Ah…one of my favorite movies is “Gone With the Wind”.
Prissy and I have something in common!
Neither of us know nothin’ ’bout birthin’ babies.
But Scarlett and I have something in common, too.
We were both faced with the prospect of having to “birth” a baby.
And just like good ol’ Doctor Mead in Atlanta, the ER doctor was needed elsewhere for more pressing matters.
The call came from the intensive care unit, right next door to the emergency department.
A patient had self-extubated and was decompensating rapidly. Would the ER doctor rush over and re-intubate this patient?
He was through the double doors before I even hung up the phone.
I was the night charge nurse at the time.
The night was surprisingly slow for that little “mini-county” of an ER. It was just a smidge before two am and only one or two patients were over on the “clinical” side.
This particular ER required that all pregnant women, even if they were at term with ruptured membranes, sit down at triage and get their vitals taken along with a bunch of other busy work that could have and should have been done up in labor and delivery.
Emergency: the dumping ground for everyone else’s scut work.
So here comes a very pregnant young lady. She wasn’t a child but resided somewhere in the nebulous area between the state saying you are an adult and actually being one. Her mother pushed her through the ambulance entrance in a wheelchair.
“Hi!” I said. “Is it time?”
“I do believe it is” answered the soon-to-be grandmother. “She’s been havin’ pains for about six hours and her water broke ’bout half an hour or more ago. Now she says she has to go to the bathroom.”
First baby. A week from scheduled due date.
Ding!Ding!Ding! The little bell in my head went off.
(Actually what went off in my head was “Oh s***!” )
But I just smiled and said “Okay, let’s have you lay down on the bed here and see what’s happening!”
The patient herself was quiet, withdrawn and seemed not quite “all there”. As the wheelchair was pulled parallel to the gurney, the patient stood up and began to walk away!
“Whoa! Hon, where are you going?” Seemed like a natural question at the time.
“I’m goin’ to the bathroom.” Ask a silly question…
“Oh no you’re not! You need to lay down right now.”
She just looked at me wierd. Didn’t budge.
I repeated the need for her to lay down, like, yesterday.
No response. Just stared at me. No crying, no clutching her abdomen. No hysterics. Just a straight stare.
So we, uh, assisted the patient into a supine position and I told her I needed to take a “peek” at what was happening “down there”.
(Son of a B****!!!!!!!!!!)
She was crowning.
(Okay. Stay calm. You have had your class in Neonatal Resuscitation. You know what to do.)
I quietly surveyed my staff. Has anyone delivered a baby before?
Nope. So that made me the senior nurse on duty.
Anne, run next door and tell Dr. Emergency that we have an impending delivery. Margie, call nursery; have them run a warmer down STAT. Joe – can you hand me a pair of sterile gloves and get the precipitous delivery pack from the top shelf and get out the bulb syringe.
(Oh s***, oh s***….newborns are nose breathers, suction mouth first…..or is it the other way around?????)
“You are doing just great!” Outwardly I was as calm as you could imagine. You would have thought I did this every single day of my life. “I see the top of the baby’s head!” Big smile.
(My pulse was 186. At least. Probably V-tach for all I knew.)
I put on the gloves just as Anne came flying back to tell me the doctor couldn’t come, the intubation was difficult.
“Just go with what your body tells you to do,” I instructed the patient. “If the urge comes to push, you just go right along with it”. None of this telling the patient not to push. The baby’s crown was right there.
So there I am with my hands about three inches away from the woman’s peri area and a bulb syringe at my right hand.
And nothing happens.
Ummm….shouldn’t she be pushing? Oh, wait…there’s one and here comes the…no, not that time.
And all around the gurney, in a half-circle about five feet behind me is every single staff member on duty that night, plus the two nursery nurses who aren’t even coming up to help, they are just standing behind the ER staff with their warmer!
(Good god, ladies, you’ve done this before, why the hell don’t you come over and help…do I look like I know what I’m doing?)
I guess I did.
More encouragement for the patient. Found out the baby was a girl. No name yet. “She has a ton of hair!” I noted.
Here comes the head! Okay honey….good girl…go ahead and pu…..
Right as that baby’s head popped out a huge mass moved my considerable bulk out of the way and a big blue hand caught that baby’s head and the rest of her, too.
The doctor had rushed through the curtain at the last minute and literally pushed me out of the way to catch the baby.
You might think that.
Loss of a teaching moment? I mean, he could have talked me through the delivery.
You might think that, too.
But I could have kissed him.
Right there in front of God, country, patient and co-workers. He’ll never know how close he came to the biggest smooch ever smooched in history.
The new mom? She did great.
After it was all over, the enormity of what just happened seemed to dawn on her and she was no longer “out of it”. She held the baby briefly and then the nursery nurses did their thing, taking the baby back to the nursery.
New Mom asked New Grandma to go up with the baby.
For the next hour-and-a-half, our ER tech held the patient’s hand and talked to her and told her what to expect post-partum. And the tech was the perfect person to do the patient teaching – she was the mother of six herself, having had the first at the same age as our patient!
It meant a lot to the patient to have that support. So much so that there is a little girl, probably in the second grade by now, running around with the same name as the ER tech!
I should have gotten the Academy Award for Best Actress (In a Stressful Situation).
Then Scarlett and I would have had two things in common.