A Time for Change... of Shift

Change of Shift is up over at Nurse Ratched's Place...

It's a Valentine's edition. Can't you feel the love?

Enjoy!

******

In other news, my creative juice pipes have frozen and burst.

Here's hoping we get a thaw sometime soon.

This week has been consumed with shoveling, snow days, shivering and shoveling some more.

BRRRRR!

On the Other Hand.

And in sharp contrast to Labor Girl:

******

She rolled in by ambulance. Well, ok, the roads were a bit treacherous.

EMT: "23 year old female, fourth baby, term, her water broke about 20 minutes ago, she usually delivers an hour after her water breaks."

Ok.

I'm getting her hooked up to the monitors, asking the usual questions...

Any health problems? No.
Any problems during the pregnancy? No.
Clear fluid? Yes.
Any bleeding? No.
Feeling the baby move? Yes.
Who is your doctor? I don't have one.

What?

I don't have one.

You didn't see anyone during the pregnancy? No.
Not even one time? No.

Okie doke.

How do you know how far along you are? I'm about 9 months.

Uh-huh.

Is there anyone on the way to be with you? No, my husband is home with our other children.

Oh my.

I said, "It's ok, honey. We're here with you." And I held her hand.

******

She did deliver a term infant about an hour after her water broke. Doesn't like doctors. Doesn't like hospitals. But my baby will be just fine.

And she's probably right.

Girls Just Wanna Have... Babies.

You know her. She's the labor-wannabe. Let's call her Labor Girl.

******

Labor Girl arrives in the ER, breathless, cheeks flushed, anxious but elated. This must be it!

Her husband, let's call him Dear Hubby, parks the car and then joins her in ER triage, arms loaded with suitcases, birthing ball, boppy, radio and fan. He is a little panicky... a trickle of persperation slides from his upper lip. What have I gotten myself into?

But Labor Girl is thrilled. The deck of Uno cards is tucked into the front pocket of her suitcase, and a CD of soothing music resides in the portable stereo. This is going to be fun!

She is quickly retrieved from the ER and wheeled to OB triage, breathing obediently when her belly hardens. The babe inside her kicks in protest. She smiles knowingly.

******

Once she is safely ensconced in her tiny (if not somewhat unsatisfactory) triage room, she slowly strips out of the clothing she had carefully planned as her "going to the hospital" outfit. Dons the threadbare and breezy hospital gown, careful not to displace her perfectly coiffed hair and generously applied makeup. Pushes the call light.

Dear Hubby commences hand-wringing in the corner. Perhaps Labor Girl should share her deep-breathing techniques with him.

******

Soon the monitors are applied, blood pressure and temperature checked. Labor Girl dutifully answers the questions of the triage nurse, alternately smiling and breathing with the periodic tightening.

"Well... I'd rate these contractions about 6 or 7 on the pain scale." Straight face. It's that darn pain scale again.

******

Bad news.

"I'm only dilated to 2 cm?"

Labor Girl is clearly disappointed.
Doubt begins to curl around the edges of her optimism.
"Are you going to send me home?"

******

After a short while, the monitors are removed, and Labor Girl begrudgingly goes for a stroll. This isn't as fun as she had anticipated. Who wants to go for a walk at 2:30 in the morning? Another wave of doubt crests. Maybe if I walk a little faster.

******

Round and round she drags Dear Hubby, whose exhaustion has overtaken his fears.

The nurses smile understandingly each time the determined couple rounds the corner. Does Labor Girl think this is a race that she can win? That if she makes it through the hallways quickly enough or does enough laps, then we'll keep her?

******

It's time to be rechecked.

"Yes," Labor Girl nods to the nurse. "The contractions feel much stronger!"

She holds her breath, awaiting the verdict.

"I'm still 2 cm?!"

******

And now, here it is: the Walk of Shame.

Poor Labor Girl.

She trudges out the doors, pouting, vistaril in hand. How can this NOT be it?

Dear Hubby gathers the belongings and follows her solemnly home. Thank goodness this wasn't it.

******

And so, you see, sometimes no matter how badly you want it, labor it is not.

Maybe next time, Labor Girl.

I'm sure we'll see you soon...

Count Me In

I want to form a committee.

I hereby volunteer to chair the Committee for Outlawing Committees that Accomplish Absolutely Nothing Except Wasting Valuable Time (COCAANEWVT). Anyone care to join me?

Seriously.

As a *lowly* staff nurse, I am subjected daily to the whims and wishes of upper management. Start a new type of charting starting by this deadline, go to this inservice on one of the above days, try to work amicably with nurses from postpartum when they need your help, don't forget your core ideals, have face-to-face conversations when you disagree with coworkers, make sure you pick up your shoes in the locker room... and on and on.

You might hypothesize that a good way to mitigate this problem would be to join one of the numerous committees that are dependent on staff nurse participation in order provide input and encourage change in the workplace.

If only it worked that way.

Despite the best of intentions, committees with which I have been involved rarely accomplish any tangible change. We spend hours brainstorming great ideas that should improve the flow of our work, the effectiveness of our communication, and the professionalism of our practice. But first we must delegate responsibility for each new concept to a subcommittee, survey staff as a whole to guage what kind of reception this change will receive, propose said idea to management for approval, and create posters and inservices so that everyone will know how to alter their practice.

Oh sure, we spend hours on implementation and evaluation of new ideas. We are congratulated by managers for our active participation in these processes. Thank you for all that you do to improve our unit, blah, blah, blah...

Does anything ever really change? No.

The finance committee has been hard at work. There are reams of paper lying around somewhere to prove that the new charging system in triage is more effective than the old one. Or were the papers used to disprove it? Who knows. And I'm sure the new Good Job forms work infinitely better than the outdated ones. Good thing the central values committee spent weeks on that. Now, how can we solve the problem of inadequate staffing during peak scheduled procedure times? Let's send an OB tech to the recovery room to help and make the secretaries do baby baths. But we'd better filter that idea down through the OB tech and secretary committees.

Last item on the agenda: the inconsequential issue of low staff morale and poor RN retention?

Let's pass that one on to the shared leadership committee. I'm sure they'll have that one solved in no time.

Meeting adjourned.

And on a BUSY night...

Finally, a busy night with the pedometer, and I feel somewhat vindicated.

15,367 steps!

That's 7.03 miles!

My dogs are barkin'... time to put them to bed.

Change of Shift is up at Kim's blog.

Cheers!

How Will Nurse Blogging Change You?

Since embarking on this nurse blog journey, I've noticed several changes in myself, both practical and philosophical. Perhaps these are changes that would have occurred in the natural evolution of my nursing career... I'll never know.

I am increasingly aware of issues about which I would never have given a second thought, and I have started to apply what I'm learning at the bedside. I've also found myself becoming more lucid and verbal in work-related situations which I previously would probably have either ignored or gone with the status quo. Lately, I look at nursing issues (and sometimes life as a whole) from a new and wider perspective.

Take some time blog-hopping, described here by the Curmudgeon. Or simply read through a few of the links on my sidebar. You'll see what I mean.

I have to conclude that reading up on the opinions and experiences of the other medical bloggers out there, and responding or at least pondering a response, has changed me. Perhaps not always for the better. I have to admit I've been caught up from time to time, mindlessly lurking from one blog to the next, soaking up useless and sometimes utterly personal information from the multitude of blogs available.

However, if I peruse with a purpose (wink), sometimes I am struck with inspiration. To change my practice, adjust my attitude, or be called to action. All of which, I find, are stretching my limits and my yearning for growth and knowledge anew.

At times, I am also discouraged by what I read. I must confess that I am humbled by the bloggers whom I admire, those who write both prolifically and eloquently on a level to which I aspire. But if I stay silent until I measure up, this blog will lay dormant forever. It is those I seek to emulate who make me both afraid to click the "Publish" button and compelled to do so.

Speaking of my heroes, you can read Kim's ideas for beginning nurse bloggers here. See what I mean? Witty, comprehensive, insightful? Check, check, and check.

I'd love to hear how blogging has changed YOU... for better or worse. After all, this dialogue is what blogging is all about.

Or something.