Dah-da-da - Nurse Crappy returns

It's been a really long time since I have even seen Nurse Crappy, let alone had to be torutred...uh, I mean, work with her. Oh, but ye gods decided to smite me with her crappy nursing skills and personality recently.

So here's the scoop, I had a patient who was being induced due to gestational diabetes controlled by meds. Oh but wait, I forgot, gestational diabetes doesn't exist. How could I forget such an important point. You might be asking "what the heck are you talking about?" right about now. I guess there are some people out there in the blogosphere talking about how gestational diabetes and preeclampsia do not exist. Or if a mother can't cure herself, then it's her own fault. The sheer idiocy that exists in the world scares me sometimes. I'm not really sure how these people function in the real world....or perhaps thy live in Idiot Land only. I dunno...but I digress...

So the patient is getting some cytotec (geez, please don't start - I like cytotec and Henci "Nutcake" Goer be damned). That happens through the night. Then first thing in the morning I get a call from Nurse Crappy. She informs me that the patient has had her 3 doses of cytotec, is feeling a little crampy, and what would I like to do now? Uh. The order I wrote says give one dose of cytotec and can repeat up to 3 more doses. Nurse Crappy says "Oh, well night shift RN (who's kinda a nervous bunny) said it was just three doses." I'm thinking (but I don't say it, Bestie will be proud of me) Oh well, good thing you did a chart review hunh? What I actually say is allow the patient to go for a walk, shower, etc then put the final dose in.

About 45 minutes later...

Nurse Crappy calls to inform me that the patient is crying and contracting every two minutes so she held the cytotec dose (thank god for small miracles - she can do the right thing occasionally). She requests orders for pain meds, and wants to know what I want done with her. Well, did you check her? Of course not. Nurse Crappy is a firm believer of always doing the opposite of what I want when it comes to cervical exams. If a patient's water has been broke for 24 hours and wants no intervention then she'll check her to satisfy everyone's curiousity. But if the patient is intact and you're calling me to make some decisions regarding the plan of care, well hell, who needs that exam as part of the database for making decisions). Oh, and the baby looks good when she's able to trace it....that would hold up in court really well Nurse Crappy.

So the exam has changed, I'm hoping the patient is kicking into labor with no further intervention required (pitocin) so suggest she try putting her in the jacuzzi tub before giving any pain meds. She's not really active yet so not time for me to be there quite yet. Nurse Crappy acts like that's an amazingly novel idea. 30 minutes goes by and Nurse Crappy calls me again. The patient enjoyed the tub and is much calmer now. But she also feels like the contractions of gotten milder. And the contractions have spaced out so I tell Nurse Crappy to give her the final dose.

More on this later...