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Thrills, Guilt and Lessons Learned

Working night shift in OB, it wasn’t unusual to field phone calls from worried parents about their newborns. Margaret, a recent graduate nurse, answered the phone in our Obstetrics Department early one morning.

“Hallo, we just have baby—” a male caller said.

When no question followed, Margaret asked, “How old is your baby?”

“One minute.”

“One minute?”

“Ah, maybe two minute now,” was the father’s calm reply.

He told Margaret that mother and baby were fine, yet she advised him to call for an ambulance, and gave him the number. We prepared a room for mom and baby, and waited for our new patients.

After the ambulance brought mother and baby— umbilical cord neatly tied—to us, we nurses marveled at the stoic Laotian woman, and others like her, whom we had cared for during seemingly effortless labors.

Margaret and I reminisced about this as we manned the postpartum desk near the end of another night shift. Our co-worker Kim, working in labor and delivery, had called Dr. B.—the on-call doctor—for a laboring Laotian woman, pregnant with her second child. Margaret and I recalled the story from veteran nurse Sherry, who, noticing her Laotian patient was beginning to push, pulled back the covers and discovered that the baby’s head was out. With Sherry’s assistance, the woman gave birth—in her labor bed—to a healthy baby girl. It was remarkable to us how these women typically labored with quiet dignity, in direct contrast to many of our other patients.

When Dr. B. passed by the postpartum desk on his way to labor and delivery, Margaret said, “Let me deliver your patient! It’ll be good experience—and you’ll be right there.” She motioned with her hands as she rehearsed emergency childbirth, “…and then you feel for the cord…”

Nurse-assisted deliveries were a rarity in our department. Protocol was in place: if the physician was absent and birth was imminent, we called for any OB or Family Practice doctor. If no doctor was present, we called for the Emergency Room physician. Yet, like with Sherry’s patient, there were those unexpected occasions when babies came before a doctor arrived. On quiet nights such as this, we nurses talked through the mechanics of assisting with a birth, hoping that, if the unexpected occurred, all would go well.

Unable to persuade Dr. B. to let her deliver the patient’s baby, Margaret retrieved the rolling ice chest and headed down the hall to fill water pitchers. I remained at the desk to answer call lights and the telephone.

Kim called for assistance to move her patient. “She’s eight centimeters,” she said, when I got to the labor room. After we transferred her patient from labor room to the delivery table and arranged her legs in stirrups, I prepared to prep her while Kim left to summon Dr. B. from the nearby doctors’ lounge.