's his baby, he wants it.

The poor adoptive couple, they just want to take the baby and go home.
For this baby's sake I hope it belongs to the husband.

Glad that full moon is gone!!!


There are some things I don't think I will ever understand.......but am trying my darndest to be sympathetic to.

We had a gal come in for induction the other night. She was single, young (late teens) and having her first baby. Prior to her arrival her sister and cousin showed up to warn us that she was on her way and that the FOB knows she is coming in and may show up later. This is an issue because there is a history of domestic violence. This man, or rather boy (19), had physically beaten this girl on four separate occasions and the last had just been a couple of weeks ago in which he wailed on her for over two hours and left her in pretty bad shape.
Being in charge that night I did not want any drama so I got a description and called to security to give them a heads up and to stay visible and within shouting distance.
The preggo mama arrived with her mother and a friend. We got her settled into her room and had a nice long chat with her about the situation she was in (after making all the others leave the room) and how she was feeling at this time. She was very concerned for the FOB (huh?!) because now that she lived with her parents and they wouldn't let him anywhere near their house that this would be the only opportunity he would get to care for his child. She wanted him to be at the delivery but none of her family or friends did and they made that very apparent (can't say I blame them).
The patient told us that the FOB was just recently (after this last beating) diagnosed with IED, or Intermittent Explosive Disorder and had just been placed on meds to help with his disease.
We told the patient when said FOB arrived that she was not to be in the room alone with him for even a second at any time, for any reason and she agreed with us that would be best.
Well, the FOB did arrive a few hours later, only he was feeling upset because the patient's family members were staring at him and refused to leave the room with him in there. I was just in shock, this guy sat by her bed and held her hand and she just hung all over him! The patient asked us to come up with a solution because her mother and sister refused to leave the room with him there and he was upset because they were just glaring at him the whole time he was in the room and making him feel uncomfortable. So, we ended up devising a schedule for him to be in the room and her cousin to stay in the room with them while her mother and sisters stayed in the waiting area and then they would switch so the mother and sisters could be with the patient and the FOB and cousin would sit in the waiting room.
I still am totally flabbergasted how this girl, having a baby, was only concerned with the FOB not being treated bad or made to feel bad by her family.
When I left the next morning she was in active labor and had just gotten an epidural. I made sure there was a request for social services consult placed in this girls chart.
I feel for her, and try as I might I don't understand her being overly concerned for this guy. She should be concerned for her own safety, as well as the safety of the child she is about to bring into this world. She had been given an opportunity by her parents (whom she and the baby will go home with) to get on her feet and to make a life for herself and her little girl. I just hope she takes it and doesn't go back to this guy.

This most definitely isn't the first domestic violence situation I have run into but it is the one that has affected me the most and one I don't think I will ever forget.

I have been married for 14 years to one incredible guy, who isn't perfect (although he thinks he is) but neither am I. But I can say with 100% certainty that the first time he hits me will be the last.

Monday, March 24, 2008

Time to.......focus

The mother-in-law came home on Friday and is recovering well. She should get completely back to normal but it will take a while. She is still very slow to respond when you talk with her but that is really the only deficit that she is suffering from.

The weather this weekend was so nice, in the upper 60's-lower 70's until Sunday then it was lower 60's and very blustery. This morning, 30 and SNOWING! The weather around here is so wacky, it's supposed to be in the 70's again by Wed.

I have access to all of my classes (class officially starts April 7) and boy do I have alot of reading to do. I am taking Pathophysiology, Health Promotion and Disease Prevention and The Role of Midwifery and Birth Centers in America.
After looking at the syllabus, Patho is the only class I have tests in, but there are five of them and then one graded assignment.
Health promo has five assignments to complete as well as a health managment plan (that is the big paper for this class).
The Role class has two large papers, a journal assignment and I have to attend a birth center workshop. So, I guess I will be doing alot of writing this term....better get out the ol' APA manual!
I should be studying right now but instead I am perusing blogs and surfing the net. Not a good way to start out the term :) Bad habits are hard to break.

I haven't worked in a week and it has been so nice, but I am back tonight and then off again until next Monday. I really like this one-night-a-week thing, but that won't last long. I'll be back to two nights soon.

Since it is cold outside today, I think we'll be having some soup for supper tonight. Potato soup sounds good and hearty, so off I go to throw some taters in the oven.

Saturday, March 22, 2008

To recertify or not recertify......that is the question.

I am trying to decide whether or not to renew my Lamaze certification. It is due in June and right now I am VERY short the required number of CEU's.
Unfortunately, all of the CEU's that I have for my nursing license will not qualify for Lamaze. Over the past couple of years I have take a two AWHONN fetal monitoring courses, STABLES, AWHONN local conferences, all my recerts for ACLS and NRP, and the monthly lunch and learns and mini-conferences put on by the hospital (none of which are normal birth related) that I don't have the resources, time and energy to find normal birth stuff to do.
If I could just pay a fee to recert, I would. It's the CEU's that are killing me, in this area anything normal birth related is pretty much impossible to find, except for the classes I teach.

Unfortunately, I am the only Lamaze certified educator still actively teaching in my city, and I only teach at one facility one night per week. So, I feel that pressure to recert to be able to provide those classes to women who want them. There are a couple of other teachers who will fill in for me if I need but no longer want to teach their own classes. Sadly, there is a certain hostility towards Lamaze by some docs in certain positions in this area. And these docs have made it so difficult to teach they have basically run all of the other teachers off. Therefore, I have had zero luck in convincing anyone I work with or know to look at becoming a Lamaze instructor.
Really, I am feeling pressure both ways. All of my students encourage me to keep teaching and refer others to my classes and I feel the pressure to provide this service to the community. On the other hand, I only teach one night per week because of work, graduate school and I still have young kids and don't want to miss out on their activities. Unfortunately, I see myself teaching less and less the farther I get along in school. Then, when I go into practice I don't see myself wanting to teach classes in the evening after I have been in the office all day.

I think I may recert this year since it is good for three years and re-evaluate once I am out of school and the recert time comes up again. The problem now is finding the CEU's!!!!!! Any suggestions?

Thursday, March 20, 2008

Spring break.....and more!

It is spring break, and oh how I love my kids but.......they are driving me crazy!
Until today the weather has not been very cooperative for going outside and doing so we're getting a bit stir crazy.
We went to the mall yesterday and to Sears for a new washer since mine decided to die on Tues. night. The new one is soooo much bigger than the old one, it should really cut down the time I spend washing clothes.

I am gearing up to start my classes on Monday. I am excited to get started but very anxious about the work load. I know that I can handle doing full-time school and working part-time but I have such a tendency to procrastinate. I am really trying to psyche myself out by telling myself how much I am going to learn and trying to get excited about the knowledge I will have and how my skills are going to really expand. But honestly, I am tired of going to school and I just want it to be over with. If I can just get through the next two years and know that time will pass very quickly.

I get very frustrated when people (esp. family) call you about something medical and then basically ignore everything you just said and do it their own way. Case in point: My mother-in-law is showing symptoms of a mild stroke that probably happened on Monday evening although no-one who had contact with her on Monday evening and Tuesday put the symptoms together and realized it until Wed. morning. When I was called and asked what I thought it was I told them it sounded like a TIA and to get her to the hospital ASAP.
My in-laws live in a very rural area and the only hospital is a satellite facility off of our large tertiary care center. Anyway, I told them to take her straight down to the large hospital (40min away) and to skip the satellite facility, there wasn't much they could do for her there except IV, labs and get her transferred (which would take FOREVER). I knew that the large hospital was on divert and would not take transfers but if she came in through the ED she would get cared for (the large hospital also has the only local accredited stroke center and has some incredible neurologist on staff).
Did they listen? Of course not, they stopped at the satellite facility instead of driving 40min more to the large hospital. Needless to say, they didn't do much except IV, labs and paperwork to get her transferred (this all took a total of 5hrs before she was transferred). And of course the large hospital was on divert so they took her to another local hospital, who took another 3 hrs to get her into a room.
My poor father-in-law is soooo frustrated at how slow everything has been at this facility that she is at. They ran an MRI on her first thing this morning but said they won't read it until tomorrow. What the..........?!!!!! And she has yet to be seen by a neurologist.
I am trying to just be sympathetic and help them understand the medical lingo and tests and such when I just want to scream, WHY DIDN'T YOU LISTEN TO ME IN THE FIRST PLACE!!!
Please, don't call me for advice and then don't even bother to take it. No, I'm not right 100% of the time, but dang it 99% is pretty freakin good! :)

Now, off to Hobby Lobby after some lunch. Gotta get the munchkins outta the house before I pull my hair out, or lock myself in a closet!

Wednesday, March 12, 2008

Spring is in the air

Oh I really have spring fever! The weather today was glorious!!!! Sunny and 70 degrees, just the way I like it. I hope we have seen the last of winter and this trend continues. My boys are playing in a baseball tournament this weekend and it looks like the weather is going to be perfect for baseball, not to hot and not to cold.

We had such a nice shift at work last night. Came in to only postpartum patients, discharged two couplets and then admitted four inductions, one c/s scheduled for this early am and then one triage who came in with SROM. So, overall it was a pretty laid back evening. I got to spend some time chatting with the gals and cuddling babies in the nursery. Those nights are so welcome when we have them because they are so few and far between.

I am taking three classes this first term that starts in April and have just been able to get online and access the syllabus for each course. I have my books and am currently working on de-cluttering my office and getting it set up and ready. Hopefully this weekend I will have it all cleaned out and set up so that I can get a jump start on my reading assignments while I am excited and motivated.

Frontier has really taken into consideration the isolation that is so common to online learning and that can be very detrimental to the learner. During orientation we were divided by specialty and then subdivided according to geographical location so that you could really get to know people that are close enough to you to perhaps actually get together outside of Hyden. My group is already planning to meet up for a weekend in May and because there are three of us in my group that are full-time and all taking the same classes we are setting up chat times and study groups. I honestly think that is going to be the greatest help in keeping me motivated and moving through this program at a pace that I am comfortable with and will get me to my destination in the amount of time I desire. Again, more kudos for Frontier and really having it all together!

Sunday, March 9, 2008

Catching up

My blog has been totally neglected the past few weeks..sorry.

I had the best time at my graduate school orientation. I spent the week meeting new people, making new friends and learning about this journey I am embarking on. It was so overwhelming at times but I really felt confirmed during that week that I am on the right path and that midwifery is truly my calling.
I have to say that the Frontier School of Midwifery and Family Nursing has it all together!! It is an incredible program, operated by incredible women, and I am very excited and proud to be a part of that school and will be a part of its rich history.
Of course, by the end of the week I was incredibly homesick and really missing my boys. Baseball season is about to be in full swing and with all three of the boys playing ball it is going to be one busy spring! I love to watch my boys play ball, because they love it so much and they are good little ball players.

I worked two shifts last week and taught an all-day Lamaze class on Saturday. I was in charge on Tuesday night and triage was hopping. It seemed everyone kept coming in with SROM, so most of them were keepers. We did have one girl who came in not in labor and not ruptured. She had called her physicians answering service and told them she was having pressure so they sent her to triage. We got her gowned and on the fetal monitor and began asking her history. It turns out she was not having contractions, nor was her water broke so definitely not in labor. She had been to the doctor a few days before and her physician had done a vaginal exam and told her that the baby had 'moved down' and was 'much lower' than at her last check. Evidently, after this visit she told either a friend or family member what the physician had said and this well-meaning person told her she needed to go to the hospital because she could--"suffocate her baby if it stayed that low for to long" Needless to say, there was a lot of education going on before discharging this gal to home.
My last Lamaze series class had five couples in it. One of the couples gave birth after the second week of class so that left us with four. One couple had a scheduled primary c/s for macrosomia at 38+5 weeks because mom was gestational diabetic, I wasn't really surprised knowing how persuasive this particular physician can be but I really did think they would at least attempt an induction first. Anyway, the baby was 8#2oz--not really macrosomic in my book.
Another couple gave birth with epidural anesthesia but had a great experience, baby was 8#14oz. The interesting thing about this couple is the mom said they were going to try again in two years and she said she would call me when she got pregnant because she thinks she would like to really try and go natural next time. That is really neat because she never had any intention of even attempting a natural delivery this time.
The last two couples to birth both had spontaneous, natural labor and birth experiences. Both of these moms called me afterwards to tell me their birth stories. They both were so overjoyed at their experiences and the fact that they were able to go into labor on their own and work through the process of childbirth without any drugs. Just to hear the pride and joy in their voices when they expressed how glad they are they gave their babies the best start possible. One of the moms expressed how incredible it was to feel the baby come out of her body and how she is so glad she did not dull that experience with numbing medication. Those types of stories keep me teaching! BTW, one of those babies weighed 7#12oz and the other was 8#14oz!

It's a busy week coming up. I am scheduled to work; Tues, Thur and Sat. night. and my boys have a ball tournament next weekend so I'll be busy working the concession stands in between watching their games.

Classes for school do not officially start until the first week in April but I should have access to the readings and assignments week after next so that I can hopefully get a head start on things. Fortunately I have a friend who is just ahead of me in the program and I am getting my books for these first classes from her on Tuesday, that will help save a few bucks.

Be sure and check out some of the blogs on my blogroll, there are some very interesting conversations happening surrounding midwifery. Unfortunately, I just don't have the brain cells these days to get into all of that. I do have very strong opinions about the topics that are popping up, but right now I am just going to prepare my mind for some higher learning and focus on being a good student, sumptuous wife, and rockin' mom.