Life at 5,280 feet...

It's Saturday morning, and I'm awake and appreciating the refreshing air a mile above sea-level.  What a difference altitude can make!  Okay... maybe not just the altitude... the plentiful evergreen pines and the staggering rocky mountains might also play a role in the beauty of this environment.  I will say, even though I am sleeping on a couch, I feel as though I am getting better sleep here than I ever did in Baltimore!  I'm sure the fact that I work 12-hour night shifts plays a small part... but in all honesty, I finally feel like I am in my element -- I have the confidence to go out and flaunt my talents and unique qualities that make me who I am.  It's quite empowering, and I am very appreciative for this experience as I transition from the title of "Student Nurse" to "REGISTERED Nurse."  Only a few more months and I will be (HOPEFULLY) working to establish myself as a nurse on a hospital unit in Salt Lake City.  As of right now... jobs are pretty hard to find, especially for us "New Grads," but I have faith that something will pan out -- the Lord has blessed and guided me to this point, so why would He stop now?  Besides... I found out that my preceptor worked on the postpartum unit at University Hospital (yes, University of Utah) before moving to Denver, and she has a great relationship with the nurse manager that I'm hoping to work for this fall... coincidence?  I THINK NOT.  Someone is definitely looking out for me....
Although I've related stories of my first few nights on shift to a few of the handful of people that actually read this blog, I know there are still some who have not had the pleasure of hearing/reading about the excitement on the High Risk L&D Unit ("Women's Care Center") at the University of Colorado Hospital.  SO, without further adieu....

Night 1
My first night on shift was a bit of an adjustment, to say the least... not only did I have to develop a working relationship with my preceptor and the other members of the night shift, but I had to do it while trying to survive my first 12-hr NIGHT shift in a hospital.  I won't downplay it... it was difficult.  I felt myself nodding off a few times between the hours of 2-4 am... thankfully L&D is busy, no matter the time of day; it's actually surprisingly more busy at night than during the day -- my theory is that women are producing hormones at night that cause their cervix to relax, making the contractions more effective at dilating/effacing the cervix.  But... that's just my theory.  Either way, I was present for 2 deliveries that night -- no complications or issues, which was not necessarily what I had expected on the "High Risk" unit.  But hey, there is nothing wrong with that!  I am all about healthy moms & healthy babies.  And I was grateful to see the team work seamlessly to help bring these newborns into the world. 

Night 2
My second night on shift was a bit more of a "reality check" -- not every woman who delivers on this unit is going to be the ideal "mother" candidate, and it can be somewhat disheartening to see infants born into home environments and situations that will not provide adequate love and support... but this is where faith comes in.  The Lord will watch out for His children... even the 6th child to a 41-year-old drug addict/prostitute who has had 14+ abortions... thankfully she had her tubes tied, the one responsible thing she did in this situation.  It was quite the contrast to my other patient, a 21-year-old wife and mother of 3 children (ages 1, 2, and 3 -- all planned pregnancies) with the 4th born while she was under my care.  Her husband was present, and they were both very engaged in the process... my preceptor hinted that this is something I should expect to see when I start working in Utah.  Made me laugh :]  But it was a warm and happy reception, with my patient knowing her role and responsibility as a new mom... while my other patient turned away from her baby girl and did not uphold her end of the "contract" that she made when she decided to continue this pregnancy.  As frustrating as it is, we as nurses are there to comfort and educate, and advocate for our patients... we do our best to engage our patients in the care of their child, but it's not up to us.  Maybe CSS will get involved and help this infant into more suitable home environment... all I can do is trust in the Lord's reasoning.

Night 3
In honor of my 26th birthday, I celebrated the BIRTH days of 3 new infants at the hospital.  It was a busy night, to say the least... my preceptor (her name is Miriam, FYI) decided to take on the responsibility of "Triage Nurse" and as I am her shadow, I followed her throughout the evening.  Triage is basically the ER for any pregnant woman over 20 weeks gestation... so we see anything and everything, from uncontrolled glucose in diabetic patients, to labor checks, to MVA issues (car accidents), and so on.  Our first patient was EXTREMELY uncomfortable -- her contractions were incredibly intense, and we checked her progress and discovered that the baby was breech (meaning that the feet are down instead of the head, not an ideal delivery presentation) and therefore we needed to roll her back to the OR for a stat C-section.  My first (and only) c/s to date, and everything went just fine.  Then it was back to the triage rooms for more patient assessments.  After a while, a patient on the floor went into active labor, so I accompanied the nurses while she was pushing... for a very long THREE HOURS.  Yes, 3.  When the little boy finally made his debut, crying loudly for all to hear, his little head was definitely misshapen and we had to reassure the first-time dad that the caput would disappear. But all was well, so it was back to triage... we had a busier night than normal, and it ended with our last patient -- a 14-year-old in active labor.  She had her mother and brother with her, and her mother was offering great support, keeping her focused and engaged in the process.  I was quite impressed, and grateful -- teenagers require a totally different approach in managing labor, and I know it was best for her mom to check her attitude.  I left before she delivered, but when I returned that evening she was surrounded by about 10 members of immediate/extended family... and she was breastfeeding... it was slightly awkward, but at least she has ample support during this process...? 

Night 4
This night was definitely slower than normal, so I spent time studying for my upcoming boards (aka NCLEX) that I will be taking later in August.  I did have one laboring patient -- the wife of a soldier being deployed to Afghanistan next week... he was there, and was a great support for his wife and their 1st (and then 2nd) son.  Bittersweet, to say the least....

Night 5
My third night in a row proved to be no less exciting than the rest!  My first laboring patient was admitted to the hospital after going into pre-term labor up in her mountain home... she had planned to deliver au naturale at their local hospital, but preterm babies do not do well at higher altitudes, so she had to come down into the city to our unit to deliver.  And she did go forward with her plans to deliver sans medicines.... my first experience assisting a patient through the active labor process without any pain relief.  It was... eye-opening.  I'll leave out the details, but around 8 cm she was asking for an epidural, but at that point she was dilating too fast to take any sort of break.  And after her baby girl was delivered, she was in complete awe of how "perfect" she was, and all thought of the pain she endured to bring her into the world was conveniently wiped from her memory.  Despite the obvious, the delivery couldn't have gone more smoothly.  In obvious contrast to this "ideal" scenario, later in the shift, we were about to walk to another room to start an IV (YES -- I am starting IVs and doing blood draws, quite successfully I might add!) but before we were able to leave the nurse's station, we heard a woman coming off the elevator (obviously in later-stages of labor) and saw just as she slumped off the wheelchair in front of the check-in desk.  Yes, she delivered a healthy baby girl on the floor of the unit's entry way.  The dad was standing above us as we rushed around mumbling "I didn't drive fast enough..."  haha.  But in the end, mom and baby were happy and healthy, and dad brought his other two children (who were still half-asleep) in to meet their new little sister.  That will be quite the story to tell once they get home!  After making sure that she was taken care of, we went down to (finally) start that IV... for a diabetic patient who was being induced due to her inability to manage her glucose levels while at home.  Quite frustrating, especially when we walked in and were met with the overwhelming aroma of cigarette smoke.  Lifestyle behaviors are some of the most critical factors in healthy living... and the hardest to treat/change in the limited amount of time that we interact with these individuals.  We make our best efforts... but unfortunately, some people are unwilling to consider alternatives.  And even worse is when we are affronted with cutting remarks while we are trying to help these people... all we can do is smile and do our job, and leave them be.  That is definitely one aspect of this job that I have had difficulty adjusting to... trying to offer my knowledge and service to people who are convinced that we are being rude, inconsiderate and condescending.  We can't please everyone I guess!

So. That's my "little" wrap-up, for now... I've had a few days off, and I don't go back to work until next Thursday so Meghan and I are heading up to Winter Park (where she will be moving to in a couple weeks for her new job) to escape and enjoy time in the mountains for a few days!  I'm excited -- and I just found out today that the resort she will be working at has 30 horses for guests to ride... and she has a fairly good feeling that we can "borrow" a couple horses for a day :]  I'm SO excited.  For that, for bike-riding through the little mountain town, for s'mores and a big BBQ, and for some SUN.  Oh how I absolutely LOVE summer, and especially summer days spent OUTDOORS enjoying and appreciating the nature we are so fortunate to have right outside our doors :]  How truly blessed we are that Someone loved us so much to give us this Earth....