Peanut butter crackers and TV dinners
We raced into the cold sterility and blinking-bright lights of the OR, bumping into the steel bedframe of the bed in our haste to deliver this baby as quick as possible.
Soon the beep-beep of mom’s heartbeat on the anesthetist’s machine was countered by the low, slow bum-bum-bum on the ultrasound, sounds of a baby’s heart in distress.
Our voices were quiet, but urgent.
“FHT’s 80s, catheter in, prep done, Dr. Simon is on his way, right?”
Hurry, hurry, hurry was the one constant running through our minds as the OR team quickly went about this business of preparing for the stat c/section. A baby’s heartbeat normally runs between 120-160 so hearing that slow beat made us hurry even faster. Losing a previously healthy baby is second only in a labor and delivery’s worst-case scenario to losing a previously healthy mother.
Now we could hear Dr. Simon and Dr. Garcia out by the sink. Dr. Simon’s booming voice was heard over the running of the water as they scrubbed their hands. The NICU team filtered in and was given a quick update.
We raced through the sponge and instrument count and the surgical time-out as the doctors gowned and gloved. Normally we would all be still and listening as this was done, but this was an emergency.
“Let’s do it.”
Dr. Harris, the anesthesiologist on call today, pushed the strong anesthesia to put the mom all the way under. We waited a few beats of the clock, then the surgery began.
Within five minutes a blue, limp baby was rushed to the radiant warmer. In another two minutes, the rest of us sighed with relief as angry cries came from him. We were good at recognizing the signs of smiles from the NICU nurses and RT, despite the masks over their faces.
“This little boy is a fighter! As soon as we can, we will take him out to the NICU to transition. I will call you in recovery when his daddy can come see him.”
“You need anything?” Lily asked, as she hurried by the recovery room.
“When you get a minute, I need a warm LR. Thanks.”
Surgery over, Julie, the nurse anesthetist this morning, and I moved the patient into the recovery room.
Labor and Delivery’s recovery room was off by itself and, as the recovery room nurse, I had to stay in with my patient so I was at the mercy of the charge nurse or Lily, the unit secretary (Or Jill of all trades, as we called her) to bring things in that I needed.
Patients who had had general anesthesia were especially vulnerable and took longer to “come around” than a patient who had just had a little sedation during surgery. I bustled around her bed, taking vitals, checking the level in her catheter, conferring with Julie about meds given and things to be aware of as my patient woke up.
An hour later I was wheeling my hilarious patient, Leigh, into her postpartum room. She had made me laugh for the last thirty minutes, once she woke up.
“Crazy! My last baby is the one delivered by emergency c/section. Three healthy, fast labors up until now – my last one in the elevator on the way up to labor and delivery – and this little squirt decides to scare us all to death. You’d better be a super laid back child after this, son,“ she says to her sleeping boy as she explained the wild morning we had to her next nurse, Suzanne.
I hurry through my report to Suzanne so I can throw back a glass of coffee like a shot before I take on my next patient (or two). It’s a busy day in L&D.
“Push, push, push!”
Joshua, the first-time dad’s face was red as his voice rose with each “push!”. I smothered a smile, holding back Heather’s leg as she strained to delivery her first baby. He had been one of my most enthusiastic and excited dads in awhile, asking twenty questions before I even got her on the monitor.
Her first labor had gone relatively quick. Now it was almost 7 and I really wanted to see her baby before I left for the day.
She had opted for just IV sedation, I was proud of her for sticking to her plan, even if it did increase my workload. I showed Joshua how to rub the heel of his hand into the small of her back when a contraction came. I helped her reposition frequently – rocking chair, bed, sitting on the “birthing ball’, standing with her arms around Joshua’s neck.
Most of our patients got epidurals, so it was always impressive when someone, especially a first-time mom, made it all the way through labor without one.
“I see her, Heather!” Sure enough, a wrinkled circle of wet brown hair was peeking out at us when she pushed.
I pressed the call light. When Lily answered, I asked her to send Dr. Jamison our way. It wouldn’t be long, and his office wasn’t on campus.
“You almost done?” a nurse asked, as she clocked out an hour later. We were all working late, due to the busyness of the unit that day.
“Yep, just need to drop this off at the lab.” I held up the specimen from the tubal Leigh had had after her c/section was done.
“I’ve got it.” Andrew, the scrub technician, took it from me. “I can take it on my way out. Sorry that I didn’t get to it earlier. The OR was a mess.”
“No problem. I completely understand. What a day!”
“How many babies did we have?”
“Ten, I think? But five were born within thirty-five minutes of each other. I checked, when I got back from the recovery room this morning.”
“Did you get to eat?”
“I had some peanut butter crackers at about 11:30 and finally had a TV dinner before I started pushing with my last patient. What was that – 4:30? You?”
“Tonight is a take-some-Advil-and-go-to-bed kinda night. See you tomorrow!”