When I was in nursing school, I frequently heard the term “nurses like to eat their young.” This did not sound appealing to me. As a new graduate nurse, I started working on a unit where almost everyone had been an OB nurse for over 25 years. I was afraid that no one would be kind to me, and everyone would take one look at me and see how little I knew and how nervous I was. I wanted so bad to be as good as they were. I use to wake up every single day and wish—just wish—that I could wake up the next day and have 30 years of experience, like they did. I didn’t want to be the new nurse. I wanted to be the nurse that knew what she was doing. I didn’t want to be the record keeper in an emergency…I wanted to be the one that knew what to do next.
One day, I came to work and my preceptor said it was time for me to make my own decisions. I was going to admit a patient and labor her all on my own. I was so excited. It was like I was the real nurse, and this was my chance to show everyone that I had been watching them when they didn’t know it, that I had been paying attention and I was going to totally know what to do. It was the patient’s first baby, she was forty weeks, in active labor, and we were both ready to rock and roll. I checked her and could actually get to her cervix (I have very small hands). She was 4/60/-2! Everything was going exactly as I imagined it. The entire day my preceptor just followed me around, as if our roles had been reversed. From a distance, she watched as I charted everything, encouraged the patient to change positions, addressed the patient’s pain and comfort, and of course, monitor maternal and fetal signs of well-being and distress. Before I knew it, the patient was 6/80/-2! Then she was 8/100/-2! And finally, she was 10/100/-2. I encouraged her to labor down and by the end of the day she was complete and ready to push at +1 station.
When the baby’s head came out, I repeated what I had heard my entire time on orientation: take a deep breath and puuuuuuuuuush. I was so excited I was about to deliver my very first patient, all by myself (well, I was standing next to the doctor). The patient pushed, and the baby’s head did not move. And the patient pushed again, and the baby’s head did not budge. I didn’t know if I was supposed to wait for the provider to do something, to say something. I wanted someone to freak out and exhibit every feeling I felt inside. I jerked the patient’s leg back and pleaded with her to push, and still the baby’s head did not budge. I watched as the baby’s head turned a dark shade of blue. In an instant, my hands started shaking and I looked around for my preceptor, not knowing what to do next. My heart was beating so hard my vision was pulsating. I had lost my preceptor in a sea of people at the bedside, but she was right there, and always had been. She told my patient to stop pushing, told the doctor she was ready for McRoberts (ready for who?!?), jumped on a stool (where had that come from?!?!), and the next thing I knew the baby was born.
The nursery nurse carried the baby to the warmer, its plump little arms and legs dangling, motionless beneath its body. I walked over to the warmer and looked at the baby lying there, completely limp. I looked at the nursery nurse as if to say what do we do now?! But the nursery nurse never missed a beat. Everything happened so fast. She was doing so many things to the baby while I just stared at it, willing it to take a breath. From her bed, the mother asked why her baby wasn’t crying. I wanted to scream at everyone in the delivery room…this wasn’t supposed to happen!! And just as the mother started to get hysterical, the baby let out a long and lusty cry, rewarding the nursery nurse for all her efforts. Less than a minute later everyone in the room was laughing and making bets on how much the baby weighed. But my stomach was still twisting and turning. I fumbled around the room, picking up stuff and labeling cord gasses, all the while wondering what the hell had just happened. Could I have predicted that? How did my preceptor know to have that stool by the bed?!? And who the heck was McRoberts? Later, I would talk about everything with my preceptor.
The baby’s head turned blue. I didn’t like that.
My preceptor laughed. I didn’t like that either.
What if the head wouldn’t come out?
Then they’d break the baby’s arm.
What if the head still didn’t come out?
Then they’d break the mother’s pelvis. She saw the horrified look on my face.
Have you ever seen that? She smiled, but did not answer.
The head can not be out longer than five minutes. Don’t ever forget that.
To this day, I don’t know how true that is…about the five minutes. But I can tell you that to a labor nurse, one minute waiting for the shoulders feels like ten, and to this day, shoulder dystocia’s still make my tummy toss and turn.
I was so fortunate to begin my career as a new nurse with so many extraordinary nurses. They never made me feel inadequate or unintelligent. I never felt like they wanted to eat the new nurse. And my preceptor would teach me so many more things than just how to perform McRobert’s maneuver 🙂
If you are a patient and have diabetes, know that controlling your diabetes is important for so many reasons, and the size of your baby is just one of them. And all pregnant women should talk to their provider about how much weight they should gain during pregnancy.
If you work with a new nurse, be patient and be kind. Don’t be the nurse that devours the new nurse. Remember that we were all the new nurse at one time. Teach her everything you know, because we all want our patient’s to have the very best care. And if you’re the new nurse, know that things do not always go as expected. No one expects you to know everything, and everyone knows that you are the new nurse, even if you don’t want to be 🙂 Ask questions when you aren’t sure. In a delivery, when you’re waiting for the shoulders, every minute counts and every minute feels like eternity, but never forget that you are never alone. Your preceptor may be waiting in the wings, and help is only one pulled-emergency cord step away 🙂
Until my next delivery ❤