Friday, April 25, 2008

Beautiful Cervix

I love this site, it's a photo journal of a 25 y/o midwifery student who has never given birth. Great for those who are very 'visual' learners.

Saturday, April 12, 2008

First week of school

Wow, the reading in this program is huge!! I knew there would be alot but I think I spent the first three days this week feeling very overwhelmed and like...what on earth have I gotten myself into.
The one sunny spot in the week was some reading for the health promotion class. We had to choose a book from a list we were given and read for pleasure...what a relief. Now, it was for pleasure but had to be read critically because we have to write an essay regarding our cultural awareness and how it has evolved..changed...been more enlightened or whatever based on our readings. I chose the book I Know Why the Caged Bird Sings by Maya Angelou. It was a very easy much that once I picked it up I couldn't put it down and finished it in one day. I recommend it, if you have not read it already. I think I may find another book or two from her to read....when I get some free time.
I am finishing up a one page paper for patho on Systemic Lupus Erythematosus (SLE) and then will prepare to take my first exam next week.
I have some more required reading to do for health promo before I can do the essay but should turn that in next week.
I have barely skimmed the reading for the role class (the role of midwifery and birth centers in America) but need to get on it and start making notecards for my first paper, due in three weeks on the historical development of midwifery. That should be very enlightening.

Work this week was busy. We did have a wonderful natural delivery of a first time mom who birthed a 10# 1oz baby after only actively pushing 4 times. What a woman!!!!!!
Otherwise, it was induction city. Why, oh why can't we just let women go into labor on their own. I'm beginning to hate working Sunday night thru Wednesday night because all we do is admit 7-9 inductions each night, not to mention the ones that actually do come in already in labor or the four that are still laboring when we come onto the shift so we have to get them delivered, recovered and passed off to the postpartum so that we can get the inductions in and started on time (in order to avoid the wrath of certain physicians). Those kind of nights go by quickly but give me no opportunity whatsoever to develop a real rapport with my patients, and that is very disconcerting to me.

Just two more years....just two more will be sooooo worth the hard work!!!

Friday, April 4, 2008

You too can have a vaginal delivery.

Unintended vaginal deliveries......that seems to be the theme for this week.
We had a patient scheduled for repeat c/s on Tues morning who came in saying she had not slept all night d/t an upset stomach and constipation (this pt is also an MD). The patient kept insisting she really needed to go to the bathroom, she said she just felt sooo bloated and constipated. The monitor showed she was contracting q3 minutes and they were palpating strong, but she kept denying even feeling them. She had only been there about 20 minutes and had refused a vag exam because she didn't think she was in labor. Finally the nurse absolutely insisted on a vag exam to evaluate and let her MD know what was happening. Well, turns out the gal is complete and +2 with a BBOW. She ends up with a precipitous VBAC (RN caught baby) and mom and baby are both doing great.

We had a G1P0 come in on Thursday morning for a scheduled primary elective c/s for suspected macrosomia. Turns out she had SROM a few hours prior to her arrival and since she was already contracting regularly decided that she wanted to attempt to labor and deliver vaginally. She did wonderfully, got an epidural @6cm and once she was complete labored down for about an hour then pushed for 35 minutes to deliver a very robust 9#7oz bundle of joy. Her labor was a total of 12 hours from the time her water broke and she started contracting. Not bad for a primip!
Guess they got the macrosomia right......too bad there isn't a little more trust in the body's ability to birth the baby that it grows.

We have had a surprising number of vaginal deliveries this week compared to what we usually have when the census is as high as it has been. Hmmm, maybe I need to check our stats for this week. The less time I spend in the OR the happier I am!