Thursday, February 28, 2008

A Lesson

Lesson for you: Fetal Fibronectin Test (fFN)- a test where a swab is taken of the vaginal secretions at your cervix and looks for a protein (fetal fibronectin) that can predict if you are going to go into preterm labor within the next two weeks. It is usually used in high risk pregnancies or women experiencing signs of preterm labor.

A few nights ago a woman came in 24 weeks pregnant complaining of preterm labor. She had a history of 3 prior deliveries all between 24-30 weeks and also had no prenatal care for her current pregnancy. Obviously, we were all more than a little concerned for her. The midwife on call, who is very sweet and very hands on with her patients orders a fFN, and while this is something that is usually left for the nurses to collect she wanted to do it herself. I went along to assist.

After you collect the sample (on a long q-tip like swab) you place it in a long narrow container and send it to the lab. I hold the container for the midwife and most unfortunately her hand slips and now the sample has been smeared across my bare hand.

While I head to the sink and start scrubbing, she prepares a slide. I figuring she is looking for a "ferning" pattern that would indicate that the patients water is broken. Instead, once we get to the back and look under the microscope it turns out the patient has a raging trich infection.

Lesson for me: wear gloves any time anything with bodily fluids has even the most remote chance of missing its intended target.

15 comments:

iambellaluna said...

Wow. I don't know how you guys do it. I could never deal with so many bodily fluids near me, gloves or not. This is why I am not a nurse.

Two Bloggin Moms said...

Yuck!

mrsmac said...

gross! definitely wear gloves!!!

Erin said...

Oh my goodness!!

Virginia said...

Just found this blog thru my daughter. Love it. Have worked in a hospital (not a nurse) for 35 years. Can certainly empathize with these blogs.

artillerywifecq said...

I learned that the other week. As a nursing student I had never seen a vaginal birth in humans (i live on a dairy farm and have delivered countless calves). I was standing at the side of the bed, holding my patients leg when she pushed, and out came the head then the the shoulders and a huge gush of blood and amniotic fluid, all down my gown. Now this should have protected me except I am almost 6 foot tall and the gown 4 feet long, thus leaving 2 feet of my legs and feet exposed. Yeah, had to change why pants 2 hours after arriving at clinical! Lesson learned, now i i know why the doctor was in a space suit.

chris said...

Who would have know? I mean those tubes are not small. Most folks should have been able to hit the tube. Do you scrub with her? Then you could pay her back in kind easily.

Chris,Ericka, & Colton said...

I must say I was just turned on to your blog and have seriously laughed my butt off for the past week! LOVE IT! I can relate to almost all these stories as I am a L/D RN myself! Keep them coming!

Sarah said...

I knew you were going to write trich before I even got to the paragraph.

AtYourCervix said...

ew ew ew

always wear gloves!

l&d.rn said...

No joke. It was one of those things I just wasn't thinking.

Lalala...midwife doing her thing...I'm not touching anyone...lalala...here, let me hand you this...

And scrub sink.

Karen said...

Wow. I totally did not see that one coming. Gross.

I have 7 month old triplets and I had so many fFN's I nearly lost count. I had bi-weekly fFN's from week 24-28 and then weekly fFN's until week 31. I delivered at 33 weeks. Suffice it to say, they were quite nervous about me, since they couldn't keep my contractions under control and my cervix was, well, SHORT.

GANGELIARN said...

I am wondering if the contaminated swab that hit your bare hand was used or a new one was obtained and tested? I hope a new one. Really good lesson

sasha said...

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