©Arlene R. Taylor PhD
It was my first night shift on the obstetrical unit, my first hands-on experience outside of clinical labs. As a nursing student I’d recently finished the OB/GYN course work, which made me eligible to work as a nurse’s aide. Such a deal, and I needed the money!
After receiving the shift-change report, the charge nurse gave me my assignment. With flashlight, clipboard, and mercury thermometers standing upright in a metal carrying tray, I took TPR’s on all my patients and carefully recorded the results on the worksheet’s midnight column. That task finished, I was to answer call lights, assist the charge nurse as needed, physically look in on each patient at least hourly, and take vital signs or perform other patient-care procedures as ordered.
Before long two women arrived in differing stages of labor and I helped with their admission process. One delivered quite precipitously (it was her ninth child), and I watched the nursery RN take the little bundle down the hall to make it more presentable. And then it was time for rounds again. Taking my trusty flashlight and making as little noise as possible, I checked the patient in the first room. She appeared to be sleeping. So did the second and third patients, as well as the fourth, a post-partum mother who had birthed twins the day before.
Out in the hall and ready to move on to the next room, I became aware of a slight sense of dis-ease. I paused but there was nothing to put my finger on. Everything had seemed to be okay with that fourth patient. What is this? I thought. Shall I ignore it? Maybe I’m just tired. After a moment’s deliberation I reentered the previous room.
The woman was lying motionless, eyes closed. Her breathing sounded normal, but the sense of disquiet persisted. Gently I touched her arm and spoke her name. No response. Hmmm. I took her pulse. Thready. Her vital signs had been within normal limits at my last check. Hmmm, again. I placed my hand on her abdomen to feel for the fundus of her uterus, hoping I’d recognize if it felt okay. It didn’t. The word boggy came to mind. Now what?
Carefully lifting up the bedcovers, I peeked beneath them and gasped. I don’t know what I had expected but it wasn’t the bright-red blood that was seeping out from under her gown. I went flying out the door to the nursing station and reported the situation. The charge nurse listened to my brief recital and immediately went into action. She grabbed the telephone handpiece with one hand, began dialing with the other, and ordered me back to the patient’s room to start fundal massage.
The largely silent and semi-dark ward came alive with lights, sounds, and movement. The house supervisor arrived, increased the flow rate on the first IV and started a second. An intern dashed into the room on the heels of the OB resident, who took over the fundal massage. A classic glass bottle showed up from the Blood Bank and, after its contents were verified, was hooked to the second IV. “Run it wide open,” the OB Resident barked, “and find her husband.”
Within minutes a 6-foot hunk burst into the room, hair disheveled, black stubble standing out against pale skin, and sweats that only partially hid red-and-white stripped trunks. The man’s fear was palpable as he sagged against the wall. The OB resident briefly explained what had happened and the measures that were being taken. Watching with anxious eyes, the husband murmured periodically,“How could I live without her?”
My job was to track and report vital signs. As blood and IV fluids flowed into her veins I pumped up the sphygmomanometer again and again. What a relief to hear the blood pressure rise to a safer range and to feel her pulse stabilize and strengthen. A second unit of blood was started and the patient gradually began to move restlessly. Before long she opened her eyes and was able to answer questions coherently. “Good,” the intern commented, “looks like we were in time to avoid brain damage.”
When the OB resident finally announced that that she was out of danger, the room gradually emptied and I went to the nursing station to catch up on charting. A few minutes later, the patient’s husband stopped by to express his gratitude. The charge nurse pointed in my direction and said, “This little student nurse is the one who discovered your wife's hemorrhage.”
Taking my hand in both of his (mine completely disappeared from view), and with tears trickling down his cheeks, he said, “I will never be able to thank you enough.”
Startled and a bit flustered at being singled out, I mumbled something about that was the least I could do. Simultaneously I experienced a new and rewarding sense of elation. I, a little student nurse, had actually done something to make a positive difference in the life of this family! I will always remember the gratitude that shone from his eyes as he returned to his wife’s room.
Next morning I had no difficulty staying awake in class. My mind kept wandering back to the events of the night before. What if, I thought to myself, I had fudged on my rounds? What if I had ignored my sense of unease and failed to investigate further? Good grief, the patient might now be dead, her husband a widower, and the twins motherless, to say nothing of the grief among extended family and friends!
That experience changed my life. For one thing it gave me a new perspective on my aunt, my mother’s older sister, in whose nursing footsteps I had followed. She was the charge nurse on duty that night, having agreed to work a double shift. The memory of her grace and competence during the crisis, and the credit she accorded me for my small part in the drama, have lingered over the years, especially since that was the one and only time she and I worked together in a hospital setting.
It also increased my interest in the human brain and the way in which it functions. It triggered a commitment to pay attention to my intuition, hitherto somewhat disregarded based on rhetoric I’d heard growing up. And it created a conscious desire on my part to craft a personal mission—to make a positive difference in the lives of others, on purpose. Funny thing. In the search for ways to fulfill that mission, the life I’ve probably impacted the most has been my own.
—June 8, 2005