In a valiant attempt to work myself into a limp and bloody pulp, I decided to go to work last night because they were understaffed and desperate for an extra nurse, and were begging and pleading, and I thought that even though I had already spent 8 hours on my feet all day doing clinicals, working another 12 hours probably wouldn’t kill me. In retrospect, this probably wasn’t the wisest decision I’ve ever made, although I did survive the night. Our unit was absolutely slammed, and none of us got breaks, and by the end of the night (well, the early morning of today), I was bleary-eyed, and double-checking everything I was doing because I was certain that I was bound to make a mistake from being so tired. How do residents do it? Or midwives on call who have back to back delivieries?? Yikes.
I ended up having three patients and two deliveries: one cesarean birth, and one vaginal delivery. My third woman was an induction for Premature Rupture of Membranes, aka PROM (a subject which has become very close to my heart, as my research proposal is on this topic); she was on pitocin, but she wasn’t progressing that quickly, and didn’t deliver during my shift. The vaginal delivery was the most fun. The woman came in at 4:15 panting and moaning. The initial exam found that she was 5-6 centimeters dilated at that time. It was her second child, and her first labor had only lasted 3 hours, so we were definitely scrambling to get a room ready. We didn’t even have a completely clean room to put her in, given that we ended up having 12 deliveries last night and we didn’t have a nurses’ aid, either, to help us get the rooms ready, so another nurse and I ended up swapping out the dirty bed in her room for a clean bed which we prepared in the hallway. We got her into the room, started an IV on her and gave her Penicillin because she was GBS positive—this was finished by 4:32 am. She was begging for an epidural, but she didn’t have time, given that she was fully dilated by 4:35 am. The baby was born at 4:39 am, after three pushes. It was all so lightning fast: first an IV, then, the next thing we knew, her water broke, then the doctor was shouting for a table, and boom, I had just gotten the oxygen and suction hooked up for the arrival of the baby, and the baby was out and screaming before I’d even turned around. Now that’s the way to give birth! What a crazy, fun, awesome precipitous delivery. Afterwards, I told the woman that she was just amazing, super strong, and then casually observed that obviously she didn’t really need that epidural after all, and she agreed with me, and said that next time, she wasn’t going to ask for one, she was just going to have her baby instead.
Mwuahahahahaha. Subversive midwifery at work! Any day I can gently convince a woman that she doesn’t actually need an epidural is a good day, indeed.
At certain points throughout the night, I just kept thinking in disbelief that only that morning, I had been doing speculum exams on women at the Family Planning clinic, and inserting an IUD. It seemed like a lifetime ago. I thought of all the women and vulvas I had seen in the past 20 hours, and was rather stunned (but pleased) by how high the number was. That’s a lot of women! Although, given how exhausted I was by the end of my shift, if work ever tries to call me in again after a day of clinicals, the answer will be a resounding NO!!