Recently*, I got to do something really cool at work.
I work in a hospital in an antepartum unit. We get the problem pregancies and the diagnoses might include preterm labor, uncontrolled diabetes, pregnancy induced hypertension, bleeding or leaking of fluid, multiples or high order multiples, or problems with the baby(ies)- stuff like that there. Some of our patients may stay with us for as long as 4 months.
Most days are pretty routine with comfort measures, medications and monitoring and some days are pretty exciting. Our floorplan is ideal- if a problem arises on our unit, we just scoot the women down the hall to L&D, which opens to the operating rooms, which opens to the NICU, all in a big square.
Recently, a patient who was ruptured and leaking with us for several weeks called from the bathroom to say “something was coming out”. Well, if you ever want to see a herd of nurses charge into your room, say that! (Only don’t say it unless you really mean it, and here’s hoping you never have to say it.)
We all immediately charged down there and I came in just as the others were putting the woman on her hands and knees in the bed for transport. I saw a loop of about 8-10 inches of umbilical cord hanging out. This is a true obstetrical emergency. I had a sterile glove in my pocket, so I jumped up in the bed and placed my hand inside- the point is to push the presenting part of the baby off the cervix and protect the cord so as to maintain blood flow to the baby until it is delivered. Somebody threw a sheet over us and away we went. I could see her visitors on the way out the door and they looked thoroughly bewildered. I really, really felt for them. Fortunately, one of the nurses saw this too and stayed behind.
We went crashing down the hall (not really crashing, but I was trying to keep my hand placed, not lean on the woman, count the fetal hear tones, and also not get the fingers of my free hand crushed by any doorways) and right into the OR. In the OR we had to turn this woman around and upside down onto her back and onto the OR table without moving my hand too much. She was being simultaneously prepped for a splash and slash c-section while having an IV stared and being knocked out with a general anesthesia, and I was her human fetal heart tone monitor. The fetal heartbeat was usually in the 90’s, with 120-160 being the norm. I could feel the baby’s hearbeat from my fingertips to my palm- that’s how I knew I was doing a good job.
At this point it had only been a few minutes (10?, 12?, probably not 15 yet), but I was becoming very fatigued. All I can say is ‘it’s harder than it looks’. You really need to try to keep your first two fingers spread right at or below the cervix, and this uses muscles that just don’t get used all that much, plus my arm was tired from the odd position. The Doctor was ready to cut when he thoughtfully asked me how I was doing. I told him I was tired, so he called for a replacement. I jumped out and another nurse jumped in. I stepped back and looked for my replacement, but I didn’t see her immediately and almost panicked- I was ready to go back in when I realized she was now under the surgical drape and lying of the OR table with the patient. I noticed her when I realized the bump in the drape was her butt. Phew.
I went outside and watched through the window. Very shortly a very small but fiesty baby girl appeared. She had her eyes open and was kicking her legs. It looked like she was going to cry, or maybe not, but she scrunched up her face and opened her mouth, and was whisked away by a neonatologist.
I was sent home shorty after this event- patient census was now down and I was injured somehow and had to go to the treatment room. I had two bruises and some strained muscles. Me left side was fine, but I was having trouble moving my right side fingers voluntarily, although they were vibrating involuntarily for about an hour. Also, I couldn’t type, and were all computerized at work. Then I was off for a week which was my normal schedule.
When I got back, I heard the baby was a “feed and grow” but we don’t really get too much info these days because of HIPPA.
Anyway, I want to give a special recognition to my (anonymous) coworkers- these women rock. Every time something comes up, these ladies drop everything and actually begin to fly. It’s a kind of controlled chaos that is remarkable, and it’s a pleasure to work with them in a crisis (even though they often drive me nuts when things are slow).
*sometime within the last few months
