OB doesn’t usually get recognized for all the complicated, emergent care that we give. When people think of the ER, they think of codes, and bleeding, and a lot of life-and-death situations. When people think of OB, they think birth, and beauty, and babies. Most people on the “outside” don’t see the three-dimensional work that we do. I think most obstetrical nurses stay in OB because of the beauty of birth and the babies, but that is definitely not all our work is comprised of. We’ve probably all seen our share of codes, and bleeding, and more than our share of life-and-death situations.
Some of us work for hospitals that do not have a dedicated anesthesiologist. I have been there. One of my last experiences with one of my favorite obstetricians was of a patient who came in abrupting. We knew immediately that we would have to section her STAT…she was a classic case. She came in to triage in tremendous pain, with a baby blanket soaked in dark red blood stuffed between her legs. We didn’t wait to hear the baby’s heartbeat in the 20s before we began doing our dance. Someone grabbed a physician on the unit, someone called the anesthesiologist, we put in an IV and we rolled to the OR. And that’s when we heard the news that would make our stomach’s drop and stop us dead in our tracks: the anesthesiologist was 45 minutes out. I have never seen so many seasoned nurses look completely—at a loss. Inside, I think we all wanted to vomit. Have you ever had to do a cesarean section without anesthesia? With local injected into the uterus? Have you ever heard a woman scream until she passed out from the pain? I hope you never do, but I can tell you…if you do not have dedicated anesthesia in OB, this could be you…it will happen one day…or the alternative is a dead baby. And isn’t all of our goal a healthy mom and baby?!?
Sometimes we are asked to do crazy things…things that no other nurse on any other unit would ever be asked to do. I have had physicians “jokingly” ask me to steal Cytotec to give to them (ummmm, NO!). We hike up legs, wipe vaginas, and encourage patients to push when they feel the urge, all while keeping a very focused face (no matter how heavy the leg is or what the vagina looks like). I bet we’re the only nurses that have crawled around on an OR floor, dodging blood and amniotic fluid, after a bladder has been nicked. If we have a sudden assessment of heavy bleeding, we dig through the trash can to pull out dirty peri pads. If our patient has vaginal discharge, we’re supposed to describe the smell (and they all have vaginal discharge, they’re pregnant!). If a patient gives one great heave of a push while the doctor is complaining that we called them too early for delivery with their back towards the patient, we will not hesitate, we will grab that baby by the ankle with our bare hands to keep it from dropping into the trash bag. No one can dodge blood squirting from an umbilical cord or a spray of amniotic fluid from an AROM faster than a labor nurse. We’re like ninjas!
Our days are made up of patients basically saying the same things and going through the same experience. But we all have those O-M-G moments. When I was working triage one day, a 37 weeker came in complaining of abdominal pain. She was a previous c-section x 1. She was contracting every ten minutes or so, and the physician ordered IV hydration. Her contractions spaced out, but she was having an unusual amount of pain with each contraction. If I hadn’t been putting my hands on her belly to know that each contraction was very firm, I would have just thought she was dramatic and had a low tolerance to pain. When we took her back for her c-section, she ended up having the largest window I’ve ever seen on a uterus. I could literally see the baby blinking and swimming around in the amniotic sac. I remember thanking God that the woman had decided to come in to triage, that I had put my hands on her belly, and that the physician had decided he would miss his golf game (it was the weekend) and come to assess the patient himself when I asked him to. The outcome could have been a lot different if her uterus would have ruptured. And we’ve unfortunately all probably seen some of those!
So yes, I know how to dance. And I can move like a ninja. I walk with a limp when I’m not in a hurry, but I’m able to run when I need to. And I can crawl on the floor and stick my head under a sterile drape without breaking the sterile field, and avoid this drop of blood and that pool of fluid in the process. And every time I wonder if I still want to be a labor nurse, I just have to laugh to myself. Even though we’ve all seen things that stop us dead in our tracks, some things that make our stomach turn and tumble, and on a daily basis we’re all praying that everything just ends up okay, I still couldn’t imagine working in any other area 🙂
Until my next delivery ❤