One Lucky Day

I just lived through the most harrowing shift I've ever experienced in my nursing career, short though it may be.

I was planning on an uneventful night shift at the smallest of the three hospitals where I work, even when I walked in and saw the patient board almost completely full when I arrived at six pm. There were only two laboring patients and the rest were postpartum or post-operative. Hmm, I thought, maybe they will even send me home after my patient delivers, as I am not really trained to do Mother/Baby work... It's almost as if I jinxed myself with overly wishful thinking.

By the time my patient delivered, there was only one room left on the floor for one very lucky person-- who ended up being just that. She came in at about five centimeters, planning an unmedicated delivery for her fourth baby. She was doing awesome-- chatty and upbeat even after her Certified Nurse Midwife broke her water, and man, that was a LOT of water, more than even the midwife had ever seen, she said. I, on the other hand, was starting to get a headache and hoping she would go "complete" soon. Baby looked a little stressed on the monitor as well, and when the midwife came back to do a cervical check, that's when everything went downhill.

The midwife felt the pulsing umbilical cord coming down before the baby's head-- a big fat obstetrical emergency called prolapsed cord. The midwife went to sound the alarm while I was left to push the baby's head up off the cord, which by the way, is very difficult-- pushing baby UP when mom's whole body is working to push baby DOWN. Every nurse on the floor came rushing in to help. Get her in hands and knees position. Get the meds. Call the MD. Set up the OR. Wheel her back! Find baby's heart tones! ( They were in the sixties- normal for baby is at least 120). Prep her tummy! Get in that foley catheter! By this time you could actually see the umbilical cord sticking out. As soon as the mom was safely under general anesthesia (and it's lucky anesthesia was there already instead of being called in from home, which was mostly due to a paperwork glitch), they sliced her open. It was only one or two minutes from cut to delivery. Baby needed immediate resuscitative efforts, but to make a long story short, mom and baby made it.

It was frightening to say the least, but the real effort on my part came after the delivery. General anesthesia is a yucky thing and is only used in obstetrics in real emergencies when an epidural or spinal isn't already placed. I couldn't leave the room until mom was stable and I had to do a lot of nursing care that I've never done before on my own. Not only that, but of course that budding headache exploded and I felt sick to my stomach. All the nerves and the excitement and the fact that I had eaten a grand total of two sandwhiches and a bunch of grapes in the last 24 hours combined to make me feel utterly miserable. When a hematocrit was ordered "stat" I was left completely alone with a butterfly needle and a syringe. Poor mom was so swollen I couldn't even see or feel a vein. That was my lowest point. It was almost three am. I felt sick. I was tired. I was worried for my patient and her baby. And I'm lousy at blood draws! So I just prayed, and poked. And poked. And nothing. I put my head down and was hoping to simply pass out when lo and behold! There was blood in the tube! It was an absolute and complete miracle.

This story is already long and more details would simply be boring. Needless to say, it was an incredibly difficult night. However, there was certainly a lot of luck that St. Patrick's Day morning-- or perhaps better put, a lot of miracles.