Keeping my Mouth Shut.

So, last Friday, I had an amazing moment.
Most of the nurses on the floor in the hospital I'm in for L&B, who discover the woman who wants to give birth without intervention, who wants to do "Natural Child Birth" (OMG!), she's automatically labeled as: crazy, insane, masochistic, f'ed up.
And you know what I said?

Nothing.
I'm a nursing student. I kept my mouth shut.

What I want to say?
When I first wrote this, I was really really angry, and I typed out what I wanted to say. But...
I was taught if I can't say something nice, then don't say anything at all. So I didn't. I want natural child birth too. I think I said that, but in a very even tone, so as not to rock the boat. And I clearly remember the shock in the voices around me, "Really? Are you kidding?"

I respect the mama who wants to scream, moan, blow out her pain with her breath.
I respect the mom who looks at the doctor with "crazy eyes" and says, "I can't do this, help me, pull this kid out of me," and the doctor says, "You're almost there, you CAN do this, I know it, breathe, focus" and then winks at me with all the love in her heart.

And I DO NOT respect the "nurse" who interferes with that beautiful, human connection that the patient and I have.

My patient:
She reached out to me, grabbed my hand while pushing, one of her most intimate moments in life that she will remember forever, she holds me, and I whisper to her, "I'm here for you, I'm right here, and I'm not gonna let you go."
And the nurse, with her degree, and her NCLEX, and her knowledge- she subtly reaches over and peels that womans' hand from mine,
and places it on a grip bar attached to the bed and says, "You might feel more comfortable here."

And the baby boy is so beautiful, and mom and baby are so happy when he is finally with us in the room, "crazy" mom and her little boy and dad who is super supportive...
and the nurse takes me aside,
"So, that birth went well, but um, DONT EVER let a LABORING woman GRAB your hand like she did, she'll break it. Protect yourself. You did really well except for that one thing. You're not aware of your safety."
And all I could do was nod.
"Okay. Thanks."

Inside, what I wanted to say, "What. The. Fuck."

I had one of the most intimate moments I could ever have with a patient- she reached for me, gently, to support her, and that nurse, so afraid of intimacy, took it from both of us.

I think that moment really topped off a very disheartening day with this particular nurse, who seemed very disconnected from her patients even though she was young and fairly new. She liked hanging out with the monitors rather than being present with the patients, and I heard the charge nurse asking, "Please, can you help and be a team player? I really need you here." And this particular nurse, sighed, rolled her eyes, and stomped off like a toddler, not even introducing herself when she came in the room with the woman she labeled as crazy for just wanting to trust her body.



Even my Clinical Instructor: "wow, what a beautiful moment..." then I continued with my story... her comment, "how sad. How sad for that nurse that she didn't feel comfortable being present with her patient at a very vulnerable moment. What a sad, reserved, afraid human that nurse must be to be so unavailable at the moment her patient needed her more than anything..."

Exactly what I thought.
How sad.
And how sad that I kept my mouth shut.
I hope that young nurse changes specialties. L&B is not for her - sheesh, maybe not even nursing. But that's not my call.

And what a blessing to be present with my patient.
What a blessing.
How beautiful.
I support a woman's right to choose, and that includes the conditions surrounding her labor and birth. What a beautiful thing.
The MD asked if I wanted a job on the floor. If emergency weren't my thing and L&B were (ok, so it is, but emergency more so), I might consider it.
More to be discussed.

The Cycle Continues

I'm backdating this blog entry, mostly because I like having Anne's sunshine smile at the top of my blog.

Friday, the 10th, I spent my first rotation in Labor and Delivery. Here's a summary of the experience:

My brand-new clinical instructor is moving very quickly towards us, somewhat breathless.
"Okay, Nicole, you and (male MEPN) are in the delivery rooms, and everyone else is in Post-Partum. Go change into these scrubs. And the women in those two rooms are pushing. Hurry!"

My cohort and I look at each other, high-five, and nod. Neither of us even had time to register nervousness- I mean, I had never seen a vaginal birth, only a C-section, and we have had about three lectures on pregnancy. New scrubs on, we stepped out, ready for the day.
For about ten minutes the nurses we were working with hemmed and hawed about the number of students allowed in one room, and I told him to go ahead- as a male, I know it's more difficult for him to be accepted into a delivery room. Not today. He merged right in to the room, needed and accepted. He had only been in there two minutes, when I hear a call for, "Hey can I get another person in here?!"
So I stepped in.
"Um, I'm a student, what can I do?"

A nurse looks at me, "Grab that towel and go hold her leg so I can hand tools to the doc."

The patient is in a traditional hospital-birth supine position, her husband is at her side. They are super cool, and very calm, all things considered.
"Hi, nice to meet you. I'm Nicole." Contraction.... "Okay, breathe deep with me, ready?"
And that was it. Off and running. It's 7:15 am, and I am helping hold this woman's legs open for a difficult birth, trying to remember what I can about fetal heart rate decelerations, next to her husband (who is also totally rad), watching the doctor work, realizing that this baby is in a little bit of trouble. And I'm watching the baby's head crown.

Holy Shit.

And I thought, silly me, that the head would be way smaller than it was.
The OB was very calm, and grabs the vacuum to help get this baby out. I see the FHR (fetal heart rate) is about 70.
Not so good.
Doc, very slowly but firmly. "Get Peds in here. Now."

A team of 3 superhero nurses emerge from the ICN, ready. They're setting up oxygen support, and the warmer.
The woman pushes again.
"Call Dr. XXXX. Get him in here." I realize that she's calling for the attending.
"Okay, now push. Hard. We need him out of there."
Attending arrives, steps back close to the ICN nurses.
Our laboring mama listens. Another nurse is pouring mineral oil and olive oil on the crown of the baby and on mama's perineum.
And all of a sudden, I realize just how huge that head is, because it's coming. Fast.
And just like that, there's another person in the room.
"Floppy baby."
Not a good thing.
He's blue and floppy, and the cord was wrapped around his neck, twice. Not 2 seconds into the world, this little guy is under a warmer, being rubbed down, suctioned, and bagged with oxygen.
The trio of superheros is working, hard.

It's almost too much to absorb. I look at mama, I look over at baby, and then I look down at mama and she asks me (and the doc), "Did I tear?"
It took every ounce of my consciousness not to look incredibly shocked.
Um, yes.
The OB: "It's not that bad."

Apparently, it's not that bad, but I have never seen a vaginal birth and I could not believe what a "not-that-bad" tear looked like. And the amount of blood that was associated with this process I was NOT prepared for.

I keep myself together, "Yeah, not that bad. How are you doing?"
And then I look at dad. "How are *you* doing?"

We start bantering, like we had known each other for a while. I glance over at the busy trio and the once-blue baby. He looks pink, to my relief. It's been almost 10 minutes.
Then we hear it... He cries!
I sighed, audibly. Everyone in the room noticeably relaxes.

They bring the little guy over to mom and dad, and let them say hi, but he was on his way to the ICN to be watched for a little bit. Both mom and dad are medically savvy, and they nod. Mom looks tired. Baby looks pink, warm and dry. He looks a little mad after being suctioned, and he's probably a little dazed.
"How long were you in labor?"
She looks at me. "31 hours."
My male MEPN companion and I look at each other and our jaws drop.
"Um, can I get you some juice?"
She laughs, and nods. "Yeah, that'd be great."
The OB is busily sewing up the tear. This mama had an epidural, which she relates is what helped her make it through. It's not even 8am yet.

And that was the beginning of the day. Literally, 2 hours later, I'm watching a C-section, then an hour after that, I'm holding the legs of another woman who didn't get an epidural because her baby was on the fasttrack into life. First baby, and she only pushed about 5 times. She tore, too. And let me repeat, NO epidural. Her baby came out with a loud cry, pink, and feisty. Good sign. The doc was trying to numb her up to sew her back together. Again, not a bad tear, but on my first day, it was pretty shocking.

At that point, I thought to myself, "Is there a third option?"
If I invent anything, it's gonna be a baby transporter beam, a la Startrek.
And I had a hell of a lot more respect for all the women I know who have gone through this process.

I then spoke to my Godsister, who is a NICU (ICN) nurse, and she relayed to me that usually women with epidurals tend to tear more often because they can't feel pain, so they don't allow themselves to stretch enough. Makes sense, naturally, when it gets too painful, you stop, take a breath, relax, let yourself stretch, and then begin pushing again. Huh. I am going to ask my prof about this (not that I don't trust my godsister, I just want to ask my professor).

L&D started with a rush of emotion.

So on the same day that I was there for 3 new people coming into the world, someone I really loved transitioned to another one.

Which is a wild head trip for me.

In the past few weeks I've lost a lot of people I've known. See my prior post about one group, but I also lost Shane McConkey, who was a trick skier filming in Italy, and fell. One of his skis didn't pop off, which screwed up his balance and from what I understand, his parachute was tangled in his ski. So he fell. 400 feet. He was only 39, and he was the most bitchin' landlord I ever had- he used to come over and drink beers with us, and his wife Sherry used to come visit as well. I remember how excited she was when she told us she was pregnant. Shane was awesome- he knew I was trying to improve my skiing and offered to ski with me, which floored me. Shane was a legend- he was Squaw's guy, and he was a friend to so many, and so down to earth yet nutty and fun. Total prankster, and totally loveable. He leaves behind his wife, Sherry, and Ayla, his daughter.

Too much.

It's a cycle. I haven't confronted death in a long time, and I've never seen birth like what I saw on Friday, so I guess it's time for reflection.