I Want to Keep my Job...so,

Recently, my employer made an announcement.

"No staff member shall tweet, facebook, blog, or any other form of social networking, about patients. This is a violation of HIPAA and you could face discipline or termination."

We were told that even if we thought we were changing detail sufficiently, the medical center would assume we were not.

So, sadly, my days of posting Stories from the Delivery Room are over.

I have taken my posts down.

It has been a pleasure sharing my adventures with you.

My writing on being a firewife and mom shall continue.

(By the way, life has gotten in the way of blogging. As always, I have missed you.)

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.

“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.”

:)

Stories From the Delivery Room-The Board

Easy going junior resident, Dr. Moore, looked at the board and tensed up immediately. By all indications it was going to be a disaster of a day.

In the middle of the nurses’ station was “The Board”, the central form of communication of vital patient data. Listed were the patient’s name, doc, gestational age, diagnosis and other pertinent information. On this day the board showed all worst-case-scenario patients: a bleeding placenta previa; severe pregnancy induced hypertension; a set of twins in labor; a set of triplets contracting regularly; another patient with a breech baby dilated to 6 and being prepped for the operating room. Additionally, four other patients were dilated between 7-9 centimeters. To top it off, a pregnant diabetic had just arrived and looked like she would need an admission to the ICU for diabetic ketoacidosis. The situation was beyond belief.

Each morning the junior resident arrived around 5A.M. to prepare a report for the oncoming senior resident and obstetric attending physician. As Dr. Moore studied the board, he began to look pale.

In actuality, the situation seemed beyond belief because, little did Dr. Moore know, he’d been set up for a practical joke by the L&D staff. The shift that night had gone from really busy, to incredibly slow. Well, slow is an understatement, we actually had no patients left. It was almost unheard of, but every room in Labor and Delivery was empty. So, as bored nurses are known to do, we decided that we needed to spice up the night…thus a brilliant plan was formed.

Gathering around the board, full of mischief, we came up with the obstetric version of the Perfect Storm. Then, we raced around closing doors, putting up name tags and preparing equipment for our performance that we had choreographed precisely.

As soon as Dr. Moore approached the unit, the chaos began. Nurses began to scurry about pushing IV poles and delivery carts. We went in and out of the empty rooms slamming doors and turning on call lights.

“Would someone let NICU know that we are going to deliver in room 4 soon,” someone shouted towards the nurses’ station, “Tell ‘em we have thick meconium!”

Dr. Moore was taking note of all of the activity as he moved toward the board.

The secretary was repeatedly calling herself, making the phones ring incessantly and also ignoring the call lights.

“The night has been crazy,” explained the seemingly frazzled charge nurse after Dr. Moore had been at the board for a few minutes, “We’ve been short staffed to boot.”

“Excuse me,” I interrupted, doing my best to act frazzled, “Dr. Moore, you have to see this!”

I held in my hand a urine collection cup which I had filled with pale gold apple juice.

“The glucose on this is off the chart,” I said as I held up a urine testing dipstick.

“The urine actually smells sweet!” I declared, taking a big whiff.

Quickly, I added “Let me see how it tastes,” and I took a swig.

Dr. Moore’s knees buckled slightly as he looked at me in horror.

At that moment, the nurses reconverged into the nurses’ station and burst out in laughter.

“What? What are you guys up to?” he asked, with a mix of realization and relief. A grin broke on his face as he grasped the fact that he’d been duped.

With that, the charge nurse picked up the dryboard eraser and wiped the board clean.

We’d pulled off a practical joke that would be talked about for years to come.

Stories from the Delivery Room, Part 2

(Once again, “Fire Hubby” is guest-writing this week’s blog entry while I am posting over on his site, Switch 2 Plan B. ...click here and read the conclusion to his "Perfect Proposal".)

***

I wonder if it ever galled my wife that her pregnancy was so…well…typical.

First comes love…

Then comes…cravings!

In Julie’s case, it started with oranges. Had to have oranges. Big, fat, juicy ones with the NAVEL proudly pointing inside out—just like her beautiful, round, smooth belly. Then it was burritos. But not just any kind—Taco Bell green bean burritos. Had to have that green sauce. Not plain, red sauce—green. Nothing else would do. “Get in the car and get me one…Now!”

So one evening deep into the first trimester, we took a “Run to the Border” trying to placate that voracious, insatiable god-of-cravings. But as we drove away from the Taco Bell drive-up window, she opened the bag to discover they had instead given her a bean burrito with RED sauce.

She started crying.

Is it any wonder men are mystified by women?

Clueless, one might even say.

But maybe it was Mexican food (the Fiesta Platter perhaps) that helped induce labor many months later. About 1 a.m. my now-huge and restless wife woke me out of my last-ever restful night’s sleep. The contractions were still far apart but unmistakable. She took a long, hot bath, perhaps contemplating the many ways her life was about to change, while I lay in the dark, visions of little denim jackets dancing in my head—much like the Heffalumps and Woozles sequence from “Winnie the Pooh.” By six a.m. she was dressed and ready, but on all fours in the living room softly moaning, “oooh.” I felt completely helpless.

Yet an hour later, when we arrived at the hospital (the same facility where she works as an L&D nurse), Jules had her game face on. After colleagues and co-workers cheerfully greeted her, each chortling “Hi, Julie!” she saw herself to a hospital room, put on a gown, and hooked herself up to the fetal monitoring unit, adjusting the straps and sensors and examining the strip until she was satisfied the baby’s signs were suitably strong and steady. Later, following her epidural, when she felt somewhat hypovolemic she reached up and expertly adjusted her own IV hanging by the bedside, over my sputtering objections.

But there was no shortage of attention, medical and otherwise, as well-wishers in scrubs dropped by. Julie had hand-picked her doctor and anesthesiologist (for the much-needed epidural) well in advance, and her best friend even served as her nurse for the day—a day that wore on as her labor stalled out.

Sometime around six p.m. she was ready to push. More than ready, in fact. After long hours of excruciating labor, the pain breaking through whatever meds were onboard, my exhausted wife could take no more. As her doctor and nurse sat poised at the foot of her bed, my beet-red wife yelled...

“Get it out of me!”

But moments later…

…our little Scout appeared…

and slid gently into my gloved and waiting hands.

My wife has helped ease many little miracles into this world, gripped the hands of young moms struggling through labor, stroked the hands of those grieving a lost newborn, and like God’s gentle emissary, shared in the joy or sorrow of each. She is this firefighter’s hero.

And at that moment there in the hospital room, her faithfulness had been rewarded.

A moment of immeasurable joy
and perfect love
safely far away
from the full catastrophe of life.

Stories From the Delivery Room

You can swap stories, you can swap wives, you can swap babies at birth, you can even go to a swap meet…but can you swap blogs?

Well, that’s exactly what we’re going to attempt here: This week, wife.mom.nurse and Switch 2 Plan B (AKA “Fire Hubby”) are trading blogs.

“Fire Hubby” (that’s me) will be writing this week’s posting here on wife.mom.nurse, while my wonderful wife Julie will be posting over on my site—and no doubt telling some really embarrassing story about me there.

Click HERE to see what she's got to say...

I understand that baby stories are popular here at wife.mom.nurse, so I’m going to tell you the ONE baby story she won’t tell you! It’s the true tale (mostly) of the time Julie delivered her own first-born.

***

I came home one morning after a long shift at the fire station to find my young bride obviously bursting with some pressing secret.

“I have something for you,” she said with a mischievous grin. “Close your eyes.”

When I opened them again, she was holding up a denim jacket—a really, really small blue denim jacket, better suited for a Cabbage Patch doll than her six foot-tall husband.

But if you give a fireman a moment or two, he can usually figure out the plainly obvious. See, only about a week or two earlier we had decided to start our family. Now, this was my wife’s way of letting me know that the magic stick had clearly turned blue already. The tiny Levi’s jacket meant we were expecting our first child.

It must have been strange for wife.nurse to transition to wife.mom.nurse. After working on the labor and delivery unit for six years by then, she would now go through the experience for herself: the barfing, the cravings, the bloating, the labor pains—the entire blessed event that, nine months later, would be swaddled in a bundle of joy and sewn up as tidy as an episiotomy.

(to be continued)

Stories From the Delivery Room

What a cute couple! Jill and Scott were in labor. Yep, they were totally in it together. You know, they were the kind who say “we’re pregnant.” They were so excited to welcome a second baby to their family.

It always makes me happy to see a team like Scott and Jill. Watching couples who are kind and respectful to each other is refreshing. I certainly do not take this for granted. Many fathers-to-be seem closer to the TV remote than to their wives. I was anticipating a fulfilling day at the office, caring for these two.

With each contraction, Scott looked into Jill’s eyes and helped her breathe. They had gone through Lamaze classes prior to the arrival of their first baby. “It helps a lot for early labor, but I’m no hero. Sign me up, I’m gonna want my epidural!” she said with a chuckle.

Within the hour, the joking and playfulness turned into concentration. The contractions were clearly getting harder. I gently pressed upon Jill’s abdomen, the contractions palpated strong. I knew it wouldn’t be before I would be calling the anesthesiologist.

When I admit my patients to labor and delivery, discussing pain management is a high priority. Breathing through the contractions, getting IV pain medication, or having an epidural are the three main options for dealing with the pain of labor. Some nurses strongly encourage their patients to get epidurals. They hate to see women in pain. I actually don’t have a preference. I truly believe pain management is a woman’s choice and that she should do what she feels is best for her. Supporting a woman’s decision is my job. Continuously questioning her or asking her if she has changed her mind only undermines her confidence.

Sure enough, before long Jill was ready for me to make the call. She was tired and ready for a break from the pain.

I walked out to the nurse’s station and paged the anesthesiologist. Within 15 minutes, I heard a cart rolling down the hall and a knock on the door. Dr Smith had arrived to place the epidural. Before he could start, he needed to take time to discuss the risks and benefits of the procedure. After Jill signed the epidural consent, Scott and I helped her dangle her legs over edge of bed and moved the tray table in place for her to lean on. Dr. Smith chatted with them as he readied his supplies. “Your position is really important in helping me place this catheter,” Dr. Smith instructed Jill. “I need you to drop your shoulders and place your chin to your chest. Good! Now push your lower back towards my fingers here, arching it just like a Halloween cat. Perfect.”

Dr. Smith’s attending physician, Dr. Wong, had arrived prior to the beginning of the procedure. By the time they begin their OB rotations, the anesthesia residents are skilled at epidural. However, supervision by an attending physician is required.

Dr. Smith’s skill was impressive, and within a few minutes the epidural catheter was in place. Scott held the over-bed table as Jill remained perfectly still, despite the strong contractions. Things were going smoothly. Dr. Smith performed a test dose to insure that the catheter was in the epidural space and not in the spinal fluid.

“Any ringing in your ears or metallic taste in your mouth, Jill?” Dr. Smith asked.

“No,” Jill replied.

“Can you move your toes?” Jill wiggled her toes in response.

“Do your feet feel numb?”

“Nope, they feel normal,” said Jill.

Those were the answers Dr. Smith was looking for. He then meticulously secured the epidural catheter to Jill’s back, using Tincture of Benzoin and 2 inch paper tape. Nobody wanted the catheter to pull out--especially Jill!

Scott hugged Jill and kissed her on the forehead. Clearly he was proud of the impressive job she had done, holding still through such incredible pain. I helped her to lay back down, flat on her back, just as Dr. Smith requested.

“Oh yeah, now I feel it. My legs are getting numb. Will my pain stop soon?” Jill asked.

“Not too long now,” Dr. Smith replied.

A few minutes later, Jill reported that she could feel her abdomen getting numb. Dr. Wong assured her that everything was going as expected.

Another minute went by and Jill started to become restless.

“My breast are getting really numb,” Jill said with anxiety in her voice, “and my hands are getting tingly too.”

The two doctors exchanged concerned looks. Scott was sitting tensely in the recliner by Jill’s side, holding her hand. Dr. Smith began to check the anesthesia level.

“Oh no, something is wrong, I don’t feel well. Oh, it’s getting hard to breathe. Something is wrong. Please, please, do something!”

To be continued…