September 23, 2013

Small steps towards an ultimate goal

For years now, I've contemplated the pros and cons of going on to school to become a midwife.  It's something that I would absolutely love to do.  Unfortunately, there are some major hurdles to jump.  First is the cost of returning to school.  The money has to come from somewhere and I'm not rolling in the dough.  Second being that fact that I have 4 children.  They are getting older, but my youngest just turned 3 on Saturday (can you believe it!?!). Husband is starting to become a bit of a birth enthusiast himself, although I'm not sure he's willing to admit it yet.  He attended the improving birth rally on labor day in my place since I had to work! But we've talked, he knows that my ultimate dream is to become a midwife. I think it *may* become a possibility in the next few years!  Several tough decisions will have to be made and my way of thinking has really shifted in the last couple years.  Home birth or hospital?  CNM or CPM?  I see pros and cons in all directions.  I have a lot to think about and have several tough decisions to make.  I never thought I'd be at the age I am and thinking on embarking on a new I'm not old per se, but by the time I am able to finish I'll be, well, older ;)  We'll see what time brings.

In the meantime, I'm doing my part to ensure that the hospital births are as mom-baby friendly as possible. We do skin-to-skin immediately after delivery with almost all vaginal births.  And I've been pushing skin to skin in the OR depending on mom and baby's condition, of course.  I've made some progress, but there is still resistance.  I've done it successfully several times and each time, the mom has told me that it made the c-section feel like a birth, not a surgery.  At the very least, if skin to skin on the OR table isn't done, the mom has that baby skin to skin as she's wheeled back into her room.  Rooming in is the norm...our respite nursery where the babies would sleep at night in the nursery is now a conference room for never saw use in our new department!  So things are better, but there is still room for improvement.

May 23, 2013

Pre-K graduation

Today my 3rd child, the first of my kids that I talked about on the web, is graduating pre-k today. I've slowed down significantly in the amount of time I actually write on this blog, not out of lack of things to say.  On the contrary, I have more opinions now than ever.  I just don't have much time to sit down and articulate those feelings because I've been busy chasing these 4 angels God has given to me to care for.  And they are a lot of work!  Between potty training, school, baseball and work...we're in constant motion.  But the fact that the first pregnancy I blogged about will be heading into kindergarten in the fall...boy, I've been talking a lot for a long time about myself!  It seems like only yesterday I was walking down the hallway to the C-section room that frigid cold December morning the day he was born.  He's come such a long way with his struggles with speech.  He's a bright kid, and now he can tell people what he knows.  He's playing t-ball this year, Husband is assistant coach, and he seems to have some athletic ability.  Of course, I'm not biased or anything.  He is a stubborn one, but he comes by that honestly.  But he's also a sweet, lovable little guy.  I was sick the last couple days with stomach flu, and it was Isaiah who made sure I had a blanket, brought me a bottle of Gatorade, and gave me a back rub.  Maybe he has a future in nursing!  Anyway, today we celebrate one of the many milestones for I-man. 

May 7, 2013

In Honor of Nurses Week...a repost

Random person:Do you really like being a nurse?

Nurse: Um, yeah, why?


Nurse: Yes.

 RP: How can you enjoy a job that demands that you work hours outside the typical 8-5 M-F, and you have to work weekends, holidays and nights? Plus, you don't have a set schedule. That would drive me crazy not always working the same days every week.

 Nurse: That's one of the great things about nursing, the flexibility. You can work around doctors appointments, school functions and other things you need off work for. You can work just weekends to be home with the kids, or you can work evenings or nights if you aren't a morning person.

RP: Another thing. Nursing is frequently cited as one of the most respected professions, but most of the time, all people hear about are how horrible their nursing care was. How their IV bag ran dry, or they waited forever for pain meds, or that their nurse seemed rushed. Oh, and the patients who think their nurse was a horrible ogre for not giving them the medication they wanted, even though it was the doctor, not the nurse, who decided against that med. Or the family who doesn't think you're doing enough for their family member, even though you've gone above and beyond to care for that patient. That's got to be disheartening. The saying "don't shoot the messenger" comes to mind. Sometimes you hear about how great a nurse was, but not as often. Plus the butt-reaming you get on occasion from a doctor, for reasons justified or unjustified, must suck. I've seen you come home in tears after a particularly horrible shift.

 Nurse: There are times when no matter what I do, I can't seem to make a patient or their family happy, and times when I've had my ass chewed by a doctor. That is very frustrating. But, most of the time, patients are pleasant to deal with and the doctors are easy to get along with. After one night of verbal abuse by a patient, I've had the doc decide she needed to go in and talk to the patient about treating the nursing staff with respect and that the decisions made for her care came from her, not me. Occasionally, I've been told I'm a good nurse, that I made a good call, that I really helped a mom enjoy her birth experience, or that I've given them great advice when caring for their baby.

RP: You also frequently talk about shifts that are so busy that you don't get eat, drink much or even pee for 12 hours! Some nurses even get bladder infections from shifts like that! Or on the rare occasion you get to sit down to eat, a family member of one of your patients sees you eating and is instantly pissed because you are sitting and eating and not taking care of their family member. You can't win. You've gone into work feeling like crap, just because if you didn't they'd be way too short staffed. I also remember hearing about a nurse working with a broken bone, or in active labor until the end of her shift, because she felt she had to. How many other professions will do that?! It's high stress, and hard manual labor turning patients, running down the hall for an emergency delivery. Plus the sadness of death, whether it's an elderly man or a stillborn baby. How do you deal with all of that? How is it worth it?

 Nurse: Nursing is very emotional. I had to understand my own beliefs so I could deal with the bad things that happen. Especially working OB. The good is really good, but the bad is really bad. We cry alongside patients and their families while still doing our job. There is a grieving process with death, not only for the family, but for the caregivers as well. I do what I can to provide resources for them and to help them start the process of grieving. I guess what makes nursing rewarding are all of the little things.

When you do something for a patient, whether by getting their pain under control, by helping them achieve the birth they want, and giving encouragement to go on, or by just listening to their concerns, that's what makes it worth it. It can be as simple as a successful IV start on a patient who is a "hard stick" and is deathly afraid of needles, or as big as reporting a suspected child abuser. It's when your bedridden patient smiles after a complete bedbath and back rub - that makes it worth it. When a new mom gets her newborn to latch on and breastfeed after hours of unsuccessful attempts. Or when you sit holding a dying woman's hand to let her know she's not alone. It's when I advocate successfully for a patient, and the patient never knows, that's why I'm a nurse. Those moments overshadow all the bad nights. Knowing that maybe, to at least one person, I've made their life a little easier, even if in the smallest measure - that's why I'm a nurse

May 2, 2013

Marathon 3 - finished!

And now I can say I've run 3 marathons. It seems hard to believe that I've tackled that distance on foot 3 times! This marathon went okay. I've recovered much faster this time than the last 2 times I've run one. I didn't have my best time, but it wasn't my worst. I felt great going into the race. I did worry about my training partner, only because she had been dealing with an overuse injury that can sideline a lot of distance runners, but she is tough as nails and I knew she'd finish. I just worried about her pain level and ability to keep running if it gave her fits. We decide to follow a pace team because I loved the pace team I follow in marathon 2. I figured it would keep us slow, help keep us motivated to keep running when we wanted to stop and plus I was hoping to hear some good stories from these strangers we'd be running with. One guy, we nicknamed him Dough Stash, had a hydration belt with gatorade and a big baggie of cut up bagels. Plus a pretty awesome mustache. Anyway, we start, the weather was perfect, and the crowd was great. After a bit, I start to feel we are running a bit faster than the 11:27 minute mile pace the 5 hour pace team was supposed to be running. I figured it must just be adrenaline and if we are running that fast, the pacer would slow us down. At mile 5, my friend checks her watch and our average pace was a 10 minute mile...much too fast for us and NOT the pace we were supposed to be running. What good is a pacer if they aren't going to actually run the pace that they are supposed to. I knew this was not good news. I did try to slow our pace, but my friend was fired up and seemed pumped up to run. I don't know exactly what our pace was but Im positive it was less than an 11 minute mile, but I felt good. At mile 11, my friend started not feeling all that great. I knew that wasn't a good sign because we had a lot of miles to go. Mile 16 comes and she's really hurting. From mile 16 - 23, it was a struggle for her to keep going. We had to walk a lot, slow jog. I kept telling her she could do it, we've done this distance before, and we just had to keep moving forward. She cried a bit, vomited and laid on the ground a couple times, but managed to keep moving. At mile 23, she insisted I go on and I knew if I didn't run at that point, then there would be no running at the end. I feel like a jerk, but at mile 23, I took off running and ran to the finish. My family was waiting at the end for me and it was awesome to see them cheering for me as I ran across the finish line. This was a first. The kids were excited and it was cool to hear them say my name over the loudspeaker. I waited at the finish for my friend to cross and she crossed the line running and looking strong. My time wasn't great, and I'm pretty positive I could have finished at what our pace team was supposed to be finishing at...about the 5 hour mark. But this was her first marathon, and the deal I made with her in January was that I'd run with her in April if she signed up for the one in October. We finished and in October, I will be trying for time. I really want to get under that 5 hour mark. I'm not sure I'll run a marathon next year because there are other races I want to do, so I'm motivated to train better than ever. Recovery, I was hurting Saturday. It hurts running that far anyway, but the stopping and starting didn't really help. I worked a 12 hour shift Sunday night and that was harder to get through than the marathon. Not a good idea, but I did it and gave my patients something to laugh at as I shuffled around. If need be, I could have moved just would have been painful. By Tuesday morning, I wasn't sore, I could just tell my quads and right calf were tired and today I'm itching to go for a run. But I'm resting through Saturday and will start running again next week. The month of May is going to be my month to run purely for fun, maybe work on some strength training and then come for marathon #4 will start!!!

April 24, 2013

Marathon #3

My poor abandoned blog...I used to be so good about writing and updating, getting things off my chest, etc.  But, life is wonderfully busy and I just don't find the time to write like I used to. 

On Saturday, I will be running my 3rd marathon.  A friend of mine wanted to run her first one this April, and I said I'd run this one with her if she'd run the marathon with me in October.  A deal was struck and here I am, only a couple days away from running another marathon.  It's been quite the change, having a training partner.  I'm not a fan of running in the cold, but she will run in any kind of cold weather, so I got out and ran even when I didn't want to.  I think it's going to make a big difference.  We've trained well, I felt great on our 20 mile run.  We aren't fast...her goal is just to finish and I'm going to run her pace.  In October, we hope to increase our speed and run the marathon at an average 10 min mile pace.  Right now we run about an 11+ minute mile.  I'm perfectly fine with that though!  We are planning on doing something to commemorate the bombing victims in Boston.  The marathon will have black ribbons we can buy to wear on our bib number or clothes, and I plan on decorating a shirt somehow, in the Boston marathon colors blue and yellow.  Its such a small gesture, considering all that was lost that day, but I want to do something. It seems silly to say, but it hit close to home...Martin Richard was 8 years old, there with his family to cheer his dad on in the race.  My daughter is 8, my oldest is 9.  This is the first marathon they will get to see because it's much smaller than the one in October.  They will all be there, to cheer me on at the finish line.  Before they caught the second suspect, I was gearing up for a short run, and my oldest came in to talk to me.  We talked a little about what happened.  I was curious to hear what he knew, what they had talked about in school...and I wondered if he was scared.  I asked him if he was excited like he was about seeing me run the marathon.  He said "Yes and no.  I'm afraid something bad is going to happen to you".  That broke my heart. We had a little talk about how I wasn't scared, how they would catch the people who did it, and how I will be safe thanks to the security at the marathon. I told him he would be safe, too, and that if he was scared, he didn't have to go. He said he wanted to still go.  So I think Husband is going to try to catch me at a spot before the finish so my oldest can see that I'm OK.  And if they are scared to be at the finish line, Husband will stand back at like mile 25, or the kids can just hang out at my parents house.  Whatever the kids want to do.  I'm excited, nervous, and ready. 

We run.  Not out of fear, but out of freedom. We run.

October 11, 2012

Marathon 2

Last Sunday, I ran my 2nd marathon and it was a much, much better experience this time than the prior year. I was in much better shape this year compared to last year, even if my training wasn't that great.  Despite not being able to follow a training plan, I did my best to get in some long runs.  I ran 2 half marathons this year, ran a couple 14 mile runs, several 6-10 and 2 18 miles runs.  With all of the longer runs, I had to walk some of it.  Not exactly how I wanted training to go.  When I signed up to run it again this year, my plan had been to train the right way, run the entire thing and do it in less than 5 hours.  But with just life in general, training was put on the back burner and I figured this year, I'd just do what I could do and be happy.  I really thought it would take me 6 hours to finish. 

I worked Friday night and we left Saturday morning to head up to the expo.  I figured by the time we hit the expo, carb loaded and checked into our hotel, I'd be so exhausted I'd fall asleep and sleep all night, like last year.  I was in bed, asleep by 7:30. Anyway, at the expo, I signed up with the 5:25 pace team, knowing I most likely would NOT be able to run it that fast because of my poor training.  Last year, it was pretty hot the day of the marathon.  Temperatures this year were upper 30's in the morning, with a high of 50.  I figured I'd be cold to start but honestly I do run better when it's cool.  At 5am, I get up, shower, get geared up and we head down to the train at 6am.  It was pretty cold.   My friend and I headed to the start after a 20 minute train ride and we find our start corrals.  Thankfully this year, I was in a corral more appropriate for my ability.  Last year the slow pace team in my corral was 3:50...this year it was 5:10.  Of course, the pace team I signed up for was in the corral behind me.  I overheard a couple people talking before the start, and said they were going to do the 5:45 pace team, but the pace would seem so slow, so they decided to run with 5:10.  It sounded like a good plan so I decided I would do the same...follow the 5:10 pace team as far as I could and when I had to stop and walk, I'd manage from there.  Thirty minutes after the start, we cross the line and the pace was actually perfect.  I felt like I could have run faster, but that's exactly what you want - you want to feel like you could run faster the first half so you can finish the second half.  Early in the race, the miles fly by.  I saw Husband and our "road crew" at mile 2 and 4.  By mile 3, I was done with my jacket, so I passed it off to Husband at mile 4.  We're still cruising along, and we all started chit chatting a bit.  It was a lot of fun.  The pace was easy, conversations were interesting.  One girl introduced herself at mile 6 and said "We'll finish together.  We'll do our own thing with this pace team, but I really think we'll cross the line together".  At mile 11, I decided to eat one of the gels I brought to help with electrolytes and refueling.  At the halfway point, I was still running, a big surprise to me and I felt great! I felt strong and like I could run forever.  Mile 16 last year was when I started hurting so I was surprised I still felt pretty good at that point.  I at another gel at mile 17,  saw Husband at mile 19 and I was just glad he was able to see that I was still running because at mile 19 last year, I was not and in quite a bit of pain.  It was an awesome feeling. I used my last gel at mile 21. The race started to get tough at mile 22.  My feet were sore, but I had come this far with the pace team, I didn't want to not finish with them so I kept going.  At mile 23, my calf and hamstring in my right leg started cramping up.  I considered pushing through, but decided to walk just a bit to stretch those muscles.  After a short walk, I started running again.  I knew if I walked for too long, I wouldn't be able to start running again.  I also realized that even if I walked the rest of the way, I was going to finish in less than 5:30!  I couldn't believe it and that got me pumped up.  I ran to about 24 1/2 and was really needed an energy gel and I was very thankful to see they had a station with these gummi things.  At mile 25, I had to start walking short bouts, followed by running on and off to keep those muscles in my right leg stretched.  Total distance walked was maybe 1/2 mile.  I got to the last 800 meters and almost just pushed through the cramping to run to the finish, but the last 300 meters there is a hill.  I walked up the hill and then ran across the finish line.  As I crossed the line, there was the girl I talked to throughout the race who said "See?  Told ya we'd finish together!"  I got my medal, my cover and headed down to the mile 27 post race party to find Husband.  I knew I had beat last years time, but I didn't know exactly what my time was because the clock on the finish line was started at the start of the race and my time didn't start until I crossed the start line myself, which was quite some time in between.  It wasn't until I met Husband and looked at the runner tracker messages that I saw my unofficial time.  5:12:21!  I couldn't believe it!  I knew I was right behind my pace team but the fact that I actually RAN a marathon and finished that fast (for me, not fast compared to hardcore runners) was amazing.  I was pretty darn sore that night and the next day and I think I strained the muscles in my hamstring but it was worth it.  Today, just a couple days later, I feel pretty good.  I can tell my muscles are still recovering and are fatigued, and that hamstring is still sore, but I can get up and down the stairs no problem. 

My official time was 5:12:21.  I owe a lot of thanks to that pace team.  It was probably the smartest decision I could have made.  They were right on with their pace to...pace was within a few seconds at the 10K, half, 30K and finish.  They kept me from going out to fast, kept me slow and steady the first part of the race and kept me motivated the second half.  It was almost like running with a group of friends instead of a solo experience.  It was fun to hear about all the marathons they had run, other challenges, like the Iron Man.  It helped the miles go by.  I don't know if I'll run another marathon.  I had said no way I would run another one until Caleb goes to school because there just isn't a lot of time right now.  But, the challenge and reward of finishing will probably draw me back to that start line with 26.2 miles ahead of me. I'll definitely do half marathons.  That's a halfway easy distance for me to run and I don't have the recovery time afterwards, and I could go to work that night after a morning race.  But we'll see.  Come sign-up time for the marathon in 2013, the temptation may be too great for me to pass up. 

September 2, 2012


A few months ago, we moved into our brand new labor and delivery unit, something we've been looking forward to since 2007 with excitement and trepidation.  The layout of the huge new unit, how we provide care changed a little bit when we moved from a LDR model to a LDRP model.  No more moving from the labor room to the post-partum floor.  Everything happens in one room, with one hallway dedicated to antepartum/postpartum for our preterm labors/antepartums and scheduled c-sections.  We are more baby friendly than we were in the past - almost every baby stays with mom unless she requests the baby to go to the nursery, all care is given at the bedside if possible, skin-to-skin is initiated, unless declined or mom/baby is unable to, within 30 minutes of birth.  And, something I'm VERY excited about:  skin to skin in the OR!!!  That has been a slower process of change with that, but it's been wonderful to see and I think its a huge benefit to moms and babies.  Even with all the positive changes, there have been some kinks, as you would expect when you move from one unit to a brand new unit and changing the model of care.  It's hard to staff an LDRP.  We have a triage area now.  The idea was the triage nurse would admit, decide if they are labor or not and if they are admitted, hand off to a L&D RN.  But in a unit that is relatively small compared to big city hospitals, it's a bit tricky because we just don't have the staff and don't do enough business to make that work and keep the cost down.  So frequently, that triage nurse will admit the patient, the patient turns into labor and then that triage nurse has to move the patient to a LDRP room, admit her and that just adds more time onto the admission.  Another hiccup is the layout of the unit.  It's huge and we are all so spread out.  And there isn't a central nurses station so knowing what is going on with other patients, what docs have patients there, etc., has proven to be a challenge.  We are getting better but I know there have been times we've called a doc for something who had just been called about another patient, or a doc calls wanting to talk with their patient's nurse and we didn't know who the nurse was.  Thankfully, over the last months, that issue is getting better.  It's a process, and we've had to be flexible and adapt.  Overall, its been great. Patients are happier, patient care is better and even though there has been a little bit of disorganization in the beginning, it never affected the patients and it wasn't any worse than what was to be expected. When comparing our old unit to the new unit, it's like comparing a Super 8 motel and the Hilton.  Both work for what they are designed for, but it's much nicer to stay at the Hilton.