Day shift is hounding me to come out and give report, but they are JUST GOING TO HAVE TO WAIT! My throat is dry and cracked, my eyes are burning, and my head aches from the mound of paperwork I finally completed a minute ago. I'm tired, I'm hungry, and all I want to do is go home. I hate crappy strips!
Sorry. Labor lingo - let me back up.
First, a quick introduction. I'm the labor nurse. I help the women give birth to their cute little bundles of joy. Of course, it's a lot more complicated than simply having them open their legs and push, although that is still a big part of the job.
The end result of all our hard work is hopefully a squalling purple infant that looks something like both the mama and the papa. It's a moment which deserves great excitement and a sense of possibility. The future opens up ahead of this new life, and wonder fills the eyes of every person in the room....
Oh, right, the whole crappy strip thing – let me explain.
The night starts out fairly easy. My patient, having irregular contractions (squeezing of the uterine muscles) comes in early on, having experienced an exciting wake-up call at eleven that night - her water had broken. Upon her arrival, we quickly attach the fetal heart rate monitor to check her baby. After a rather straightforward admission, we allow her to walk for a couple hours.
She quickly grows uncomfortable, and requests an epidural, which involves a five inch needle injected in the spine to deaden the nerves with pain medication. After settling her with an epidural, placing a catheter for urine, and checking the progress of her labor, I turn off all the lights and encourage her to sleep. Returning to the nurses' station, I sit down at the desk, the fetal heart rate displayed on the computer screen in front of me. The monitor itself prints out on a line of multiple paper graphs, showing the baby's heart rate and the time of uterine contractions. We call it a strip, because of the many diferent strips of paper attached to each other.
Before I could even grab a bite to eat or even a drink, my patient's strip begins flashing red on the computer screen. I look up to see a deep variable decel, or a drop in the babys heart rate. Okay if it drops from 120 beats per minute down to 100 or thereabouts. Not so okay if it drops down to sixty. Which it does. Enter crappy strip.
I leap from my chair and dash down the hall, two other nurses hot on my heels. “Honey, you need to turn to your side, right now,” I state to the patient as calmly as I can, holding back any panic I feel. The other nurses assist me as we turn her to her left side, slap on an oxygen mask, and open up the intravenous fluid tubing to rush fluids into her for the baby's sake.
It's not enough to improve the baby's heart rate, so off we fly to the operating room, rushing her through the process of consents and set up, so the doctor can scrub in to cut the baby out by Cesarean section. When the baby comes out, they find its umbilical cord wrapped around the neck and the body as well!
With all the excitement, and the different tasks I have to do to stabilize both mom and baby, my paperwork backs up severely, leaving me with a couple hours of charting to inscribe. I have to run back and forth from the room to the desk to the supply cart and such, and the mother wants to bond with her baby as well.
It's a miracle she has a healthy baby, though. I lean in to tell her, and she thanks me profusely for responding so quickly.
Birth is an amazing event. Even with a crappy strip.
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