Admittedly, the morning was not starting off in my favor. I had hit snooze twice after sleeping very little through the night and realized I had fifteen minutes to get ready and get out the door. In a hurry, I packed a leftover soup tupperware for a lunch container the size of my arm, not bothering with a repackage. Despite being in a hurry, I wanted to make sure that I ate at least something small for the off chance someone would be giving birth so I shoveled down a muffin and ran out the door. Self care wise, I was not mentally prepared for this clinical day, however it ended up being one of the best ones I’ve ever had. 

The nurse I was with came in ten minutes late during the report, so she was a little frazzled starting off the morning. Despite my own rush to get out, I was still my usual fifteen minutes early and I wasn’t sure how I’d feel learning from her as we began settling in. After those fist twenty minutes of settling in,  soon after she showed that she was the one of the best, if not the best nurse I have ever learned from in my clinical experience. Because of her lack of self care as mine, we both started off the morning a bit slower looking up the patient’s electornical medical record, but soon after we got into the groove which is where this story begins. 

When we got to the hospital our clinical instructor said that one of the patients was in active labor. Of the three of us nursing students, all equally wanting the opportunity, we duked it out and I happened to be the winner of rock-paper-scissors. This was the only time I saw a patient give birth during clinical rotation though I had seen a couple births during a summer externship that I did. Going into it, admittedly I was a little nervous. What if I passed out because I didn’t eat enough breakfast? What if she didn’t want me in there at all? I was also nervous because the patient was my age. Would she think I’m not qualified enough to be in the room? Would she feel less inclined to allow me the opportunity? All of these doubtful thoughts were rapidly debunked when I met this patient and truly got to know her. 

Around 8:15 a.m, the nurse I was with was talking the patient through what the process would be like, what she can expect, and how her visitors and I could help her through it. I didn’t fully know what I was signing up for when I won the rock-paper-scissors. I had no idea how many hours the entire thing would take until the nurse said that the average push time for a new mom tends to be 2-4 hours. This past summer I had seen a vaginal birth during my externship, but when I showed up the baby was already starting to come out, so I never knew about the hours leading up to it. But, I was up for the challenge!

The nurse I was with in the introductions asked the patient where she wanted each of the people helping her. She chose to have her mom holding her hand by her head and to have the boyfriend and I each with one leg with the nurse obviously at the foot of the bed. The nurse laid out the expectations for the patient’s boyfriend and I of how to best support her legs. In a partially joking, but serious matter the nurse explained to the boyfriend that he’d be on the window side with the couch and that if he felt light headed at all just to take a seat. We all laughed but I knew that if it came to it, that couch would save that man’s dead from a nasty gash from the windowsill. Selfishly, in that moment I was thinking of the little muffin I had had and absolutely hoping deep inside no matter what went down that of course the patient would be fine but that I too would not need the utilization of the couch. However, the boyfriend and I were totally good to go.  

I was right at her side as the nurse coached her through many contractions. The concept of pushing through the pain and the amount of positivity and coaching was very unique from my other clinical experiences. At first, I felt I didn’t know what was the right thing to say and how to best help in an encouraging verbal way. Shortly after a little while I began getting more comfortable coaching the patient as well and eventually it was me coaching her through each of the pushes during one of the half an hour time spans towards the end. 

Between her contractions, I really got to know the patient. It wasn’t the typical small talk at clinicals between head to toe that you’re asking the patient about their thoughts on the weather, and the oh you grew up in New England too, what did you do for a career, how’s your family, the usual anything to try to connect with the patient for just a short time. I got to know her favorite color, the shows she liked, how she felt about becoming a new mom and much more. We spoke about the complexities of naming children and how difficult of a time she and her boyfriend had picking thier son’s name. We even talked about her favorite tv show and how her son’s middle name was because it was her that was the name of her favorite character because he was the bravest and that’s how she wanted her son to be.

About an hour into her contractions the boyfriend and I both had sore arms and backs and the patient could tell. She said are you guys good? We all laughed as she could see the height at which we had her legs was slowly dropping centimeter by centimeter as the boyfriend and I tried to power stance our legs as much as we could but I couldn’t hide the slight shake in my arms. Of course I immediately jumped into denial of my tiredness it and said absolutely, how are you doing after all, you’re the one giving birth! She was the kindest patient I’ve ever had. How could she be thinking of me and my arms when she’s the one who is in active labor!? As we continued to build rapport, we were cracking jokes left and right and I never imagined a hospital experience could be filled with so much joy and that in the patient’s most vulnerable state she was still willing to share even more of herself.

The couple minutes after she gave birth, was when I felt the increasing  gap of care with regards to the communication to the birthing individual. I could sense the difference in the communication that not only the nurse had given to the patient previously, but also the difference in the communication between the nurse to the patient and the doctor to the patient. As the boyfriend and the mom swarmed the baby through his first APGAR’s, weight, height, etc, the doctor and I were the ones who were left at her side momentarily. The patient could sense that the doctor was taking a bit of extra time and that he was trying to move with increased pace. She had a 2nd degree laceration; I watched blood trickle out of her like a slow faucet. She asked in the most serious voice am I okay? A borderline, am I going to die, the kind of tone that chilled me to the core. At first I didn’t answer her question because I didn’t want to promise the patient anything I didn’t quite know, and I felt it would be more reassuring to have the person who was actively stitching her up be the one to say that she was okay. When the doctor didn’t answer at first, she repeated the question and I knew it was my time I could step in as I was right at her side.  

How could we as health care professionals have not talked her through this experience enough that she was actively worried that she was going to die? When she asked for the second time after waiting a couple seconds for the doctor to say something, I jumped in. I began explaining what the doctor was doing and how it happens often with births just because of the size and way that babies come out sometimes compounded with the amount of pressure in that region. Though I wasn’t an expert, I could tell what little information I walked her through was easing her mind and I could see her hand relax a bit more on her grip to the bed and her eyes softened at the corners. Though I do agree that given who was in the room and what was needed, prioritization wise the nurse made the right call to take care of the infant. However, it really stuck with me how ineffective communication influenced the experience for the patient. 

The physician continued stitching her up, eventually the patient held our second patient who was the baby and the rest of the family came to the room. In past simulation experiences my peers and I have joked after about the extent to which I very lengthy with conversations to my mannequin patients but after this day, I knew I would never do it any differently (with exception to sheer emergencies). As she looked me right in the eyes and thanked the nurse and as we were walking out I could tell in the sincerity of her voice how much we had helped her. The nurse let the boyfriend and I both hold the placenta later on and medically, from a scientific perspective of learning about the Factor V and also everything else, I was absolutely geeking out but it wasn’t the depth of knowledge I got from this experience that made it stand out to me, it was really how much I felt like I made an impact. I was fighting back tears walking out of that room knowing I helped in every way I could in the biggest moment of her life thus far. This experience really gets down to the fundamentals of nursing, the raw emotions. In all honesty, I cried when I got home that day because I truly felt like I had made a difference in her life and I came to appreciate more of everything my own mom had done for me.