“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.
“I...”
Sniffle.
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.”
:)
my heart melts...
