My Life as a Neonatal Nurse Part One

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Three years ago, I retired from my life-long career of nursing. I spent around 35 years working in various hospitals and always with infants.  Oh, there were the occasional times when I was “floated” to different areas within the hospital where I struggled to be the med nurse on the surgical ward or the “active listener” in the Psych department. I never felt comfortable with adult patients. My heart, my mind, and my expertise were always with the babies.  In later years, hospitals quit floating nurses from specialty units out to general medical floors.  I guess they realized that after so long working with only infants, we were literally “winging it” with the adults, and it just wasn’t smart or safe.

Before I actually retired, many of my co-workers would tell me, “you’re gonna miss the babies!” I’m still waiting for that to happen.  What I do miss are my nursing colleagues, and members of the ancillary staff too. Nursing in a hospital is so very much a “team sport” and I truly enjoyed getting to know everyone that was part of our team.  I don’t miss getting up at 4:15 am, the 88 mile drive in to the hospital, the long 12++ hour days, or working nights, weekends, and holidays. I DO miss the paycheck. I do miss my friends. I do miss the rare afternoon at work where I wasn’t running my tail off and could actually sit down and just hold and rock one of my tiny patients.  On those days I remember thinking, “they actually pay me to do this”. Okay, so maybe I do miss those babies, a little 🙂

My career spanned a period of time when LOTS of changes and discoveries were made in how we treated premature infants. Believe it or not, there was no oximetery back in the late 70’s and early 80’s.  We had to draw so many blood gasses to determine lung function and ventilator settings that every few days we’d need to transfuse the baby to replace what we’d taken. There were no surfactants and nobody used CPAP, either – at least at the beginning of my career. We had many ventilator dependent patients that were extremely difficult to wean off — and how many little ones ended up with severe vision problems because we couldn’t keep a super close eye on their oxygen saturation?  Seemed like we did lots more exchange transfusions (for jaundice or high bilirubin problems), and we were taught to always be attuned to a baby who began to run a low-grade fever, or suddenly was cold and couldn’t seem to warm up. Yes, this was in the days prior to all pregnant moms being tested prenatally for Group B Strep – a killer bacteria that is extremely dangerous for newborns.   All this reminds me of one of the many significant events of my nursing life.

It was about 1980. Could have been ’79 but it doesn’t matter either way. It was a LONG time ago. I worked evening shift back then, 3 – 11 pm.  My own two boys were really little – just 2 & 3, so I stayed home with them till about 2:30 pm when it was time to leave for work. Then my parents would come stay until hubby got home about 5:30 in the evening.  I was happy to work just three days a week, and on those days, I literally felt like I “worked” from morning to night. I’d be busy all day, taking care of the toddlers, doing your normal household chores, and I usually tried to have something ready for the family dinner when I wasn’t there.  Some days I’d go to work and start my shift already feeling totally exhausted.  I enjoyed my co-workers so much, even back then.  One of the other nurses was very pregnant with her third child.  “Janie” worked nearly right up to her due date, and seemed so full of energy – more than I had, that’s for sure. She was so good with parents and doctors, and of course with the babies.  Back then, in our rather small-town hospital, we had a large traditional newborn nursery and a small (3-4 bed) Special Care Nursery. We switched off working in both areas.  I loved the experience of working with normal newborns.  There was no “rooming in” in those days, so we “newborn nurses” walked literally miles every shift, carrying each baby to mommy’s room several times in an 8 hour period, and then back to pick baby up for a return trip to the nursery. Most evenings were very busy, depending of course on what the census was.  In those days, mom’s with normal vaginal births normally stayed in the hospital for 3 nights.  C-section moms were most often hospitalized for 5 nights.

My work day always began in the locker room back then. It was there that we had to change from our “dirty street clothes” into hospital provided scrubs prior to our shift. Everyone was talking about how our co-worker Janie had had her baby the day before. We were tittering on about how it was a girl and how big she was – at that time, prenatal ultrasounds were pretty much unheard of. Let me amend that.  Nobody ever got an ultrasound back then. It just wasn’t done, so we were all excited to learn it was a girl.  Janie now had a boy and two girls. Of course we were just thrilled for her. That evening, during my shift, one of the other nurses noticed that Janie’s baby had a bit of a temperature elevation. Since we were pretty cautious about that, we called the pediatrician to let him know.  Yes, nearly ALL the Peds were men back then. In an abundance of caution, the doc, who knew all of us nurses well, decided to come in and have a look at Janie’s newborn daughter. He decided just to be safe, he’d draw a CBC & blood culture (nurses were never allowed to draw blood cultures back then – at least where I worked).  None of the results were back before it was time for the evening shift to head home.  The next day upon arriving at the hospital, there was an entirely different aura.  Janie’s baby had taken a turn for the worse and was now in our small Special Care Nursery, on a ventilator with IV antibiotics going. She almost had a gray cast to her skin, she looked so unwell. It was so sad and difficult to see a baby belonging to one of our own – so sick,  and Janie, clearly very frightened as well.  Baby’s diagnosis came early in the shift. Overwhelming Group B Strep Sepsis.

Honestly, there couldn’t have been a worse diagnosis.  The neonatologist had already put little “Anna” on IV antibiotics, but it seemed like they weren’t helping.  Janie pretty much didn’t leave the Special Care Nursery at all, understandably wanting to be at her baby’s side.  Family members were in and out constantly. Still, little Anna didn’t seem to be responding to treatment.  The next day, with baby Anna getting worse instead of better, our neonatologist decided (with parental permission) to try a treatment that is normally NOT associated with Group B Strep.  Within a few hours, we were set up and doing a Double Exchange Transfusion. This entails slowly and carefully removing a few milliliters of blood from the baby, and then replacing it with new donor blood. The process can take several hours.  It was clearly and admittedly a last ditch effort to rid this baby’s body of the streptococcal bacteria.   I wish I had a wonderful, miraculous ending I could share with you, but I don’t. Janie’s baby Anna died that day. We tried everything we could to save this infant, both conventional and unconventional treatments, but nothing was effective. Words can’t describe how sad we all felt for Janie and her family.  Several months later, Janie did return to work and continued to be a wonderful, well respected nurse.

Nowadays, in the USA, all pregnant women in the care of gynecologists get a test for GBS at about 37 weeks gestation.  If it’s positive, they are treated with IV antibiotics when labor begins. This is a highly effective treatment for the prevention of transmission from mother to baby. I only wish we would have had this insight back in 1980 when Janie was expecting Anna.   On a similar note, I have very recently read online that routine prenatal GBS testing is the standard not only here in the US, but also in France, Germany, Spain, and Canada.  It is NOT available through the National Health Service in the UK. Apparently the test costs 11 pounds, and the government is choosing not to provide this as part of routine prenatal care. They are also concerned about the cost of antibiotics, should a mom test positive.  Here’s an interesting article on the subject: http://www.mirror.co.uk/news/uk-news/government-leave-700000-mothers-untested-6966169   I usually try to stay apolitical on my blog, but MAYBE the recent British exit from the EU will allow Great Britain to spend some “new found” revenue on their own citizens — it seems to me that GBS testing on all pregnant women would be an excellent and prudent use of tax money.

I have lots of memories about actual events that happened during my career as a neonatal nurse. I will never share real names to protect privacy.  Please be on the lookout for the next installment in “My Life as a Neonatal Nurse” in a few weeks!

Time for a big change

I have a funny feeling that our lives are about to make a big change.  It looks like the long awaited twins will be arriving sooner rather than later.  Possibly as soon as next week.  The huge worries about their health and well being, while not totally gone, are much eased.  The doctors  guess that the twins are approximately 4 1/2 pounds each.  Considering where they were back on January 13th, that scary Friday the 13th when dear DIL had to be transported via ambulance at 24 weeks to a Seattle hospital, we now have a couple of “big babies” on our hands!  There was one thing I decided NOT to mention to my son and DIL at that very scary time.  Someone at my hospital gave birth to 24 week twins that same weekend.  One died the next day, and I’m not sure if the other one survived or not.  By the grace of God, we did NOT have twins that weekend.

Now we approach the time when two new little people will enter the family.  Other than by marriage, we haven’t added anyone to my side of the family in 33 years!  It’s about time!! 🙂  I remember when I had my first baby.  Life was suddenly different, never to be the same again.  Now it’s my turn to sit back and watch it all happen.  It’s wonderful, exciting, tiring, miraculous, precious, exhausting, and unforgettable.  We’ve heard the term “the new normal” bantered about quite a lot these days…. in reference to monetary things.  Well, my son and DIL are about to slip into their own “new normal” –  which, lets be honest, equals CHAOS!  You will think you are the ONLY people awake in the middle of the night feeding two little babies.  You will shocked at all the diapers you’ll go through.  There will be times you will think… or say out loud…”I can’t believe ALL THIS came out of one tiny baby!!” You will be amazed at the amount of laundry two infants can make.  You will be surprised at how the days and nights fly by, with thoughts only of “the babies”.  Sometimes new daddies get pretty darn jealous of all the time the baby(ies) take from them.  Mommy’s focus must change somewhat, while the babies are little. New parents now have to face huge new responsibilities.  No longer is is just the two of you you’re looking out for.  It’s all a period of adjustment.  We’ve all been through it, and survived it… but it’s not too surprising that new parenthood can feel very overwhelming at times.  It’s also fun, and exciting, and terribly rewarding.  You are about to embark on a huge new journey… one that – contrary to popular belief – doesn’t end in 18 years.  Once you’re a parent, it never stops.  They’re always your kids.  No matter how old, no matter how far away they live.  This, my dears, is a journey for life…a journey you are blessed to be able to take.

A crazy week… in many ways….

I thought by now I’d have my first book review posted for the year, but it sort of slipped to the back burner this week.  A week ago today, I was attending an mandatory meeting at work and got a call from Son #2.  Dear DIL was (unbeknownst to all) having premature labor!  At 24 weeks, we knew this was not a good thing… to say the least.  I truly believe it was God’s hand that allowed dear DIL to have an appointment last Friday morning with a high risk OB specialist MD who had come to their community from Seattle.  He noted immediately that she was in early labor and that action needed to be taken – now.  I can only imagine how frightening this must have been for both my son and DDIL.  She was quickly transferred to an ambulance and taken to a hospital in Seattle, where I can guarantee you, they know how to handle premature labor!  After many tests and examinations, as well as an IV with MagSulfate, her contractions slowed, her cervix closed, and the bag of water from baby “A” which had been bulging – disappeared back to where it belonged!  Oh, the prayers that were sent up for these precious babies!!  And the joy that God heard and answered our prayers!!   Looks like our little momma will be hangin’ out with the folks in the big-city hospital for another 5 weeks or thereabouts.  I know it will be boring, but I also know it’s the best place for her to just rest and gestate!  Here is a photo taken early this week… of course AT the hospital.

Another development this week was the announcement of our babies names!  Now we know we’ll soon be meeting (well, not TOO soon!) Jacob Thomas (“Jake”) and Katelyn Macy.  🙂  🙂  When the parents-to-be asked me for input on baby names, I pretty much refused to give any.  All I said was… “don’t pick anything too weird and please, whatever you do, don’t name your little girl Bertha”.  My granny was named Bertha, and I loved her dearly, but I can’t say I was too fond of her name.

Also, this week we had some perfectly HORRIBLE weather.  All the predictions for snow came true, plus more.  It was all bad enough to keep us from making our flight down to Palm Springs this week.  What a disappointment, but what can you do?  Wait for it to melt and reschedule, I guess.  That’s what we did today!  Here’s a huge shout-out to Allegiant Airlines for refunding our money for the flight we were completely unable to make!  We will be going down next week to put the finishing touches on the vacation rental home… and, it looks like we have our first serious renter lined up for several weeks in February.  YAHOO!

Be watching for an update next week from our sunny place in the California desert!

Hello 2012!

It’s only taken me 12 days, but here I am, ready for my first blog post of the year.  At the end of last year, I stated that I’d be reviewing books under the tab of “Books 2012” as I’ve done in the past.   You may have noticed that the tab, “Books 2012” has disappeared.  Yep, I’ve changed my mind.  It’s all for a good reason – I’m participating in the Historical Fiction Challenge 2012 and as a participant, I need to leave links to my book reviews.  If I post all my reviews on the separate page, then every review will have the same link, and people would have to scroll through them all, each time.  So, it’s back to reviews in the body of the blog, where each posting has it’s own link.

Our Vacation Rental Home in Indian Palms Country Club

It’s been a hauntingly mild winter here so far…. but I’m afraid that’s all about to change.  “They” are predicting snow for this weekend and much of next week.  I used to love snow.  Now I hate it with a passion.  It’s all because of that nasty 88 mile drive I make weekly into Seattle for work.  Since I have no control whatsoever over the weather, I’ll just have to wait and see what happens.   On another note, next week we are headed to the Palm Springs California area, to work on getting our vacation/rental home ready for use!  I checked the weather forecast for that area, and YAY!  It’s supposed to be sunny and in the 70’s the entire time we are there.  Honestly, that place is heaven-on-earth this time of year. Recently, hubby pretty much finished and then published the website for our vacation rental home.  There are still some tweaks to be made and additional pictures to be added, but do feel free to check it out at:  MountainVistaPalmSprings.com

I also have an update regarding our twins.  Yesterday dear DIL went to the OB doc and was told it was time for her to quit work and be horizontal more than she is vertical.  They are not actually calling it “bedrest” yet, but her activities must be very limited.  She has another appointment on Friday with a “high-risk” OB specialist, so we’ll know more then.  We would sure appreciate prayers for both mommy and babies and for a safe delivery.  Here is last week’s baby bump photo.

It’s amazing how much we already love these babies that we haven’t even met yet.

On a completely different note, let’s talk about the football playoffs!  Okay, my team (Seahawks) didn’t make the playoffs – no surprise.  Normally I have little interest in the post season, until the SuperBowl happens…. but this year — well folks, there’s a phenomenon happening.  He’s called Tim Tebow.  I love this guy!  He’s young, he’s fit, he’s the quarterback for the Denver Broncos (a team I used to love to hate).  He’s not the best quarterback in the league, but he is doing his best to lead the team in his 2nd season.  He is very open about his faith in God, and frankly, it’s refreshing to see a successful young guy who is not afraid to tell the world where he gets his strength.  We’ll be watching Saturday night as Denver takes on New England for the next round of the playoffs.

Soon, I’ll be posting my first book review of the year!  More updates on our twins as they happen!

A Friday in Fall ~~ plus Twin update!

Eight years ago I was finishing up my fourth year of living in the Southern California desert.  It was really fun to live in an area that was soooo foreign to me – weather wise, but after four years of “the fun” I was sure missing something.  Missing it real bad.  That something was the changing of the seasons.  For the most part, the trees never lose their leaves in Palm Springs.  If an evening temp gets down to the 40’s (around 7C for my non-American readers), well, that’s pretty miraculous.  I think what I missed most was Autumn.  I love the changing colors, crisp days, extra blue skies, or – the pouring rain like we had today.  Today was lovely.  We didn’t have to go anywhere… and I sure do enjoy my days at home.  Hubby and I got the house nice and clean and also performed an autumn rite of passage…. we put the flannel sheets on the bed today!  Ohhhhh I DO love the coziness of flannel sheets 🙂  Eight years ago, there were NEVER any flannel sheets on the bed.  I rarely made hot soups on weekend evenings, and huddling up before the fireplace was unheard of!

Today I also fired up the oven and baked a batch of yummy pumpkin-apple-walnut muffins… oh the delectable aromas in our house!  That and my wonderful “Scentsy” warmer with “Sentimental Cider” making our home smell heavenly.  For dinner I made a delicious meal of pork chops with apples, garlic smashed potates, and sauteed brussels sprouts with lemon zest.  Ahhhhhhhh……. the joys of Autumn.

Last week we made a trip over the mountains to visit family.  It was probably the last trip over with our motorhome, until spring.  There’s just no chance we want to have to drive that thing in the snow.  Anyway, we had a nice visit with Son #2, dear DIL and my brother.   I am hoping to get weekly updates in the way of “baby bump” photos that I can share.

Here is dear DIL at 12 weeks.

Then on Monday, they had another ultrasound… Here are the twins, both looking great according to the Doc. 🙂

Then today I received the latest baby bump photo….Still pretty tiny, but definitely growing!! 🙂  Won’t it be fun to watch the twins (and dear DIL) grow?!

Here are a couple more photos from last week’s trip.

I’ll end this post with a Happy Halloween greeting from our beautiful black cat, Mr. Jinx!!

Twins update

I have a feeling that I’ll be doing LOTS of these “Twins updates” in the coming months.   Since we live 250 miles away, I don’t know all the little particulars of every day, but I do know that dear DIL is still feeling pretty yuckky much of the time.  She says that if she forces herself to eat, then she actually feels a little better.  She is still awfully tired, and just going to work every day really takes it out of her.  I tried to reassure her that in a few weeks, both of those symptoms should fade away and she should start to feel a whole lot better.  I do hope and pray that is the case.  I asked my son if DIL has a “baby bump” yet, and he just laughed.  Apparently the answer is “not yet”!  With permission, I will post baby bump photos (assuming I get some! hint, hint) and we can all watch our darling little embies grow.  Here is the most recent ultrasound photo – taken the last week in September.  Amazing, huh? 🙂

Last week we were in Palm Springs, looking at property – hoping to find a super reasonably priced vacation place for a rental investment.  While there, I couldn’t miss the opportunity to do a little BABY SHOPPING!!  I did find it a bit frustrating, though.  These days, everything – even from the tiniest newborn outfit – are gender specific.   Well, obviously we don’t know the gender(s) yet, so I combed through several stores, trying to find something CUTE and unisex!  I was thrilled to finally find a couple of adorable receiving blankets, bibs, and booties that have SHEEP on them.  I should say “lambs” I guess.  I have been a collector of sheepy things … well, forever!  So when I saw these, I just KNEW I had to get them. Pretty cute, huh??  I just couldn’t resist, I’ll tell ya!  I was talking this week with one of our twin moms at work.  Her two little girls are still hospitalized but she told me that she wishes she would have received more “practical” stuff for them.  She said everybody wants to buy clothes, clothes, clothes!  Well of course, because there are such incredibly cute clothes out there these days!  So I asked, “well, please tell me, what is practical?”  She mentioned bibs and diapers – and honestly I can’t remember what else.  Oh well, at least there are three bibs in my latest “baby haul”.  I feel quite practical now!

On another subject, we have indeed purchased a Palm Springs property for investment, rental, and vacation purposes!  More on that soon!!

We’ve got TWINS on the way!

I think we are still digesting the news… in fact I’m pretty sure we’re still in a little bit of shock — but it’s happy shock.  You see, back in April of this year Son #2 and dear DIL went through the frozen embryo transfer process for the first time.  DIL took all the pills and hormones and shots everyday for weeks to get ready for that transfer.  They drove to the clinic in Seattle with high hopes and many prayers were with them.  Unfortunately, the outcome was not so great.  ALL the embryos they had adopted had to be thawed, just to get two that were viable for transfer.  Son and DIL were most certainly amazed to learn that most of their embryos had failed to survive the thaw.  There were conjectured reasons as to why most didn’t make it – but at any rate the two that did were carefully transferred in what must have been a very bittersweet moment for our parents-to-be.  Ten days later, the blood test was negative.  None of their 10 embryos survived and they had to start the process again, the process of being matched with another generous family who wanted to give their embryos a chance at life.

As we now know, this time things went much, MUCH better.  The clinic only had to thaw two, to find two healthy thriving embies.  Those two were transferred and found a happy happy home in which to grow!  Last week Son and DIL went in for the first ultrasound.  I think it was with joy and amazement, as well as with prayers of thanksgiving that they actually were able to see the super-tiny beating hearts of TWO babies.  Wow.  Has obstetrics ever changed since I was pregnant!  I never had an ultrasound.  I think I heard the baby’s heartbeat once or twice in the doctor’s office, and only when I requested to listen in!  When my two arrived, I had no idea if they were boys or girls… it was an old fashioned total surprise.  You know, that might be fun when you are having your 2nd or 3rd baby, but I would sure want to know the first time around.  I think the curiosity would simply kill me! I was plenty curious way back then, but since there was no way to REALLY know (short of an amniocentesis), I didn’t dwell on it much.

Next week will be another ultrasound.  I think they want to measure the growth of the babies and of course count the heart beats.  It looks like the due date will officially be in early May, but since twins pretty much always come early, I’m going to be requesting time off work in April, just to be prepared.  I’ve had a “little experience” with babies over the years (ha!) and quite simply can’t wait to be a hands-on Grammie…. well, as “hands on” as Son #2 and dear DIL will let me!  🙂    More as it happens………………………….