All Nurses Share a Secret

secretts

The majority of days I work, I leave feeling exhausted, as if every ounce of energy has been drained from my body. My feet throb and my scrubs feel heavy with sweat and hard work.  My legs ache from all the running around and constant back-and-forth movement from room to room, but somehow, my baby-weight from last year has not managed to melt off. Sometimes I’m short with my husband for no reason at all. Sometimes I’m short with my daughter.  And even though I spend more time at work with my patients than I do with my family, when I’m home and have five minutes of quiet time, I inwardly groan when my baby wakes up early from a nap and takes away whatever stretch left I have of “me-time.”  All of this leaves me in a constant state of “I’m-so-tired” and feeling like a candidate for the worst-mom-of-the-year award.

And work never gets easier. Every day I feel as if we’re delivering more babies and I feel like moms are coming in with more problems.  Even though the information is out there, so many women are misinformed about inducing their labor.  Every week I work, there seems to be a near-miss of someone who comes so close to having the worst possible outcome.  And when we walk off of our unit to go home, no one knows what kind of day we had. We can’t talk about how great or how hard our patient was, we can’t detail how great or how bad our day was, and we can’t mention how great or how difficult the providers were who we worked with that day.

Recently, I was laboring a mother who was progressing nicely and the provider on call was in no hurry.  I couldn’t have asked for a better start to my day.  I didn’t feel rushed to get anyone delivered, the provider was content with letting labor progress naturally.  Because the patient was contracting adequately and making cervical change, Pitocin hadn’t even been mentioned.  I had actually eaten breakfast and was planning on what to order for lunch with all of my coworkers. I walked out of my patient’s room trying to decide between burgers and Mexican food to hear a scrub tech say that she was going to go open up the OR. I could feel the sense of urgency in the air.

I was working with a handful of new grads that day, so I tried my best to stay calm and collected.  I walked into the only other room that had another mom in labor, ready to ask my coworker if I could do anything for her.  The patient’s partner was standing at the head of the bed, holding the patient’s hand. The patient’s mother and sister were seated in the corner, ohhing and awwing over a swaddled baby in their arms, completely unaware that a pool of blood was collecting below the bed.  The provider was seated in between the patient’s open legs, sewing up some sort of perineal laceration.  Laps soaked in blood were scattered around the physician.  She called out orders for labs, she called out orders for medications, she called out for instruments…but she never stopped trying to repair the bleed.  I didn’t end up asking my coworker if she needed anything. I walked out of the room, called for the charge nurse, grabbed an 18 gauge needle, grabbed more Lactated Ringers, and went back to start a second IV. I barely had time to flush it before the patient was gone, taken to the OR less than 10 minutes after delivering her baby.

I picked up the laps, heavy and saturated with blood, and tidied up the room the best I could.  I knew that if time went by, her family would come back and see the delivery room for what it really looked like: a trauma scene.  For now, the patient’s family did not ask many questions, they did not know to be concerned. For just a moment, I watched her family as they held the baby and I prayed that the patient would make it out of the OR to see her first child.

When I got to the operating room, I saw that it was full of nurses and scrub techs.  Two nurses were hanging blood, another nurse was giving the physician Cytotec, scrub techs were holding different parts of the patient and handing different instruments to the physician, and another nurse was writing everything down.  The anesthesiologist was diligently monitoring the now-intubated patient and her vital signs. Seeing “the dance” already in progress, seeing that everyone was already performing their role, I stood back in the corner and waited for them to need a runner for more medication.  Everyone was so calm and focused. Everyone moved with purpose. And when I finally left the OR, the patient was alive, but had narrowly escaped a hysterectomy, with an EBL of 3500mls.

When the patient was transferred to ICU, her family came back-and-forth from ICU to labor and delivery, since we were now caring for the baby.  Every time we saw them, they thanked us.  They were so happy over the birth of their first baby, their first granddaughter.  But every time I saw them I wanted to tell them the truth. I wanted to tell them the secret. I wanted to shake them and whisper in their ears…you don’t know, but your wife/daughter/sister almost died. Did you see her eyes roll into the back of her head and did you see all that blood in her bed? Did you know that things were so bad? …that came close to being the only baby she had. I wanted to tell them that if it weren’t for her physician, if it weren’t for the nurses and the scrub techs, if it weren’t for that anesthesiologist, they would be leaving the hospital trying to figure out how to raise a baby without its mother. But I couldn’t tell them that. I couldn’t acknowledge all of the secret good work that we did that day, or how well we all did it.

So if you’ve ever been the patient or the family member who watched as a nurse’s step quickened, or if you’ve ever seen a nurse magically get help, even if you never heard them ask for it, know that every single thing we do has a purpose.  Know that your health is always our top concern.

And if you’ve ever been the nurse who tried to stay calm and collected, or the nurse who simultaneously worked with the people around you to save a patient in so many different ways, know that I share your secret. I know how many times we have wanted to tell a patient how close they came, how lucky they were, and how thankful every healthcare provider was that things turned out alright.  Know that we all share this secret in one way or another.  My only wish for you is that you are surrounded by coworkers who will know their role in your dance, and that your dance produces the very best outcome.  And we may all be in a constant state of exhaustion, and we may not win any parent-of-the-year awards, and maybe no one will ever know the real work that we do, but we all have one thing in common: what we do and what we do together makes a difference in people’s lives every single time we put on scrubs and go to work.  And even though we can’t talk about it, because no one will understand, remember that we all share this same secret.

Until my next delivery ❤

And for any maternal-child nurse other there…Quantifying Blood Loss …because 500mls is sometimes 800, and 800 is sometimes 1200… (right?!?)


27 thoughts on “All Nurses Share a Secret

  • October 27, 2014 at 2:29 am
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    Do y’all ever use the BAKRI balloon for moms that are hemorrhaging? It is literally a life saver. I truly enjoy your blog. I have been an L&D nurse for 30 years. I have loved every minute of it.

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    • October 27, 2014 at 2:31 am
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      one hospital I work at does, and the other one does not (but we have them at both). sometimes it’s hard to teach an old dog new tricks. lol thank you for reading my blog. I have loved every minute…. so far. lol

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  • October 27, 2014 at 2:38 am
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    I hemorrhaged a bit after my second child. I guess it was’t bad; they gave me some drugs to make the blood clot but I was inwardly freaking out b/c of the ER episode where Carol hemorrhaged and had to have a hysterectomy(i figured the nurse would either find that funny or irritating). I never forgot how calm and soothing she was. Thank you for the blog and what you do every day.

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  • October 27, 2014 at 8:55 am
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    omg…love this blog! QBL is a scary thing. Recently had a mom who did lose her uterus, total QBL in room prior to OR was 4300. Yeah…the dance steps were a little faster that day. And her family member who was with her knew just how bad it was because when I went up to visit the mom in ICU she hugged me and cried and thanked me for being so calm and so patient with the million questions she was asking all while I continued to work and save her family. All I kep thinking in my head while I was working was “this momma has 3 other babies at home who will never understand why she never came home if I can’t help “fix” this.” Scary moments. But I would never give up what I do. I share your secret!

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  • October 27, 2014 at 10:44 pm
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    Thank you for telling us what really goes on behind and in front of the scene, God bless all of you for what you do!

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  • October 27, 2014 at 11:09 pm
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    I am not a nurse, just a caregiver for elderly people, but I love your blog! I was within 30 minutes of dying when I had my daughter 21 yrs ago from eclampsia w/HELLP syndrome. I owe the drs and nurses at Sentara Norfolk Hospital and Kings Daughters Children’s Hospital my life and my daughter’s life. They saved us.

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  • October 28, 2014 at 4:29 am
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    I was an L&D nurse since 1975 and a traveler for 4 years of that. I’m retired now but love to read your blog. It kind of makes me feel like I’m still in the game. I can relate to everything you say and have probably had that experience at some point. Thanks for what you’re doing!

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  • October 28, 2014 at 2:09 pm
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    there are far too many near calls at your place of work… something statistically is amiss.

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    • October 28, 2014 at 2:30 pm
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      The near calls happen anywhere and everywhere–at any time, and with ANY delivery (complicated or not, and with or without risk factors). We have runs of them from time-to-time, and months where almost every delivery has no complications. Many times, there are more stories of complications during deliveries, if you are delivering at a higher risk hospital. More complications mean higher risk, so yes, you would see more at a ‘larger’ hospital.
      This also doesn’t mean these close calls happen every day, or even that week. Many of these are stories we remember from our years of service. The stories stick with us.
      I have personal experience with several high risk hospitals, and a community hospital. I remember stories from each place I’ve worked. Those stories get shared many times over the years.

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      • October 28, 2014 at 4:01 pm
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        @bensbabe. I couldn’t agree with you more. These close calls, or bad outcomes happen everywhere. I used to work in a large unit with a very high risk population where we would see these things frequently, but I also see them where I am now and we do a third of the deliveries as my previous hospital and our clientele is much lower risk. In order to make that judgement call you need to compare apples to apples And know all of the statistics.

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  • October 28, 2014 at 2:20 pm
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    We had something very similar happen this week at work….on night shift, when we have so many fewer staff members to take care of it all during the “dance.”

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  • October 29, 2014 at 5:19 pm
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    Reading this, I was curious why no one bothered to update the family on the gravity of the situation.

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    • October 29, 2014 at 8:19 pm
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      Typically in these types of situations, we prefer to let the physician that is primarily caring for the mom share the details of what happened. Other nurses or residents, etc may briefly tell them, “your wife is bleeding excessively so we are going to the OR to try and stop it.” The OB is usually high-tailing it back to scrub an prep a fast as possible. After they are done in the OR the OB will go back and fill the family in on specifics. Hope that helps!
      Ps. Love the blog! ?

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      • October 29, 2014 at 8:44 pm
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        You took the words out of my mouth. Lol I didn’t respond bc I was thinking…they’re obviously not in these situations. The doctor is tied up!

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  • October 29, 2014 at 10:43 pm
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    I am also a labor and delivery nurse and I absolutely love your blog! It is exactly what we do….when I read your stories it’s like I am standing right there experiencing it all with you. Keep up the great writing! Thank you for sharing what we labor and delivery nurses do!

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  • October 30, 2014 at 8:43 am
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    never forget, when yall run into this room, i am watching everyone else
    i feel like, we who hold down the fort, don,t get the glory but are just as important

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  • December 5, 2014 at 2:20 am
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    I was a maternal near-miss patient myself. Unknowingly I woke up in ICU without my uterus. I had a total of 12 transfusions of blood product with an ebl of 4600. The severity of my situation didn’t hit me until 2 days later when I went to the postpartum floor. Your words are absolutely haunting yet beautiful and help to give me some insight of what was happening while my life was on the line. My entire team was amazing and I am so thankful for them. I will never forget the kindness they showed me during recovery. I’ll always have a special place in my heart for several of the nurses and my OB who literally had my life in his hands. You all do amazing work! THANK YOU!

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