It is a fact universally acknowledged that, when it comes to my patients, I am a tad territorial.  Think nesting alligator territorial.  This is usually not a problem since everyone is aware of it, I do my job and do it competently, and I'm nice about my territorialism, until someone gives me a reason to not be nice about it.  I love my job and I know when I need help , which is why I decline offers of help until I need it.  I know how I like things done and I'm severely anal about how things are done.  Why that doesn't overflow into my home life I have no idea. In spite of all this, or in a vain effort to change the way I am, I get a lot of students, orientees, and preceptees.  Right now, I have a brand new grad that I am orienting.  Which means not only is she new to nursing and nursing process, she is new to labor and delivery.  So, I have to explain a pretty much everything and make sure she is understanding why I am doing something.  This is not a problem, other than the fact that I have to make sure I am telling her what she should do, instead of what I have found to be the most efficient way to do something.  Totally a case of "do as I say, not as I do."  Develop your own bad habits, because I don't want to be blamed for them! She's going to do fine, but has said a couple of times, "Do you think I could do more stuff?"  Yes!  I do!  But you have to tell me to back off, because if I see something that needs to be done, I'm going to do it! It will make me crazy not to.  So, that's our goal for next week, for me to back the hell up and actually let her do the patient care.  We've just got to work on time management a little more...

So, New Grad showed up on Wednesday wearing a mask.  She told me, "They said I should wear a mask in patient care, but I feel much better than I did yesterday and last week."  Awesome.  So, after close contact with her at the desk, (not to mention last week when she was completely INFECTIOUS) along about the end of the shift, I started feeling like caca-doody.  I had thought the constant tickle in my throat all day was from trying to kill myself drinking water on the way in.  But alas, it was not to be.  I went to bed, hacked my way through the night and woke up feeling as though I'd been dead three days.  I was working an 11-19 shift, so I went to buy some herbal wellness drops and some DayQuil.  I know it's a little odd to buy naturopathic remedies with mainstream meds, but I was desperate.  I'm sure the herbal stuff is more placebo effect than not, but whatever.  So, I down those, get to work where I, once again, have to park at the helipad.  The parking lot and the grass overflow were both full and I was thinking of ramming the fence to the softball fields when a gentleman, who had to be a retired chief, flagged me down for his spot.  And wouldn't let any of the other cars looking for parking as well, park there. :) I went in to work and immediately got a mask.  My orientee saw me and asked why I was wearing a mask at the desk.  I replied that I didn't want to infect anyone with the Black Plague, cuz I'm considerate like that.  Yeah, it was shitty.  What of it?  I spent the next 8 hours explaining that I was sick, I wasn't desiring to be an OR nurse, and no, it is not an effective muzzling tool.  I had a change of shift delivery which put me home in time to send the kids straight to bed.  I was coughing my lungs out, expecting to see my toenail polish at anytime, and wishing for some cough syrup with codeine.  It's great for uncontrolled coughs.  Hey! I thought.  I have Mucinex, which is guaifenesin (cough syrup) and I have Percocet.  That has to be nearly the same thing as guaifenesin and codeine, right?  Right! So, with my little nurse-y brain convincing me that it was totally okay, I hammered back the Mucinex and chased it with a Perky treat.  It wasn't until this morning as I popped more DayQuil, that I realized the Mucinex wasn't straight up Mucinex, but Mucinex Cold and Flu.  Which has acetaminophen in it.  As does Percocet.  And DayQuil.  A quick calculation brought to my attention that I was kind of pushing the lowered maximum daily dosage for ye olde acetaminophen.  So, then I did the standard medical professional thing and thought, "It's fine for me though."   I continued the cough fest throughout the day, which included taking tackling a cat on the kitchen floor so I could take him to get his rabies shot (how do they know it's time to go to the vet?? He's not literate, so I know he isn't reading it off the calendar!) and wrestling to freaks of nature to the groomer.  The DayQuil wasn't cutting it in that department, so then I started swilling Delsym straight out of the bottle like it was Jameson and I was at an Irish wake.  At this point, I now longer cared that it was a once a day dosing of two teaspoons and that gauging I hadn't exceeded that by "it didn't feel like two teaspoons in my mouth" probably wasn't the most accurate methodology.

Once in a while it's kind of fun to look at the stats and see what actually brings a person to the blog.  Here's one of the search terms: "booba bouncing while she rides cock."  Whiskey Tango Foxtrot?!?!?

I was inventorying the kids' Halloween candy (read: pilfering their hard begged candy to feed my nefarious, and ginormous, sugar jones), when I ran across a bag of fruit snacks.  Fruit snacks?!?  Who the hell gives out fruit snacks?  Don't they know that they are treading a dangerous line, preventing middle aged women from getting a chocolate fix?  Seriously, if you give out fruit snacks, good for you for not bowing to commercial pressure and trying to stem the tide of childhood obesity in your own small way.  But, you suck, and it doesn't make you better than I.  So there.

My career choice, and the fact that I practice it in a part of the country/state I live in that likes to "grow 'em big," has resulted in chronic back pain that has escalated in the last 6 months to DEFCON 1 on the old pain scale.  (Not to be bothered with the FACES or numeric pain scale, I prefer to gauge my personal pain based on the defense level light board from WarGames.) I don't know why 14 years of hauling 200+ lbs of healthy womanhood and feti (plural of "fetus" that I just made up), epiduralized up to the nipple line (or "tittehs" as I have a tendency to say), would cause a condition that affects my quality of life, but it does.  I actually made an appointment with my well loved, but seldom seen, PCM, PCP, FP, GP, or whatever the hell we are calling them this week, to get a referral for physical therapy and/or chiropractic care (so I can continue to work, keep a roof over our heads, put food on the table, edification in my children's expanding minds, and keep FBs orthodontia from making us destitute), and not, I repeat NOT, to seek drugs as I think pretty much anyone I work with partially believes I am wont to do.  Methinks,  I wax Percocet poetic far too often.  Well, I received my referral, but I got meds without even asking.  Of course, these meds put me in the drool locker, thereby making them inappropriate to take at work.  That's not the only reason I can't take them at work, but it's a pretty good one.  So, when I get home after a rough day of helping women through the joy of childbirth and get all the animals, both bipedal and quadrapedal settled for the night, I get to pop my little cocktail of joy.  And spend the next 4-6 hours blissfully trying to scratch my skin off, but not really caring.

So, the Lawn Boy is still maintaining my lawn, but is no longer maintaining my lawn, if you get the way I'm drifting.  Seems that his life is a little too complicated and chaotic to have anyone else in it.  And I respect that.  His life is no different now than it was a year ago when we started this whole, whatever it is, but, okay, he feels what he feels.  I'm letting it go because I was widowed at 38 and know  life is too short to want someone who doesn't want me.  Got it.  Loud and clear.  So, I'm back to being me and the boys, doing what we do, and luckily,  I'm okay with being alone.  If it doesn't drop in my lap, it's probably not going to happen.  I work 12 hour shifts, I have a teenager and a tweener, and I have no time or energy left over for high speed pursuits. Although, I do miss having somebody just want to spend time with me, laugh, kiss, and oh, goodness, do I miss sex. Y'know...with someone else involved.  I get plenty one on one time.  Good thing batteries are fairly inexpensive.

I had a patient the other day that made me feel like I was back working at Big City Hospital.  She had no prenatal care that we could discern, despite her claiming that she had.  So, on a closing note, I just wanted to reiterate a few truisms from the labor and delivery world.  Ahem....

1. We live in the 21st century, not the 19th.  Records are electronic and easily verified.  By the time you tell me you got some care "in California" I have already received confirmation that you have never been heard of by any of the facilities you told me had seen you.

2.  Claiming we lost your records instead of confessing to no prenatal care also doesn't work.  Especially when the doctors you claim to have seen are on the floor and have never heard of you.

3. Please don't insult our intelligence when your "38 week" baby  is delivered and is clearly 33 weeks by saying we're wrong because there is no way you could have had sex when your husband was out to sea.  We are well aware that you can.  And did.

4. If you are a military dependent you should realize that we will get in touch with your husband's command and inform them that you had no prenatal care.  And then his ass is in a sling.  As well as yours will be when he finds out the baby is presenting as 33 weeks gestation.  See above.

5.  Screaming and breathing like you are giving birth to a Blue whale, will not put you into labor.  It will also not change your cervix from 2 centimeters.  Only labor contractions will do that.

6.  Simulating contractions while on the monitor will also not change your cervix.

7. We are professionals who look at fetal monitors A LOT. We can tell the difference between a real contraction and your little ab workout you are practicing in the triage room.

8. Throwing yourself on the floor, or better yet, out of the car at the gate and scaring the shit out of security without a person coming out of your body, RIGHT FREAKING NOW, does not impress us.  We will scoff.
9. Please remember what happens to post coital semen when you were not pregnant.  The same thing happens when you are.  Don't think your water has broken EVERY SINGLE TIME. If you insist on doing this, we will insist you stop having the sex.  Fair warning.

10.  If your water has broken, please let us know so we can best advise you.  Please don't stay home for two days, "because I didn't have contractions."  You will possibly come in infected and with a baby who is most displeased with its habitat and then every body gets cranky.

11. Remember I actually do love my job and it's my job to help you have the best labor/delivery experience possible, following your birth plan as closely as possible while still having a happy, healthy mom and a happy, healthy baby.  That is the ultimate goal.  Hospitals and the medical team are not inherently evil and do not look for every way possible to thwart your wishes.  Be informed, be flexible, work with your care team and make sure you fully understand everything that is being presented to you so you can make informed decisions with your care team.  If you believe our goal is to deprive you of your birth plan and discount your wishes, perhaps this is not the best place for you to deliver.

The Percocet is kicking in and I have to buy donuts tomorrow.  Good night.