Day 69: 6th Handle!!

NOTE: To get the most out of this blog, pay attention to times and names. This will give you a real glimpse of how Birth Shifts can be sometimes....and most all of these birth were without complications....

I have heard about 'crazy shifts', but never until today, did I get to experience one to the fullest dramatic effects like I did today (though that breech birth a few weeks ago, was the next best).

I worked Swing Shift, which, though it technically starts at 2 PM, everyone is supposed to assemble for endorsements at 1:45 PM. Our team today, was Ate´Suse (JR), Hannah (HC), Lincey (LK), me (SP), and a Tecarro student-Ann (MAG). Well, today (thankfully, we were all on time), we had all barely gotten in the door, when we were immediately endorsed a pushing laborer #6- Narlie. Hannah delivered a baby boy-Rezal John (no tear) at 1:57 PM. Her attendants were JR (super), me (assistant), LK (charter), and the patient's mom.

The board at almost the end of the night......oh yeah, we had a labor walk in too.

We were then endorsed 4 postpartum patients: 1 immediate and 3 continued care, and 1 labor - Jazmin. (Just to add to the story, FYI, the Day Shifts patients gave birth at: 8:03 AM, 9 AM, 10:10 AM, and 12:39 PM.) How fun!!

At 1:55pm (2 minutes before Birth #5), JR admitted pt. #7-Marites.  Ann (the Tecarro student) was given the endorsed labor (#6-Jazmin) at 2:25pm. Then, JR went on a roll and did the pt. #4 PP check, and did 2 IEs on pt. #6 and #7. (pt #6 was found to have head visible, at which time, Lincey and I both quickly finished up our duties with pt. #5, and then scurried over to help Ann with charting and assisting. (I charted, LK assisted).

Meanwhile (while pt. #6 was pushing), JR admitted pts. #8-Joy and #9-Ruvelyn into Mercy and did IE's on both of them at 2:48 and 2:50pm. She then assisted pt. #4 to the continued PP from the Birth Room, before coming back to supervise Ann's birth at 2:59pm (a baby girl-Rivera). JR did the 1st immediate pp check at 3:22pm, before going to make her rounds again.

My baby---Hanz Dayll...he loved covering his face for pictures!! Crazy kid!!

At 3:40pm, Lincey left assisting to go check on pt #7, and shortly found that there was 2 cm head visible (there were no initial vitals done either, except those that were done when she came in early this morning.... :D) At 3:45pm,  I finished charting, and went to help Lincey with her patient. At 4:16pm, her baby was born-a little boy-Andres Miguel. I charted, Hannah assisted, and JR helped as necessary.

At 5:07pm, I finished my duties as a charter, and went out to see what needed to be done next, and found more than a couple charts with IE's done on the table (I think we sent 2 or 3 gals in early labor home, after Ate´Suse  checked them. :D...if they weren't close, they didn't stay, and the ones that did, got to labor out in the hall, because we had no bed space for them in the Birth Room!!)

Proud mommy and daddy!!

I grabbed a chart, and did the initial vitals for pt. #8-Grace Joy, a G2P0, 19 year old girl (her first baby was miscarried)...this will show you how busy we were: Joy's IE was done at 2:48pm showing 4cm, but she didn't get checked into Mercy completely until 5:22pm!! Good thing I grabbed her, because I had barely finished Vitals, when her water broke (not SROM yet though),and right before I had gotten her, she was standing out in the hallway, eating dinner, laughing, and carrying on with her bantays!! At 5:50, Joy got an urge to push and had SROM.

Tired but happy midwife...and baby is tired too!! lol

At 6:11, head was visible, and at 6:17, head was out with a double nuchal cord, not extremely tight (thank you Lincey for helping me with my handle!!), but tight enough that when little Hanz Dayll was born at 6:18pm, we suctioned him well and immediately administered O2 to him. His Apgar Scores were 6 and 8 and he was very floppy. We continued O2 until he was nice and pink.

Joy's whole family came.....She is the 3 youngest of 4 girls...first grandbaby.

Joy tore slightly, but there was no need to suture. Her EBL was 450cc, and so we did active management to stop complications in their tracks. Hanz weighed 6 lbs 12 oz, and was 21" long, with no complications afterwards.

During my patient's labor, between 5:45-6:14pm, JR bathed 2 babies and discharged pts. #1, #2, and #3 patients, and then made her rounds to all the other immediate postpartums as well.... Also, Hannah admitted pt. #9 at 5:45pm. At 8:05, pt #4 decided to go home, even though she hadn't met the end of the stable hours left...she was very reluctantly discharged. Hannah's patient gave birth at 8:51pm to baby Alexandra, with just Hannah and Ate´Suse  attending.

This probably was just a blur of activity, that didn't make sense to you....but then, in some ways it didn't make sense to us either..... Here is a timeline which may help you understand a little more...

TIMELINE:
8:03am   1
9am        2
10:10am 3
12:39am 4
1:45pm-new shift approximately came on
7 1:55- JR admitted patient
1:57pm:  5-HC, SP, LK, JR
6 2:25 Mag admitted patient

4 2:35 JR checked pt-bb nursing
7 2:37 JR did IE

6 2:42 JR went to do IE, found that head was visible
5 2:43 LK left to assist # 6, I followed shortly after finishing assisting to chart # 6 (head visible)
8 2:48 JR did IE
9 2:50 JR did IE
4 2:55 JR assisted patient to to Cont'd. PP
2:59pm   6-MAG, LK, SP, JR
6 3:22 JR did first pp check
6 3:40 LK left around then to check on pt. 7
6 3:45 Finished charting and left to help LK with pt. 7
7 3:50 LK came in and found 2 cm head visible (no initial vitals)
4:16pm   7-LK, HC, SP, JR
7 5:07 I left birth-charting (finished) and admitted 8 (see below)
8 5:22 I admitted her and did initial vitals
1 5:45 d/c by JR
9 5:45 admitted by HC
3 6pm-bathe baby by JR
3 6:05 d/c by JR
2 6pm-bathe baby by JR
2 6:14 d/c by JR
6:18pm   8-SP, LK,  MAG,  JR
4 8:05 d/c w/o blessing
8:51pm   9-HC, JR
What I Learned/Highlights:
- Lincey and I were both at 3 of the 4 births
- Hannah delivered 2 babies-the first and last of shift
- Ate´Suse is the epitome of a multi-tasker...she is AMAZING!!!

Text From the Bukid:
God said: I am with you and will watch over you wherever you go...I will not leave you until I have done what I have promised you. ~ Genesis 28:15