Saturday, September 15, 2007

A Couple of Days in the Life of...

Thursday I was charge nurse (have I told you how much I hate being charge?) and since, the night before, the house was apparently full, a woman in sickle cell crisis had been placed on our unit (did I mention I work OBGYN/Midwife?) for the obvious reason that she had a vagina! I begged the house supervisor to find her a bed on a medicine floor, as my nurse most of whom were "casual" not staff were having a heck of a time caring for her. Fortunately, the house sup. saw the wisdom in my thinking and we were able to move her after a few hours during which three nurses were unsuccessful in placing an IV in her dehydrated veins. No me gusta.

Later that night we got a Woman in through the ED whose uterus had been perforated by her recently placed IUD. Yikes! And I am SUCH a huge proponent of IUDs. I totally loved mine and know that the risks of perforation are super low but nevertheless I was not happy to hear about this poor lady's situation.

Last night was slow and sleepy until about eight pm at which time I got a call from the frantic husband of a frantic first time mome who refused to get on the phone had contractions coming every 3-5 minutes and suspected ROM. When I told them there was no midwife on duty but that I would call one immediately and could they please wait until hearing from her they replied that they were comeing in. Now I had a sneaking suspicion that Mom was NOT that far advanced in her labor, but since I wasn't able to so much as hear her breathing through a contractions I really had no idea what was going to come through the doors. My thoughts were "Either she's going to push this baby out the minute she gets here or she's going to be one cm dilated and just can't cope." Well, ten minutes after I paged the midwife stat and told her she had a labor rolling in, I get a call from the MIL of the laboring woman saying now the contractions weren't so bad, and maybe they'd wait a little while and then come in. I tried to verify whether or not her water had broken as they were pretty unclear on that and asked them to please pool for ten minutes or so and give me a call back.

So, by this time the midwife has arrived and I've got the delivery cart and the baby warmer all set up, and we get another call from the MIL stating they're coming in but still doesn't have an answer regarding the state of Mom's bag of waters. Oh well. About ten minutes later they arrive, Mom's in a wheelchair covered with blanket follwed by Dad, Dad's Mom, Mom's sister, and her four year old niece. I get everyone settled and it's clear Mom isn't coping well so I work with my labor Spanish to try to get her to relax. "Respira profundo, mas despacio, relaje' la boca" etc. I attempt to get an admission strip but leave the room briefly and come back to find that she's taken off the belts. Again, oh well. Then the midwife comes in and attempts a cervical exam. Oh boy. Mama is NOT having that. My first thought, and question to the Dad was "to your knowledge, has she ever been sexually assaulted?" She was simply UNABLE to relax enough to have two fingers inserted inside her. After a lot of sweet talking and words of encouragement from everyone present she allowed a very brief exam. I was wrong on both ends. She was 7 cm.

Long story short she had her baby about an hour and a half after getting to the hospital with no meds over a very, very, VERY long perineum (differences in human bodies never cease to amaze me!) and her little boy was one the cutest babies with the longest eyelashes I'd seen in many months. She also had such a lovely reaction to her baby who went right up onto her chest. It always makes me rather sad when women are too stunned, or too drugged out or too something not to react with delight and excitement over their new babes. But this one, the ecstasy was HEAVY in her voice. It was lovely.

I cared for them this evening and have done virtually nothing, only because they haven't needed me for anything! This baby breastfeeds like a champ and I've just poked my head in occasionally "Necessitas algo?" and the answer's always no.

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