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Friday
Oct282005

Where Was I?

Oh, yeah, studying.

The students came to the office today and practiced IVs on each other and on willing victims - Baby 1 and partner included. I, needless to say, do NOT offer up my veins for practice purposes. There's a new midwife in town and she is cute as a button and I thought she and Baby 1 (23 years old) might get along (they do) and she practiced on him, but the other midwives and I were a tad concerned about her lack of sterile technique. "Oh, I hate using gloves - do you mind if I don't?" I wanted to scream, "DO YOU KNOW HOW MANY WOMEN MY SON HAS HAD SEX WITH?!?!" but said, "You never know if that person might have hepatitis or HIV - you have to assume everyone does. Wear gloves." She took them off to remove the (unsuccessful) IV and we made her put a new pair right back on explaining that more bleeding comes with removal sometimes than with insertion. She huffed a little, but did it anyway. Hmm.

I got my partner on the first try.

I have tried to do IVs about 30 times I guess and have only gotten one successfully. Well, I should say I have gotten flash (the sign that I was in the vein - when blood "flashes" back into the needle's port), but have only once gotten fluids to run successfully and that was when I had to because the woman was bleeding to death. EMS got there about 3 minutes later and took over. I was never more proud of my bloody, messy antecubetal IV insertion!

I'm a great phlebotomist - can find a vein nearly anywhere. I know that comes from being a fat sick person and I learned how and where those veins sit. They are always there, even if you can't feel them. Always. We all have them. And digging need not occur, either.

So, getting the flash isn't the hard part for me, it's the running the fluids. Did the site clot in the 2 seconds before I ran the fluids? Did I dislodge it as I was connecting it? I haven't quite figured it out, but today was the first day I got it and ran the fluids (partner insisted on the entire 500ml bag of Lactated Ringers) successfully. I was happy!

Another midwife introduced us to a new IV catheter/needle set-up. They are the friggin' coolest things going. You can see them here (BD Insyte Autoguard Shielded IV Catheters):

http://www.bd.com/infusion/products/iag.asp

They have a push button needle retraction that makes inserting the catheter itself infinitely easier because the catheter is so flexible, it easily follows the path of the vein. (This is not the catheter I used, by the way. I used the old-fashioned ones.) I loved this thing, but one must be careful not to click the button prematurely or else restarting another poke is necessary. I ordered 50 of these today. It might be for safety reasons, but I know it will make IV insertion so much easier for many of us who don't do this 30 times a day.

My dear friend/client's daughter's baby is breech. She's 36 weeks. We're doing everything to turn the kidlet. No version yet, though. Chiropractic and visualizing and homeopathy at the moment.

I helped save a foreskin today. Whee! They seemed so sure and then waffled slightly and then their pediatrician said, "What?!? You had a home birth! What in the world are you doing circumcising?" and then they had lots of questions since Baby 1 is circ'd and Baby 4 is not (yeah, they know I talk about their penises in my blog). They have 99% decided not to circ now. Yay! Hurrah for the pediatrician, too (a woman).

I'm trying to simplify. I've given away a huge bag of clothes to a pregnant woman I know that doesn't have money for new ones and my skinny girl clothes will fit her pregnant body just right. I cleaned out my office, throwing away lots. I'm bringing all my old issues of Mothering Magazine (and I easily have 300) to the office and giving them away. I'm visualizing their taking flight and prospering into the world instead of sitting and taking up space and collecting dust in my house-office.

References (2)

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    - Navelgazing Midwife Blog - Where Was I?
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    Response: phil st ores
    - Navelgazing Midwife Blog - Where Was I?

Reader Comments (1)

It's funny how this made me feel. I am so in envy and awe of your midwifery skills that I feel quite inferior.....but I have started lots of IV's. I had to. My hospital didn't have an IV team. Before PICC lines(peripherally inserted central catheter) we usually had to do two or three a night because we were running so much Vancomycin and it tears up veins. You had to make at least two tries before asking another nurse, was the unwritten rule. We also got lots of dehydrated little old ladies in. Sometimes I wished we had the tiny butterfly needles from peds, and in fact someone once went to peds and got some, when we had an especially tiny dehydrated old lady.

It is definitely the hard part to thread the catheter up the vein without going through the vein.

I still look at people's arms and without thinking about it find myself thinking "Where would I put an IV in him/her?" Not the antecube, because when people bend their arms it makes the pumps beep. The old pumps we had would then beep until we went to shut them off. And if the person was in isolation, that meant donning gloves, mask, and gown, just to go in and push a button.

Being a nurse was the best of jobs and the worst of jobs. I am a much better paid bureaucrat now, alas.

Susan Peterson

August 13, 2010 | Unregistered CommenterSusan Peterson

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