Stories from labor and delivery

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March 19, 2012

(read post from jan. 19 for back story)

I had the immense privilege of going to a memorial service for a baby this week. As the service came to an end and people began to disperse, I caught the eye of the mom who had lost her baby. In that moment I saw a wave of relief pass across her face. I knew that the presence of a nurse from the hospital was what she desperately needed, to know that the few people who held and saw her baby cared and remembered. I realized in that moment that I held a precious gift. I had a memory of a little person who hardly had a chance to exist. There are only a handful of people who ever got to see him and touch him. So when she showed me the small booties she'd made I could honestly say that I remembered what his feet looked like. I can still feel the weight of his body in my arms. I have a connection to this family that should never be broken... because I carry the most precious and important memory they have. I carry the memory of their child.

There are days when I am so incredibly thankful for what I do.

March 18, 2012

My day started out great. I got to catch a baby and just be helpful because there was no patient for me to take. I had to leave mid-afternoon so the goal was to keep my patient load light. Things were going well, the floor was calm, patients were behaving, all was good. It looked like a just might make it out the door on time. As the day progressed things got worse and worse. It started with a hemorrhage and ended up with my patient delivering her baby in the shower minutes after I had changed my clothes to leave. But I had to just laugh as I ran in and out of the room, toting supplies in to the other nurse, all while dressed in a skirt.

March 9, 2012

There are days when I get home so exhausted I can hardly get my shoes off before getting in bed. The other day I agreed to come in early for someone on night shift, so my day began at 6am when I took over triage. Triage is actually my favorite place to work because you see everything there. You see patients from the first moment they walk in the door. You are the one to first assess whether they're in labor, did their water break, is their baby happy and healthy, do they have a bladder infection, are they at risk for seizures? You see so much in triage. But part of the beauty of triage is that you don't keep patients very long. You figure out what's going on and you either send them home or admit them and pass them off to another nurse.

So when I came in to work and found out my only "triage" patient was an 8cm labor patient who was feeling pressure and wanted to push, I knew I was in for an interesting day. At 6:50am my first real triage patient arrived. Rule out rupture (ie: did her bag of water break). Easy. No big deal. It's not too hard to figure out if someone's ruptured, though my patients seem to have an incredibly hard time with it. You would not believe how many people come in and it turns out they just peed on themselves.

Anyway, I brought my new patient into triage and began my assessment. As I put her on the monitors I mentally noted that her belly was quite large... enormous. Now, had it not been so early in the morning and had I not still been adjusting to being awake, this might have triggered me to ask a few more questions in regards to this huge belly. But I didn't. I just plugged along with my assessment.

When I got to the question about whether they wanted circumcision, I asked... "Do you know if you're having a boy or a girl?" "Boy." "Do you want a circumcision?" "Yes. 2 boys." "Oh, you have a boy at home too?" "No, we're having twins. Both boys."

This was all before 7am. But that was just the beginning of what turned out to be the most insane day I've had in a long time. Diabetes. Preeclampsia. Twins. Let's just find every possible difficult thing we can and wrap it up into one patient. Oh... and she's also 8 cm.

I'm generally very aware of what's happening on our unit. I know who has what patient and what's generally going on with them. But even if you're not a like that, everyone can sense a crazy day coming. There's an energy in the air. There's a flurry of activity on the floor. It's the kind of day when you get to 6pm and see a nurse walk by that you didn't even realize was at work that day. It was one of those days from the start. It was a day when our charge nurse, who generally does not have patients, already had 3 patients of her own.

It's the kind of day where you know that despite the fact you are triage, you know that you will be keeping the preeclamptic, 8 cm, twins. I didn't even have to ask. I just knew. As I was coming to that realization my charge nurse, unaware at the time of what was going on with my patient, called for me to come help her with another patient. "My twins are 8 cm." Later that night as my charge nurse and I sat charting she said she couldn't believe how calmly I told her that. Like it was really no big deal. But that's just how things role on our floor.

Now, most of you probably don't really understand the complications that came with this patient and the things that needed to be done to prepare for the imminent delivery of her babies. But don't worry, I will tell you. These are the things that had to be done, all within less than an hours time...

1. Move patient from triage into a delivery room, preferably one close to the operating room.
2. Start an IV. Draw blood.
3. Sign consents.
4. Locate an extra baby warmer.
5. Rearrange all the furniture in the room to allow for the extra baby warmer.
6. Create a path to allow for the quick transportation of the patient from the delivery room to the operating room in case the 2nd baby had to be delivered by c-section.
7. Bring in the ultrasound machine and find room for it.
8. Open the delivery table and find extra instruments for the extra baby.
9. Organize all the baby supplies so nobody confuses baby A and baby B.
10. Figure out who can come act as the baby nurses during the delivery.

That was just the basics. All of this was to be either done by me or delegated to the few poor medical students who came in to offer assistance, all while both ensuring the patient was OK and watching the fetal monitor strips to make sure both babies were behaving. And of course, there was the fact that she was preeclamptic and at risk of having seizures.

All of the above took place before 10am. And then came the pushing. An hour or so of that and then the decision to take a break, get the patient an epidural (because she's done it all so far with no pain medication), and let her labor down (translation: not push even though she was 10cm).

After all the excitement, which had finally come to a rest for at least a short time, I decided to sit down and do a little charting and then have some lunch. But things on labor and deliver don't ever stop.

"The patient in 14 has an IV that's leaking. Can you go help her?" Sure, I'd love to.
"This triage patient needs to be sent home. Can you go discharge her while I catch the baby in 3?" Sure, no problem.
"12 needs a baby nurse." Quick glance around the desk to see that there isn't a single nurse in sight and there's another patient at the desk who the charge nurse will be seeing since she took over triage for me. Sure, I'll go catch the baby in 12.
"The doctor wants to start pushing with the twins again." Are you serious! I have half an avocado sitting out on a piece of bread that was in the process of being turned into a sandwich for lunch, I haven't charted a single thing today, and I'm starving!! And my legs hurt. But sure, let's go push.

So back to the room I went. The pushing began as I was now having to repeat several of the steps from above because by now my arranged baby nurses are no longer available, the ultrasound machine is no longer in the room, and the furniture has been rearranged.

Finally, the babies are born. Amazingly, both normal deliveries. No trip to the operating room. Happy, healthy babies. And 4 hours to catch up on the now 9 hours that I haven't charted anything. No problem, I've got this. 

After you've worked as a nurse for a while you begin to develop a 6th sense about things. This feeling in your gut that tells you that you should or shouldn't do a certain thing. I had that feeling with this patient. Don't take out the epidural. She's going to bleed. That's a voice you don't want to hear when it's telling you something like that, but I have learned to listen to it.

Part of the recovery of our patients involves assessing their uterus every 15 minutes. We push on their bellies to see if their uterus feels hard and make sure they're not bleeding too much. So as I went to do one of my assessments and saw several large gushes my stomach tensed just a little bit. It's ok, keep massaging, it will stop. When is became apparent that the bleeding was increasing too much and the blood began to spread across the chux under her bottom, spilling onto her gown, I quickly called for a doctor to come in. It's hard to explain what happens in a hemorrhage because our floor becomes this chaotic, yet extremely well organized unit. People are coming in and out of the room bringing supplies and doing whatever needs to be done. As the primary nurse, my job is to run a hemorrhage. That means I oversee everything that happens. I call out the orders, I delegate, I make sure that everyone is doing what needs to be done. And I write it all down, minute by minute. This wasn't my first hemorrhage and definitely not my worst, thus I have become somewhat skilled at running an emergency like this.

So for an hour I stood calling out orders. Looking people in the eye and telling them exactly what I needed them to do.

Please start an IV and draw labs. 
Bring me x, y, and z medications.
Get me the hemorrhage box.
Someone please take the babies out of the room.
Please weigh this.
Bring me this tubing.
Get the chux out of the 2nd drawer of the cabinet that I moved into the bathroom.
I need blood up here stat.
Activate the rapid response team.
I need anesthesia in the room.

All the while you have to been completely aware of the patient and what she's experiencing, of what her husband is experiencing. You have to be explaining things to them, to be comforting them and helping them through the chaos.

I often describe the after effects of a hemorrhage as looking similar to a massacre. The entire bed sheet soaked in blood up the the patient's shoulders. Blood on the floor, on the walls. Piles of blood clots sitting between the patient's legs. Blood on your arms, on your scrubs.

Then there's the cleanup, the recovery, the critical moments after where you're rapidly transfusing blood, where you're monitoring the patient's vital signs and hoping you don't see any more blood in the bed. There's the time spent comforting your patient, ensuring that they understand what happened to them.

And so, finally 7pm rolled around and my shift came to an end. Report was finally handed over and the charting finally began. It was 11pm when I finally left that day. 17 hours after I walked in that morning.

But my patient was alive with her 2 healthy babies.And that's all that matters.

February 28, 2012

Lately I have been blessed immensely by my amazing coworkers. I am surrounded by talented, creative, hilarious, kind, supportive people. People who I hadn't taken the time to really see until the past few months. I used to lament that the people I worked with here weren't like the one's at my old job, my job at camp where we were all best friends, spending days and nights together just being a community. But this is different. It's a different kind of community, but one I've come to love. One that I will dearly miss when I have left it.

This past year has been an incredibly difficult one for me and while that's not a part of my life I've shared at work, the women that I work with have stood around me in ways that they are completely unaware. Work has become a relief, a safe place where I get to spend 12 1/2 long hours with these women who make me laugh hysterically, who tap dance at the nurses station with me, who tell stories of their wild children, who gather together and offer support to a grieving friend, who text hilarious stories back and forth, who know that I don't like pretzels and what my elementary school was like, who sit and sew together and bake cupcakes, and eat lunch together while discussing placentas. These ladies make me smile... and I haven't really smiled in a long time. They have become dear friends. And I am so thankful for them.

February 26, 2012

Yesterday was one of those days that just plain sucked. I wasn't supposed to be at work. I wasn't even on call, but when my phone rang and the name of my hospital appeared on the screen I answered it without thinking. 'Could I come in to work for 4 hours? They just needed a little extra help.' Sure, why not. I wasn't really doing anything productive so I might as well go make time and a half for a couple hours. 'Will I work on mother/baby?' Well, only 4 hours, that's not so bad. Plus, it will count as my obligatory trip to that unit that we all have to rotate through.

So off I went to work. I happily accepted my 4 patients and went in to meet them all. I then promptly discharged 2 of them home. Then came the phone call... 'Can you stay a little longer? Just a couple more hours?' So I agreed, just a few more hours. I'd prepare my last patient going home and then hand over my other one to another nurse. Then home.

As I told the other nurses I'd agreed to stay they all asked me... what deal did you make? Shoot! I forgot to make a bargain. That's the one advantage of agreeing to stay late is you can usually get some sort of deal out of it... less on call shifts next time, off another day, something like that. Typically I'm pretty good at devising some sort of beneficial plan that makes staying late worth my while. But of course when your friend who happens to be in charge that day is the one to call you and ask you to stay your first thought isn't to bargain. So I quickly picked up the phone and dialed the big boss's number... 'I want a deal.' She laughed, but agreed to take off some of next month's on call and not call me before 7:30am the next day when I was actually on call.

Midway through my discharge teaching I hear my name being called in the hallway. It's one of the other nurses so I quickly excused myself and promised I'd be right back to finish my discharge teaching. 'They need one of us to go back to OB and catch babies.' Seriously? I just want to go home. By this time in the afternoon I'm beginning to feel the dull ache in my shoulders and head that signifies a migraine coming on. I hastily decided to run over to OB, because honestly, discharge teaching is my least favorite thing to do. Please don't ask me about how you should manage introducing your new baby to the three year old at home. Don't ask me about your dog adjusting to the baby. I don't know the answer! You realize I don't see your baby past the time you leave the hospital, right?

So off I trotted across the hospital and over to our labor and delivery unit. Armed with a stethoscope I made my way from room to room setting up the baby warmers for those that were preparing to enter the world. After catching one baby I settled in at the front desk and waited for another. The chaos was erupting around me. People running back and forth. Doctors and nurses in and out. It was one of those days that just never ended. And it was finally nearing the end of the shift. As I sat at the desk I realized that our poor charge nurse had been so busy running around she hadn't had a chance to figure out staffing for that night. So there I was, trying desperately to go home, a migraine that was now raging strong, and suddenly I'm scrambling to put together that night's staffing before they all showed up for their shift. It's like doing a giant math equation... trying to figure out how many nurses you need, which floors you need them on, which patients will be transferred, who's going to deliver soon, etc, etc.  Have I ever been trained to be charge? No, no I haven't.

So, that was my crazy day. Things are never dull in labor and delivery.

February 21, 2012

The chattering of voices often fill my patient's rooms. Family members surrounding them, all certain that they know best. Advice flowing from every mouth, judgments and assumptions, stories from the past. The other day I had this sweet young girl who was laboring without any pain medication and who got stuck at 9 cm. She couldn't stop herself from pushing, which i turn caused her cervix to swell, making that final transition from 9 cm to 10 impossible. Desperately wanting relieve from the pain, I suggested she get an epidural, allow herself to rest and relax so she could finish her labor. That's when the chattering voices returned. I couldn't understand them because they were speaking in another language, but I could read the faces. The faces of judgment from her elders. They did it without pain medication. Why can't she? That's when they begin to shoot me dirty looks, willing me to shut my mouth and leave them be. Sometimes I do, but sometimes those protective instincts kick in and I want nothing more than to protect my patient from their crazy family. That's when words no longer matter in the conversation. It's when the desperate eyes of my patient tell me that, yes indeed, she would like that epidural. So off I go, bustling about to get everything ready. Signing papers, giving fluids, calling doctors. And finally, the grand finale ends with me kicking the entire family out of the room. It's a sterile procedure you know, so no, your judging eyes and whispering voices are not allowed in my patient's room.

January 19, 2012

There are days when my job absolutely breaks my heart, where I end up facing myself in the mirror, eyes brimming with tears, and I have to remind myself why I do this job. I have to force myself out of the bathroom where I would rather hide because I know that the fact that I simply show up is all my patients need from me. This job is full of fun and hilarious moments, it's full of joy and celebration, but those aren't the stories that I remember. It's the heartbreak and the tears that stick. It's waking up in the morning and seeing the face of death that doesn't ever leave you. The past 2 days I spent caring for babies who didn't survive and mom's who were facing the fact that the future they imagined for their child would never come to pass. I cradled a perfect formed little baby in my arms yesterday, only his body was rippled with bruises from the attempts to resuscitate him. I laid him on a blue blanket and posed his little body so that I could capture his tiny features while his mother sat watching, tears streaming down her face. Days like that are hard. They grip your soul and refuse to let go. But when I was sitting with that mom and saw how thankful she was to have someone care for her little baby, it makes it worth it. And it makes me thankful that I have a heart that can withstand such things, because not many people do and these families deserve to be surrounded by people who will treasure their children as much as they do.

Dec. 7, 2011

Note to self... sometimes sending home the patient in early labor is not a good idea because they end up delivering their baby at home in the toilet. Oops.

Oct. 31, 2011

My floor is supposed to be a happy place where people come to start a family, the place where the happiest day of your life happens. But sometimes it's not. Sometimes it's a place where the greatest sorrows happen.  A few days ago we lost a mom and there's a good chance the baby won't make it either. It's not the kind of thing you can ever be prepared for. It causes the hearts of all our staff to break, even those who weren't directly involved in the case, because we aren't a place where people come to die. We bring life and hope and joy. I've said this before, but even in the hardest situations, I'm glad I get to be a part of those stories. Anyone can take part in the joyful parts of life, but to be able to stand beside someone in their greatest hurt and love them is a much greater gift.

And if you think of it... pray for that little baby. Pray for healthy, joyful, abundant life for that baby.

Oct. 25, 2011

I caught my first baby. Literally, caught it. We use the term "catching the baby" when you're the nurse that the doctors hand the baby too after they deliver it, but this time, I actually caught the baby.
It was her 5th baby and she told me that when they break her water, the babies come quick. So when the doctor came in and broke her water without telling anyone, I was a bit irritated. Here is the sequence of events that followed...

1600: I walked into the room to check on my patient. 'How are you doing?' I asked. She told me the pain was a little more, but hardly flinched with the contractions. 'OK. Call me if you need anything.'

1604: The call light goes off and the secretary answers it and proceeds to tell me that the father of the baby said the baby is coming.

1604: I run into the room to find the dad standing at the head of the bed holding the sheet up and peering under it. I reach for a glove and put it on my right hand. The dad then proceeds to pull the sheet down to reveal that the head of the baby is out. Keep in mind, during this whole thing the mom is calmly sitting there in bed (and no, she did not have any pain medication).

1605: I run to the bed and take hold of the baby's head, reaching in to feel if there's a cord around the neck. Then out slides the rest of the body into my bare hand. Scooping up this tiny screaming life I held her up for her mom to see. At this point a resident and doctor appear in the doorway to find me standing there holding this new baby.

So there it is. My first delivery. I feel like that was my true initiation into being a labor and delivery nurse, because I have now delivered a baby. Keep in mind this was the world's easiest delivery, but it still counts.

Oct. 21, 2011

Blizzard babies... they are the ones that are filling our rooms and over flowing our floor. They are the one's that are being born 9 months after the blizzard. Last week I was triage which means I see every patient who comes in who isn't obviously about to pop out a baby. We have 6 triage beds. I filled and emptied every bed 3 times. In case you're having trouble doing the math, that's 18 patients. Keep in mind, we only have 9 labor beds on our floor.

My day started out perfectly fine, with no patients in triage. But pretty soon the flood gates opened and people started pouring in. Elevated blood pressures, stomach pains, preterm labor, and the list goes on. Hardly anyone in labor actually came in, which was good because every other room was filled and I doubt anyone would be particularly thrilled with the idea of delivering in the hallway, but we were getting to that point. From 10 am until 7pm every time I walked out of triage to the desk there would be another patient, or 2 or 3, waiting for me. It was a never ending flow of pregnant ladies. I think I sat down once all day to wolf down a few bites of mashed potatoes. And I believe I threw my head down on the desk at one point and begged by boss for just 3 minutes to nap. My report sheets where filled front and back and overflowed onto a second paper. I got to the point where I could no long keep everyone straight. Who's in room 301-2? I have no freaking idea! I left work 10pm that night because it's impossible to chart on 18 patients when new ones refuse to stop walking in the door.

Get used to it. That's what I keep hearing, because it's only going to get worse.

Oct. 13, 2011

A few days ago I looked up from the desk to see a little girl of about 3 years old being wheeled down the hall in a stroller to visit her new sibling. She caught me off guard when I looked at her face and saw it was bright red, the skin peeling. I've only seen something like this once before, back when I was a student and took care of an infant with something that looked similar while working on a peds floor. I think of this little baby often, wondering what happened to her. Did they find out what was wrong with this tiny baby, laying alone in her crib with only a nurse decked out in a bright yellow gown and mask to hold her? Did her teenage mother grow to love her?

I feel this often as I sit holding these sweet babies who have no homes to go to. What will happen to you, I wonder. Will someone love you well when you leave this place? Will they know that you like to have your back patted or be held close to make you stop crying? Will they get frustrated when you take to long to drink your bottle? What if nobody every wants them and they get stuck in the system, always the baby who was born addicted to heroin? "You are loved, baby girl." That's what I find myself whispering into the ears of these sweet babies. I want them to know that someone loved them, that someone will remember them, even after they're gone from our nursery. These little faces don't leave my head very easily. They are imprinted on my heart, forever part of me, because I was possibly the first to love them and to tell them that. But I leave at the end of the day wondering what their future will hold, wishing I could take them home with me where they will be safe and loved. But I have to hand them over, praying for their safety and that they will grown up well.

Yesterday as I sat in the nursery watching the sweet little girl with the peeling skin play next to the crib of her sister, wondering about the baby I took care of a couple years ago, something suddenly struck me. The name of the baby she was playing with. It was the same as that baby I cared for before. "How old is your daughter?" I asked her. "Was she in the hospital as a baby? Which one?" It was her. It was the same little one that I watched over 3 years ago. The same one I mourned for because I was so afraid of the life she would lead. But here she was, a happy, healthy little girl standing in front of me. Every once in a while I am blessed with a glimpse of the life of a baby I once cared for. I run into their mothers in the store, on the train, and about town and I get to see that they are happy, healthy, loved children. And it give me hope for all the rest that I won't ever see again.

Oct. 10, 2011

Vomit, poop, swaddles, and tiny shrieking creatures. That's what my day consisted of. Our nursery is overflowing with babies, half of them withdrawing from drugs. I'm dizzy from the amount of bouncing I did. Up and down, up and down, swinging from side to side as I made my way in circles around the room putting baby after baby to sleep. I currently smell like formula mixed with the sweet scent of newborns. When babies stay in our nursery for any extended period of time we all get to know them, even those of us who don't usually work in the nursery. We have our favorites, the one's we love to cuddle. My sweet girl is the skinniest, scrawniest baby you've ever seen. Her arms and legs are like little toothpicks but she's stronger than any other baby there. Little Houdini is what I call her because no matter how tight I swaddle her she can always kick her way out of it. She's currently withdrawing for drugs, so life isn't a lot of fun for her, nor is it particularly fun for those of us taking care of her. "You should take her home with you, she looks like you." That's what all the nurses say to me. I'm not sure how I feel about the references to our similar appearances given that she poops every 5 seconds, screams louder than anything and turns bright red as she throws her head from side to side in search of her Binky, and is angrier than any grown person I've ever met. I love her anyway. I love all those babies. I don't know how you can't adore them, even though they scream like little monsters. My other sweet drug baby spent have the day tied to my front with a blanket and despite the nuisance of having a small human attached to me, I adored my time with her. I am, however, beginning to understand how people end up shaking their babies. They can really scream and kick and fight and refuse to be pacified by anything. I mean, seriously, the bottle is in your mouth. What else do you want me to do for you? It is so not necessary to scream bloody murder when the bottle is in your mouth! I'm trying to teach these babies to behave, but they just don't listen to me. And soon, they'll go off to families who may or may not care for them, or they'll end up in foster care, and we'll no longer be able to watch over them, to make sure someone holds them close when they cry and bounces them until they fall asleep. They'll be gone. That's one of the scariest parts of my job. We hand over these tiny humans, sometimes to families who can't care for them, who don't deserve them, and we can't do anything to protect them anymore. We have to trust that they will be loved and cared for. I pray over these babies all the time that they will grow up feeling loved, that even if they don't see what love is, that they will somehow be changed by the love they get from us, and will grow up knowing that somebody cared for them, even if it was just for a little while.

Oct. 3, 2011
We call them VIP patients. They're the ones every body's a little afraid to take care of. They're the daughters of hospital administration, the niece's of doctors, the medical students. They're the one's that either are connected to someone in power or they're the one's who are so knowledgeable about medicine that we have to watch our every move. You don't want to screw up an IV on a nurse or forget to ask an important assessment question. Yesterday I have 2 of those patients. The first was a couple where the husband was a former medical student on our floor and his wife was a midwife student. 'Don't screw up on the IV. Don't miss the vein.' That's what I kept thinking as my shaky hands moved towards her arm. What do you think I proceeded to do? Yes, that's right. Missed my IV stick. Of course, she had picked the specific vein she wanted me to use, which didn't help things. So out of the room I slunk to find another nurse who was better at getting IV's into the arm. I certainly wasn't going to screw that one up again.

A little later in the day one of our attending physicians came in through triage for something (not labor). There was some shuffling around the desk as everyone tried to figure out who would see her. Nobody wants to be in charge of a doctor, the person we usually work under. After a minute or two the charge nurse's eyes shifted over to me. "You're a nice nurse. You want to take her?" So down the hall I went to see the doctor who I last worked with a couple months ago during a massive hemorrhage emergency. I walked into the room not really sure if I should let her dictate what the plan was. She did, after all, come in based on her own self diagnosis. After hooking her up to the monitors and chatting for a minute I shuffled out the door to find out what I was supposed to do with her. Upon my return each time I'd ask her if there was anything else she wanted me to do. Betamethasone? Sure... you never know when you're going to go into preterm labor. Might as well be extra cautious. Right? Not that we'd ever do that for anyone else in her situation. But what do you do when an attending asks for something? You do it! So, despite the nerves and fear of royally screwing something up, I managed to get my job done. And I think she might have been even more nervous than me... I don't think she was sure how to be a patient, to let the nurses she readily orders around take care of her. But we did our best to navigate this unusual situation. Right before I sent her home I walked in to give her the discharge papers and found her siting on the edge of the bed, the ice pack I'd given her to soothe the pain of the shot I'd given her still applied to her arm, nervously grinning as I walked in. 'She's just like everybody else,' I realized. She was scared and nervous just like every other mother that walks in our door. And she has no idea what we do as nurses outside of the actual moment of delivery that's she's present for. And so as I left her room, I became aware of the fact that I was given a chance, however brief, to show one of these sometimes harsh and unaware doctors, just what the role of a nurse is... that I'm there not just to follow the orders of a doctor, but to care for the heart of my patients. To ease there fears and become a friend and advocate for everyone who falls under my care.

I spent this beautiful morning sitting in Starbucks with my chai latte and pumpkin bread writing the above story and working on numerous other things. And just moments ago I looked up to see the previously mentioned doctor walk in the door. She smiled, like a friend, and nervously proceeded to tell me she was on her way to the hospital for her follow-up injection, but was running a little late. Looking down to see the time, I told her she had 10 minutes to get there to make her 24-hour mark she was supposed to meet. Hmmm... maybe there's hope for our crazy nurse/doctor relationships [which one day I will tell some more stories about]. At least, maybe for this one.

Sept. 29, 2011
Today was one of those days where things just seem to explode. It wasn't one of those days where every room was full and I found myself sprinting up and down the halls trying to remember which rooms my patients were in, but it was busy enough to keep me on my feet most of the day and delay my lunch until 3pm. One of my favorite things is when I get to meet a patient on one shift and then deliver them on the next. The technical term for that would be 'continuity of care.' This morning I got to see a sweet family I'd admitted the night before. When I came in she still appeared to have a while until she was going to deliver so I grabbed my string cheese and sat in at our staff meeting and assumed I'd have time afterwards to make my breakfast. Since moving to the day shift I decided that breakfast at home just was not possible. I have to be at work before 7am, which basically means I roll out of bed at 6:30, throw on some pants and a sweater, and out the door I go. This plan does, however, cause problems. Like this morning when the resident called to me at 8am to tell me my patient was complete, which means a good 2+ hours before I get to sit down again. She proceeded to have a quick and smooth delivery. The kind where basically all she did was cough and the baby flew out. Those are my favorite. I don't get stuck with hours of holding up legs and yelling "PUSH!" and exclaiming how well she's doing, even when the baby has hardly moved a millimeter. So out came the baby and there were tears and joyful exclamations. As the day progressed and I made my way from room to room, I got a chance to talk with the family some as they told me about how all there children were named from the bible. Names of significance. 'Was I married?' they wanted to know. 'Did I have kids?' Questions I get weekly from my patients. 'God will provide you with a good and faithful husband' the man told me. Thank you. Thank you for giving me that. It's in the midst of craziness and stress, a little nugget of truth. A good word from the Lord to get me through my week. And on continued my day of crazy and busy. Another delivery a few hours later. A little more trotting up and down the halls. Some jokes with coworkers and a few cookies. And finally, 7pm rolls around and the night crew makes there way onto the floor. And I've survived my day, so thankful with the patients I was given. So thankful to be a part of their lives, a part of their stories, even if it's just for a few short hours. And so thankful when they impact mine, when unexpected truths and much needed words are spoken.

Sept. 7, 2011
Working with the midwives, I get some pretty strange patients. There are the ones who refuse things like a bath for their baby, which, can I tell you, is no fun for your nurse. She doesn't want to have to touch your dirty baby for the 2 or 3 days you're in the hospital. Or the ones who refuse to use regular diapers, which is fine as long as you bring your own diaper, but babies poop a lot. And the first couple days it it seriously the most disgusting thing you've ever seen. Fine if you want your baby to poop all over your chest, but I will have nothing to do with that. There are the birthing balls that at times end up being flung across the room, the endless rearrangement of pillows to try and make the writhing mother more comfortable. Add a couple strings of IV tubing, fetal monitors, catheters and it literally becomes a web to untangle. Now, the one patient who stands out to me above the rest was actually one of the more normal ones, if I'm remembering correctly. To be honest, I don't remember very many of my patients. When I see them in the grocery store and they ask if I remember the baby, I just have to smile and nod telling them how adorable s/he was. I wouldn't recognize this woman if I saw her again. Nothing about her was particularly memorable. Except the one image I have ingrained in my head. I had walked into her room to listen to the baby's heart rate with this little machine on wheels that I drag around with me. She was in the bathroom, laboring on the toilet, which I always fear is going to end up with a water birth, but I guess that would make for a fun story later. So I walk in the room, she's sitting on the toilet, the woman I thought to be her doula is in there with her. And she has needles sticking out from all over her! As a nurse, your job is to never appear shocked, disgusted, or nauseous when around your patients. I quickly had to rearrange my face to some form of normalcy and continue with my job of listening to the baby. Of course, as soon as I walked out of the room I ran straight to the nurse's station to inform everyone of the scene I'd walked into. And to ask, "Are other people allowed to stick needles in my patient?" because doesn't that seem like it would be breaking some sort of hospital rule? Probably. But whatever. It's just another day in OB.

1 comment:

Holly said...

Oh my goodness, the March 9th entry is so impressive, Jenny! I like hearing the details of your job. I would want you to be my nurse if that happened to me. I hope you were able to catch up on sleep after that crazy day.