Friday, February 5, 2010

Stories From the Delivery Room-Never Let Them See You Sweat

“Julie, we're out of fetal monitor paper! What are we going to do?” Lisa asked in a panic. “You need to get some, quick.”

It was my first night in charge---ever.

I was green. Having only been in Labor & Delivery for a little over a year, I was a rookie. For reasons I can hardly explain now, I was one of the most senior nurses on that night. And almost immediately, I could see it was not going to go smoothly.

It was 1991 and obstetrical nursing was only beginning to come out of the stone ages. There were no computers, therefore there was no way to see or store a fetal monitor strip if there was no monitor paper. And I did mention it was night shift, right?

“How am I supposed to get monitor paper at night?” I asked, trying to hide my anxiety.

Nobody had an answer for this dilemma, including me.

Keep it together. You need to look confident. Don’t let ‘em see you sweat.

“Okay, let’s call the house supervisor and see if she can send someone to another hospital to get some,” I said thinking on my feet. “We should have enough paper to make it a few hours.”

“Hey Julie, I need you in room 3,” Carolyn said in hushed tones. “I’ve got a fluffy patient in here. Probably a good 300 pounds.”

“The problem is...I can’t get her baby back on the monitor,” she continued, “and she’s been having lates.”

Another crisis at hand, less than a half an hour into my shift. Walking into Room 3, I began adjusting the patients external fetal monitor. The baby had been showing signs of distress, so it was not an option to keep the baby off of the monitor. The patient was propped on her left with a mountain of pillows, an oxygen mask strapped snugly on her face, looking a bit stunned by the rush of activity. Unfortunately, her cervix was not dilated enough to have an internal monitor placed. It was looking like we might be going for a crash Cesarean Section.

“Carolyn, I can’t get the baby on either. Let’s get the resident here ASAP.”

Looking out the door, I saw a nurse pushing Room 4 from the tiny labor room towards the delivery room. There were no Labor/Delivery/Recovery Rooms in our facility yet, so every delivery was done on delivery tables in stark, cold delivery/operating suites.

The secretary found me in the hallway as I left Room 3.

“Julie, ER called. There’s a trauma coming in.”

My staff of five nurses would now have to go down to four, including myself. With three other patients in active labor and a nurse back in delivery, I was not eager to send a nurse off the unit. But I had no choice. Myra left the unit a few minutes later with the fetal monitor card in tow.

L&D was being stretched thin, and so was I.

Suddenly, I heard a raised voice coming from the delivery rooms and the electric doors burst open.

“Who’s in charge tonight?” the attending physician demanded loudly.

Walking into the postage stamp sized nurse’s station, I saw the red faced doctor with hands on her hips.

“I am,” I replied with hesitation to my voice.

Be brave. Stay calm. Stand up to her.

“Why was I not called for this delivery? There is not excuse for this! I am right down the hall and I missed it. This is unacceptable. This is the third time this week.” she thundered in a burst of sentences.

“I don’t know why you were not called...”

“Well, you are in charge,” she said cutting me off. “You need to know what is happening on this unit at all times! Why was I not called?” she demanded.

“I was in another patient room taking care of a problem,” I began, trying to defend myself.

“That is no excuse! You need to see to it that I am called to deliveries!”

“I, I...”

I suddenly felt completely overwhelmed. Angry. Frustrated.



Feeling face flush.

Tears swelling up in eyes.

“Oh, oh no,” she gasped, her eyes suddenly wide open. “Don’t cry. Julie, don’t cry. I didn’t mean to make you cry.”

“You”re not making me cry,” I whispered, trying to compose myself. “I’m just overwhelmed. I am in the middle of three crisis’ right now. It’s just a bad time to have this happen.”

"I'm sorry," she apologized, "I really didn't mean to upset you."

I just nodded.

"Would you please go see the patient in Room 3," I requested, "She's having lates."

As she headed out of the station, I quickly gathering myself and went back to problem solving the matters at hand.

That day I resolved to have thicker skin and to not let anyone at work intimidate me. I was a changed person. I became more and more of an advocate for myself, and more importantly a fierce advocate for my patients. Although the families I care for only get to see the kind, sweet, compassionate me, I stand my ground firmly and confidently at the nurses station.

Nineteen years later, I can say that I have not crumbled again under the pressures of my demanding job in Labor & Delivery.

I proudly accept my husband's title for me- “Salty Old Nurse.”



Mr. Daddy said...

that is quite a term of endearment....LOL

We do live and learn don't we??

Pam D said...

And so, I see why I have problems in the workplace. That just seems overwhelmingly TOO much for one person to keep track of, imho. You're not just talking about a blown contract or a late package delivery. You're talking about lives... about not having the coverage that you need to see the signs and be proactive rather than putting out fires. I would have been in tears, too, but the difference is that for me? It wouldn't have been the last time. You obviously are in that sweet spot of doing exactly what God created you to do....

mama's smitten said...

I am listening very carefully!

Mrs. Lukie said...

At this exact moment in time? I can see myself in your shoes in that moment. Looks like I have some interior toughening up to do ;)

Morgan said...

I would have cried too. Salty Old Nurse, huh? So what do you call him then? ; )

Rachel said...

Awww! I totally second PamD's comment. I think you are perfectly placed where God gifted you to not only save lives, but heal spirits. Can you imagine how many women have come under your care that may have had not-so-great experiences previously?

From everything you've written, I think you and I both believe firmly in life being a miracle - and that is such a gift to honor it with your care.

(Someday I'll have to tell you about my own L&D nurse... and her freakouts. It really and truly is only hilarious to me because I had such a great support team otherwise :)

He & Me + 3 said...

Wow Julie that would have been enough to make me run away. Good for you taking it all in stride and good for you standing up for yourself & loving your patients so much.
I would have been so blessed to have had you as my labor and delivery have such an important job & you are great at it!
Happy Weekend!

Jen said...

I totally get this. I do charge for my unit. It is not an easy job and totally requires some really thick skin!

Beth.. One Blessed Nana said...

Oh, bless your precious heart! I think that I would have just cried myself.

Love your blog! As a mother of 3 and seasoned nana of 5, I have been in the delivery room many times. I have witnessed all my grandbabies births and even been there when 2 of them had to be whisked off to NICU immediately!

Love to you,

~*Michelle*~ said...

I have thick skin when it comes to some things, but other times, I am very sensitive and I well up easy.

Just reading the chaos that was going on, made my blood pressure rise.....I cannot imagine being "green" and having that all dumped on you. I probably would have peed my pants a little. *wink

All I know, is that *if* I ever have the opportunity to need and OB nurse....would you be willing to fly out to CT and be my personal one?


Half Gaelic, Half Garlic! said...

I can see why you had the tears welling up..... I would have been ready to lose it myself. I would imagine that most nights are like the one you described, so I am glad you have grown some thick skin since then!!


Just Breathe said...

I can't believe what I just read. I don't know how you do it. I can't imagine all that you must face in your shift. Your patients are so blessed to have you. That must have been some night for you.
I'd like to know how the rest of the night went!

Foursons said...

Wow- I'm not sure I could have pulled it together to get everything done that needed to be done.

I love that you can look back and see how much you have grown since then.

Lesli said...

Good for you and I am sure you do a great job at it too!! I have a little something for you over at my blog!!!

The Blue Sparrow said...

I hate hate hate conflict and especially at work but it sounds like to me that you did and have been since then handeling yourself just fine! *HUGS*

Teri said...

Love this story of your early days. You can be my nurse anytime! :)

Muse Mama said...

Work can still get to me, but hopefully I'll grow that thicker skin. I think it's hard not to take it personally when we invest so much of ourselves in the work we do. You're an inspiration though, Julie. Thank you for your stories.

christy rose said...

Love your story! i can not imagine doing all it takes to do what you do. It is so cool to look back on our lives and see how we have changed, huh? You are an amazing nurse.

Helene said...

I would've lost my cool and ran out of the building crying...and refusing to ever go back!

Julie, you never fail to amaze me!

Rebekah said...

Love it.

Beth E. said...

That is wonderful...unfortunately, I cry when I'm mad, sad, happy, embarrassed, constipated....well, you get the idea! ;-)

Becca~TimeWellSpent said...

oh Julie, it's situations such as those that make me sick to my stomach about going back one day. Just. Sick. To. My. Stomach. That's the part of nursing that I could hardly deal with~the rough way docs and nurses talk to each other. Not all but there are always couple that I would just flee from when they came in site and beg not to take their patients or work my schedule so I wouldn't have to work with a particular nurse. I obviously need to toughen up!
After 15 years not sure it's going to happen though:)

Mags said...

Keep standing strong!!! You're a great! :)

Kelley said...

I still get very tearful during confrontations. I'm just kind of a wuss, BUT I still advocate for my patients! I am constantly working on growing thicker skin. Thanks for the story!