The problem nurse is gone they created a job for her at another hospital, her buddies from the leadership brought her a bunch of flowers she resigned and nobody has officially told us but there was much rejoicing. I guess in the end they decided that loosing 1/2 the staff because of her might be a problem. No doubt she sees herself as a victim and she is planning her return in triumph later but with any luck I'll be retired.
Problem baby of the week was a gorgeous little fellow under lights for jaundice he was so jittery which can be a sign of withdrawing from drugs, or low blood suger etc. He didnt appear to have any of these so we asked the mother if she drank a lot of coffee or coke or ate a lot of cocolate. She said no at first but she remembered later she had had a craving for chocolate over the last two weeks of her pregnancy. Another easter baby I thought, I've always felt some babies dont tolerate caffeine in the mothers milk and turn into screaming irritable wreaks. Googled my observation and babies metabolise caffeine slower the younger they are. Before babies are born the mothers liver gets rid of babies waste products[ basically broken down cells especially blood cells] After birth the baby's own liver has to do it. That is what normal jaundice is all about the liver isnt fully able to metabolise all the broken down cells so deposits the partly broken down products in the tissues. If the babies liver is being asked to break down other drugs as well such as caffeine or antibiotics, more chance of having high levels of jaundice.
Probably worth limiting the caffeine intake in the first week of life then slowly having in the diet to the level that the mum and the baby are comfortable with. By the 2nd night beautful boy was much happier and sleeping so it is not a big crisis but mums get very worried if their baby is so agitated.

Been to see Keating the musical so good. Brought the CD liked it so much.
Last week we saw The year of magical thinking a play by Joan Didion with Robyn Nevin it was very moving. It was a stunning bit of writing wonderfully acted. Truthful and honest, without an easy answer to grief.A lady next to me turned to me and said that was self indulgent whinging, her friend said well you've never had someone close to you die. I said I thought it was very real about how people respond to the death of loved ones. Still you know you done some moving theatre when strangers talk to each other after it!
We dont see much theatre then we see it all at once, Tell Me On A Sunday next

We can google at work how exciting is that, it made the nights so much better and more interesting. We thought they had blocked it but it worked last week. They blocked games and most fun things on the computer because I guess they think you will play games instead of looking after patients. Nursing admin have always assumed that nurses are slack and do not work unless they are on our backs all the time. I've found the people who treat you like this are themselves the most slack ones. If some people put half the energy they use getting out of work into doing it would be fairer and easier for everyone. Getting things sorted with patients before they become disasters is so much better. Lots of nurses love disasters thru. sad.
When I was training a sister said to me that lady is going to arrest, I said move her to coronary care then, oh she said so she did it and the arrest happened there where they were all prepared for it instead of a big mess on the ward with only 2 of us. It pisses me off the way people like drama. I once said to a doctor that i didnt know how a sister we knew could work in kids cancer for years he said she likes it all that grief. I call them the bottom feeders.
Anyway back to my googling at night. We had a girl breastfeeding who had very sore nipples from the first feed. Same history with the first baby. She feed the first baby till they bleed and finally gave up when she couldnt take the pain anymore. Now this is a different picture than mums who have very sensitive nipples, when you ask them can they stand anyone touching their nipples they say they cant. That is not about damage to the nipple and these girls often feed well with a nipple shield.
The usual sore nipples you see are around the 2-3 day mark and are a gradual onset.
My girl had almost instantly sore nipples from the first feed which is quite different. Nursing mothers theorizes that thrush in the ducts may cause this problem and that treating the nipples and the babies mouth may get rid of it so thats what I was investigating on google. I didnt look up the scientific papers on it but the mothers stories on different web sites. I suspect that no one has done any studies thru you could try to culture the breast milk of these mums and see if you came up with thrush, good research project someone.
Anyway she is going to try some thrush treatment, I told her my google search and she was going to tell me how it went. Nobody stays in hospital long enough for there to be any outcomes so unless she writes us a card I"ll never know. I"ll do my breatfeeding, lack of support rant another time back to the garden.

Ahh 17th of june already and i haven't posted for ages, there are too many things to do. I am madly knitting as its so cold this year and everyone wants beanies to wear. I made my friends kid one but my daughter grabbed it and wont give it back, so I have to make it again, a white beret.
Interesting patient of the week was a girl with hyperemesis, thats vomiting a lot in pregnancy. It starts earlier in pregnancy than morning sickness, is more common in a twin pregnancy and occurs in under 4% of pregnancies. The interesting thing for me was that we were always taught that there were underlying psychological problems which caused hyperemesis. It was really morning sickness which had gone out of control due to issues such as an ambivalent attitude to the pregnancy, wanting to abort the pregnancy, depression etc. Of course its the chicken and the egg thing is the vomiting a cause or a result of the mental issues.
Gotta a go do aqua walking at the gym finish later.
Later, I was the youngest of the aqua walkers always good a retirement crew, but I love to be in water.
Back to vomiting I was thinking they should make one of those dealing with issues shows about hyperemesis but you can see problems with it, a lot of people cant watch vomiting people. I looked it up on the net all these stories poor girls and how dangerous it can be. Charlotte Bronte is supposed to have died of it. The emo theory is discredited now but I still think there is that side of every disease. Vomiting is awful but vomiting plus depression and lack of support is that much worse. Rehydration and getting any food in seems to be the important thing. Anti vomiting drugs work variably, from not at all to moderating the vomiting to working for some people.
Anyway yah for the net which is so good for hearing patients voices in a system that barely gives you time to say hello and lets you update yr ideas quicker.
Thank you to the patient of the week who said to me I am not really like this you wouldnt recognise me if I was my usual self, which made me go look up this condition and revise my thinking.

Well interesting nights at work. Not so busy but lots of politics some strange subinvestigation going on into bullying in our workplace sort of focused on one particular person or maybe not. She is mates with the hierarchy so we dont think anything will happen. There are people on stress leave because of her and one court case over bullying that was won against her. She used to work on our ward but she is in another area now thank god. I was one of her targets for some reason she moved me off my usual shifts and onto weekdays, no penalty rates then had me rotated around everywhere told me that it wasnt her who was responsible. Someone printed off an article on psychopaths in the workplace, this person fitted all the criteria. The interesting thing is it says if you are targeted by them you may as well find another job which i will be doing if she ever crosses my path again. It also says you are left "cold cynical bitter and almost unable to function." Lucky I couldnt give a shit about nursing by then anyway and she oddly protected me from herself by getting me moved. Anyway nursing is full of those nutters and they are usually in charge but they put the knife in each other more than anyone. They dont like night duty no glory in that so I just stay in the dark. Don Juan calls these people the petty dictators he says they are gifts to a warrior because a warrior can temper themselves in the battles with them. So there you go.
It was a bit of a mad night with patients as well. They were really kind of sweet one had the family wheelchair with her but the tyres were flat.
Got to do some aquarobics in the am and wash away all these crazies thank goodness they work full time thru there are some golfers.......