Minutes Matter in Nursing

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My first day of orientation in OB, I watched a delivery for the first time and was in awe. That day, I watched everything unfold as it should. The mother delivered a pink and screaming baby, which was placed immediately skin-to-skin. The patient and her family surrounded me with a surge of emotions. They laughed and took pictures, talked about the baby’s hair and whose lips the baby had, and they were so overwhelmed by the beauty of it all, they cried. That day, I watched three other women deliver, and witnessed the same process unfold at each delivery. And it was that day, my first day of orientation, that I became hooked on the beauty of OB. Labor and delivery is breathtaking and magical. It’s overwhelmingly beautiful. But that isn’t this story. It wouldn’t take me long to find out that OB is not always about birth and babies. Sometimes no one smiles, cameras are forgotten and untouched, and tears fall freely from faces.

The next day I eagerly went to work, ready to take part in the magical moment of each delivery. Our patient and her family were excited about the birth of their first boy. Her daughters were fascinated with the fetal monitor and the baby’s heartbeat, which they said sounded like galloping horses. The mother allowed me to place her IV, even though she knew I was a brand new nurse, and I was so grateful I went to the gift shop and bought a little plastic horse for all three of her daughters.

I still remember this family and their delivery as if it happened yesterday. When her water broke, blood spread quickly, saturating her blanket. From the fetal monitor, we heard the sudden drop of the baby’s heartbeat. It was slow and sluggish, as if the baby was trying as hard as he could to keep going. My preceptor pulled the emergency cord and told whoever was on the other end to call any doctor, to open up the OR, and to get 4 units of blood. At the same time, she threw an oxygen mask on the patient and started bolusing her with fluid. Other nurses inundated the room, repositioning the patient and pulling anything out of the wall that was holding the patient hostage. Underneath the non-rebreather, the patient looked frozen and frightened. Tears escaped from her eyelids, squeezed shut. Her husband stood dazed in a corner, not fully understanding what was happening, but recognizing the urgency of our actions. I didn’t know what to do, so I touched his arm and whispered that we were going to the OR. But before I could even finish the sentence, the nurses and the patient and the bed were all gone…it all happened that fast. And as that patient’s mother ushered her granddaughters out of the room, the littlest one looked at the fetal monitor and asked what happened to the horses.

960

From the time the silent abruption declared itself, to the time the doctor pulled that limp and lifeless baby out of that woman’s abdomen had to be less than four minutes. But it was four minutes that he just couldn’t keep going. When the baby was brought to the warmer he didn’t make a sound, he didn’t make a move, and it hit me…this family would not take him home in four days. I watched as the nurses began to compress his chest, never taking their eyes off of him. I remember looking down at that mother, her eyes closed under general anesthesia, so afraid she would wake up and have to be told that her baby was dead. In the background, I could hear the nurse’s calm and steady voices—One and two and three and breathe. And after a minute or two, when I thought for sure that there was no hope, I watched the work of nurses compel a cry from that baby.

That day, in that delivery, I was engulfed by different emotions. Witnessing everyone’s efforts to save that baby, witnessing the urgency in everyone’s actions, I felt overwhelmed with gratitude and a sense of responsibility. Being a new nurse, I didn’t know what to do with it all, so I stayed in the corner and choked on the fear of what had almost just happened.

Nurses are in a secret kind of club. No one knows the work we really do, and the struggles we face every day we come to work. I couldn’t tell that patient that if we had taken a few more minutes to get to the OR, her baby would not have survived. I couldn’t tell her that if all the nurses had not worked together, she wouldn’t have taken her baby home. Sometimes our days are so bad and our patients are so sick. Sometimes our outcomes aren’t good, regardless of the hard work we do. As nurses, we can’t even talk to our own families about our bad days. We aren’t allowed, and it wouldn’t matter, because they wouldn’t understand anyway. Instead, we keep it all inside. It bottles up inside of us, exhausting any energy we have left. But we keep coming back to work for the love our patients and for the love of our profession.

Different events throughout my career as a nurse project in my mind like a reel from a movie. But my eyes only focus on one constant: the patient. Our goals have to be driven by improving outcomes for the people we take care of. As we enter into the New Year, I hope every single nurse knows that they are the only ones that can limit their potential. Do not let bad experiences or poor outcomes or busy days weight you down and tire you out. Use that to fuel the fire inside of you to enact change for our patients, for ourselves, and our profession. Imagine everything you could do that could affect your patient, or your hospital, or your community, or an entire population. Do not limit yourself, because I have seen what nurses can do when there is a sense of urgency, and I know that we are capable of anything. If you are a patient, know that you can also fight for better care and for better outcomes. We impact each other. We can change things together. And we have to work together to create a sense of urgency, because if I know anything from labor and delivery, it’s that minutes matter and everyone deserves a chance to witness the beauty of OB.

Until my next delivery ❤


42 thoughts on “Minutes Matter in Nursing

  • December 31, 2014 at 9:55 pm
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    So many of your articles make me cry because I’ve been there. As Im reading you recount your story, Im remembering my own experience similar to this. I absolutely love your blog & share it with my friends & family as often as I can because your right-they just don’t understand. And there’s so many days so many situations where you just can’t form an answer when your asked ‘how was work?’ Your blog often gives those answers I can’t put into words. Thanks so much for all you do, and for putting thoughts & emotions into words. ?

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    • December 31, 2014 at 9:58 pm
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      Thank you ♡♡♡ that was so nice. The first time I wrote this, the baby died. Then I made the baby survive. I can recall so many times where it went either way. ..

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      • January 3, 2015 at 5:21 am
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        Y’know, I thought that’s what I’ve read before! Over and over again, can I just tell you how much I love your blog?! You are one gifted girl!

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      • January 8, 2015 at 1:19 pm
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        Thank you that is so true life of a labor and delivery nurse

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      • January 30, 2015 at 2:55 pm
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        Wait, what? Can I ask what really happened to the baby in THIS true story? Because these three little girls and their horses are going to haunt me otherwise.

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  • December 31, 2014 at 10:23 pm
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    Thank you. Just thank you.

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  • December 31, 2014 at 11:41 pm
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    I love your blog. I worked as a Nursery/ NICU nurse for 13 years before I began to teach. I classify myself as a Mother/Baby Nurse because that was what I liked best. Two years ago I had to give up clinical after a mastectomy, chemo and radiation because I fell and shattered my left humerus on the radiation line. Every day I miss it. You make my heart either sing or cry based on your experiences. Thank you for being a voice for mothers and babies. My mission now is teaching nursing students to love mother and babies too in lecture. I am starting my 25th year of teaching. Keep writing.

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    • December 31, 2014 at 11:44 pm
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      thank you for such a sweet comment <3 i'm glad someone's teaching nursing students to love moms and babies!

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    • March 19, 2016 at 9:55 am
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      I had an OB tell me it’s the “best you can get ” BUT there are days, when it’s bad, it’s the most “awful you get.” When it’s good it’s really good, when it’s bad its,really really bad.

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  • January 1, 2015 at 1:30 am
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    I needed to hear this right now. I’ve always loved reading your stories, because like everyone says- you put all of our experiences into words. I had a baby die for the first time in my career last week (that it was MY pt) & it shakes you to the core. It makes you question if you’re in the right field. It makes you think you’ll never be good enough at what we do to save them all….. But as you said, that is what needs to be the fire. Thank you when I needed it the most.

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  • January 1, 2015 at 2:15 am
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    Reblogged this on dromedaryingoldcountry and commented:
    Two years after retiring I realize the toll of forty years of attending births. This Labor and Delivery Nurse speaks as if she is in my head. She gets it exactly right. And I cry every time.

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  • January 1, 2015 at 4:11 am
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    Thank you. I am a new nurse in OB and I had my first IUFD. That was one of my most challenging days. My fellow nurses explained to me what to expect, but there are no words that can describe what really happens.

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    • January 1, 2015 at 4:15 am
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      I don’t want to say it gets easier, but it does. It’s still horrible and gut-wrenching, but you’ll get better and not letting it affect you as much as it now. :( xx

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  • January 1, 2015 at 7:19 am
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    I found IUFDs to scratch the hospice itch I have. Love L&D, but felt very good about caring for the precious moms whose babies didn’t make it. It’s a different angle of nursing, but helps with the perspective.

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  • January 1, 2015 at 10:00 am
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    I was a patient who had a silent abruption at term. Upon arrival at the (large) hospital the same nurse who had helped deliver our daughter was waiting in triage. I think of her as our earthly angel. She was with us on both the happiest and saddest days of our lives. I’ll never forget her tears- her telling us that she would never forget us. I’ll always cherish memories of our floor nurse, too.. She brought my husband food against protocol, she had the perfect mix of guidance and tenderness..she witnessed the 24 hrs we had to memorize God’s fingerprints- she wrote on the white board how beautiful our son was- she discharged us herself- walking my wheelchair to the car & crying with me as we hugged. I know these days were very hard for our nurses, too. I will appreciate and love them for the rest of my life.

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  • January 1, 2015 at 4:09 pm
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    I have been working in l&d for 7 years & I still get butterflies in my stomach before I go to work. I work In a high risk hospital so we get some really sick patients both mom & baby. I can’t even tell you how many times I have questioned myself if I made the right choice. I have cried myself to sleep more times than I can count. Reading your blog is so therapeutic for me. Truly gives me courage & makes me proud, but most of all lets me know that I am not alone. Great work! Bless you sooo much for doing this, I thank you from the bottom of my heart.

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    • January 1, 2015 at 4:22 pm
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      lol thank you so much for that. I needed that after those haters busted my bubbles for ‘lies by a labor nurse’. lol xxx

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      • January 3, 2015 at 5:28 am
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        And that was a super funny article. Don’t let haters get you down. Most of us know the truth of the situation and if you can’t laugh at the funny stuff, life gets super boring! Lol. You gotta have a sense of humor to be in this biz. ;-)

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  • January 1, 2015 at 6:55 pm
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    This past Nov 8th, I threw a baby shower for my dear friend, 35 weeks pregnant. The kind of friend who comes over, unannounced, several times a week. She showed up looking horrible. I wanted to cancel the shower, but she pressed through, her breathing shallow, her face pale. We played games and oohed and aahed overt pretty little girly things. When the shower was over, I convinced her husband to take her to the hospital with or without her consent. I knew she was bad off, but I was completely unprepared for the text message I got from her husband. “The baby is dead. They are rushing Steph into surgery.” She was in heart failure. I rushed to the hospital, tears falling freely. I watched Rebecca’s terrified and grief stricken daddy hold her tiny body and sob. The doctor came in and told us another 30 minutes or so and my friend would have been gone as well. She spent a week in ICU, and a few more days in the hospital. She will be *months* recovering her heart function. The nurses there that first night, well, I suppose it wasn’t their job to take care of the husband and best friend, but they sure did. I talked with one of the nurses about how hard their job could be sometimes, because L&D isn’t always a happy place, and a loss like that must be hard on them. Thank you for all you do. Really. Thank you.

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  • January 2, 2015 at 1:29 am
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    Very heartwarming to read! My unit was a women’s surgical unit that got all of the IUFD’s. I quickly learned how rewarding it could be to work with these pts. I still keep up with some of these pts. I have some letters as far back as 30 years ago. The nurses can’t know how valuable they are and how much they touch others until they have done this job. Thank heaven for them and their compassion! !! Thanks so much for your blog!

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  • January 2, 2015 at 1:55 am
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    I’m currently a PNP, but started my RN career in OB, just as you did. I felt like I could have written the beginning of this, just like every good OB nurse out there could. The rest of the post, took me back. I remember those moments, and you just don’t really know if you’re not or haven’t been an OB nurse. As much as I like peds, my first love is still OB. Keep up the great work!

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  • January 2, 2015 at 2:35 am
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    I enjoyed reading your story very much. I have been an OB nurse for 28 years. Primarily in management and just recently decided to go back to the bedside. It was more difficult than I remembered and unfortunately my age got the best of me. I wanted to share those same feelings again as I did with many families over the years as a labor nurse. But my memory was not nearly as good as it once was. I left my position after three months. I had such a fear of forgetting something that was important. I couldn’t live with myself if I ever did something that caused harm to the patient and her baby.

    I will always be a labor nurse and where that label proudly, but as Kenny Rogers says you have to know when to fold them. I leave my chosen profession with pride and sadness. But I know I served my patients well years ago and even in the last three months. I am in awe of the nurses of today and may God bless you all.

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  • January 2, 2015 at 6:53 am
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    Just wow.
    I’m not an OB nurse, I’ve been an acute surgical nurse and educator for 25 years, so have seen my share of emergencies, but my experiences as a student doing maternity placement which stick with me. I remember that feeling of helplessness, when the nurses had gone quiet, looking at one another, and the teenaged parents were in blissful ignorance that their baby had a congenital abnormality. The babies with ambiguous genitalia, and their parents struggle to comprehend how this could be. The postpartum haemorrhage.
    I’m so glad to have found your blog. Thanks for letting people know how difficult, but how rewarding, it is to do what we do. Regardless of the field of nursing.
    I look forward to reading more of you!

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  • January 2, 2015 at 7:43 am
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    What an amazing perspective. This gives me hope as a new RN grad. I can’t tell you how much I loved reading this.

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  • January 3, 2015 at 4:17 pm
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    Thank you for this story. I sent it to my orientee, who thinks she’s not L&D material. I told her every shift she has the soul of an L&D nurse. I believe, one day, she will believe me! Please keep writing!

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  • January 3, 2015 at 4:41 pm
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    This is also my story, though I’m the momma on the table, hearing the hurry and panic around me. Instead of 4 minutes it was 20; instead of water breaking it was pushing! But praise God, we are the story of survival! Thank you for what you do!

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  • January 4, 2015 at 12:51 am
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    all of us at the iwk birth unit in Nova Scotia follow your stories and they all hit so close to home. Having had an experience much like the one you described on Christmas Day you should know that this rings true this year more than ever for us. Thank you for your stories.

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  • January 4, 2015 at 1:51 am
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    I’ve been a labor and delivery nurse for 271/2 years!! We all work as a team!!!

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  • January 6, 2015 at 1:15 am
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    Thank you from an old L&D nurse. You’re correct that unless you work in the department you really can’t understand the elation felt at each successful birth and the total sorrow when things do not go well. Love your stories. Makes tears come to my eyes. I worked 35 yrs in L&D. Obviously my passion.

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  • January 6, 2015 at 2:34 am
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    Shirley…….you have just risen to the top of my respect and love for you.I admire your love for your family
    and now for all of your very fortunate patients.
    With all my love……grandma Charlotte

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  • January 16, 2015 at 2:18 am
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    45 years nursing and the last 35 as labour and delivery nurse with crossover to postpartum some days. Have been there and it never gets less challenging. The patients and families are only a portion of the work we do. The support we give/receive from our sister nurses is wonderful. Retired now and miss OBS. Keep on working and leaning. Hugs to you.

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  • February 4, 2015 at 4:40 am
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    I am a nursing student getting ready to start my Peds rotation and, later this year, begin my OB rotation. This story literally brought me to tears. I know that loss will happen… I also know that no matter how much I prepare myself to try and accept that, it will hurt. It will be hard. It may even feel impossible to get past. I just hope that I can carry on like so many other nurses do, to keep fighting for the all other patients who need them. Thank you for this story and a new perspective.

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  • March 16, 2016 at 8:03 pm
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    This is so refreshing and heartwarming to read as an (almost) new grad. I’m so grateful for all that I have gotten to experience in my preceptorship, but every pregnancy/delivery is unique and I know that I still have so much left to learn. I’ve always had a love for this patient population and I know that caring for these mothers and babies will keep me coming back, even after the hard days.

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  • March 16, 2016 at 9:31 pm
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    This post could not have been written at a more fitting time. I am a new grad on my sixth month of orientation to an LDRP unit. Yesterday I was “catch” for a baby who came out of a STAT section lifeless. Apgars 1/1. It was the longest 10 minutes of my life working with my preceptor and the Pedi doing chest compressions, bagging, and intubating the baby. I tried to explain the feelings of pure adrenaline and raw emotion to my fiancé, but only other nurses truely understand how terrifying moments like these are. Especially as a “rookie”. Thank you for writing this and reminding me that no matter how much experience you have, you are never completely prepared for traumatic births.

    (Happy to get report today and find out the baby is extubated and doing better)

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  • March 18, 2016 at 7:49 pm
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    Just yesterday I asked my mom “Mom what do you think I do at work?”. Naturally she responded ” You’re working in the OR as a nurse”. I am not sure what we were talking about exactly that made me go on this tangent but I went on to explain “Everyday, I am holding it all together. I am seeing my patients, spending my mere minutes with them awake but making them feel comforted and safe, regardless of what may be enusing in the OR around me. I am coordinating the room, smoothing ruffled feathers, precepting, descalating the many strong personality’s that converge in my OR, I am being an excellent nurse, and Team player not to forgetting to mention all the other responsibilities I have volunteered myself for on my unit. I am not letting the patient know how hard our day has been, or how challenging their case will be. I am not letting one team members less than stellar attitude and work ethic effect the care our patient will receive on my watch. I am constantly going” and fade out… I love to read nurses stories, I love to learn about other units and how they function; it reminds me that though we are in different areas of practice we are bonded by our principles and hard work. I too agree it can be challenging to explain how you simultaneously had the best and worst day. How a good simple day can leave you completely drained and a challenging spastic day can leave you invigorated. It certainly is an interesting ride.

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