Reflections on Women’s Health
I
From the Emergency Room to the Birthing Room
Illustration © iStock Collection / thinkstockphotos.com
I became a nurse because I wanted to be a midwife, but my first nursing job was in a busy emergency department (ED). It was the only job I was offered out of school, and I jumped on it. I felt shocked and privileged at the opportunity, and although I faked composure, the chaos of the day-to-day work felt overwhelming to me. It took me 3 months in the ED to stop feeling completely useless, 6 months to feel like I wasn’t the worst ED nurse on the planet, a year to feel like I was good at my job and 2 years to know I needed to leave. My co-workers in the ED were tough folks. They could keep their cool during codes and look at nasty wounds without blinking. But whenever there was even the suggestion that a birth might happen in the ED, my friends would freak. The same way my heart would race when
*All names in this essay have been changed.
540
© 2014, AWHONN
life12169.indd 540
Emily Fitzgerald someone was dying, theirs would race when someone was being born. It was around that 2-year mark that a woman was wheeled into my ED room on a stretcher with a fetus’s head stuck in her cervix. At first, when I looked between this 19-year-old woman’s legs, I didn’t recognize what was coming out of her vagina. “Is that her uterus?” I thought. I wasn’t thinking clearly. Her approximately 17week fetus’s body was red and breech, and halfway out of her own. As what seemed like dozens of staff members flailed around the room grabbing blood pressure cuffs and tourniquets, as is their custom, I looked into this beautiful teenager’s eyes and asked her if she wanted her partner and her mother with her. They’d been left on the other
continued on p. 539
http://nwh.awhonn.org
03/12/14 12:28 PM
continued from p. 540
life12169.indd 539
on Women’s Health
December 2014 | January 2015
Reflections
side of the curtain when it was pulled by a panicky staffer. The woman nodded and I guided her family to the head of the bed. They kissed her and held her hands as her uterus contracted involuntarily. A moment later, the resident guided the fetus out and quickly put it into a little bucket, just like a fish. It looked like a bright pinky-red frog, no more than 10 inches long. When things calmed down and the ED staff left the room, I told my patient that she could decide if she wanted to see the baby. She didn’t respond definitively. Later I asked her again and she said that she did. I told her that the baby was very tiny and very red. I wrapped the fetus in a tiny blue drape from the delivery tray. It felt so delicate, I was afraid a limb would come off if it wasn’t supported. So I placed it in an emesis basin, and wrapped the basin in another drape. I brought the tiny bundle into the room and gave it to its mother. While her own mother and the baby’s father looked on, she unwrapped the drape and looked at her baby. “It’s a boy?”, she asked me. I nodded. I stood there for a moment, expecting them to need some explanation from me, or some comforting. But they simply examined the baby quietly, so I left them. They appeared calm, accepting. After 20 minutes or so, the woman’s mother came out and said, “She’s ready.” I carried the makeshift bundle to our lab. I slowly, carefully, picked up a fetus with my gloved hands and put it back into the small bucket, like a Tupperware container, with the woman’s name on it. I looked at the fetus for a long time, never having seen one before—at least not like this. Then, I closed the lid and left it there next to the tubes of blood and cups of urine. As the woman and her family left the ED, they said “Thank you.” I’m not sure how to
I needed to get closer to what brought me to nursing in the first place—the drive to care for women and to be reminded of and fascinated by where we all begin describe how I felt. I’m not sure I know how I felt. Not grief, not trauma. But nor did I feel nothing. Perhaps it was simply an urge to demand dignity and to execute utmost respect. I went home that morning knowing that the time had come for me to leave the ED. I needed to get closer to what brought me to nursing in the first place—the drive to care for women and to be reminded of and fascinated by where we all begin. NWH
Emily Fitzgerald, CNM, is a recent graduate of the University of Illinois at Chicago and lives in Minneapolis, MN. The author reports no conflict of interest or relevant financial relationships. Address correspondence to: [email protected]. DOI: 10.1111/1751-486X.12169
Nursing for Women’s Health
539
03/12/14 12:28 PM
I
From the Emergency Room to the Birthing Room
Illustration © iStock Collection / thinkstockphotos.com
I became a nurse because I wanted to be a midwife, but my first nursing job was in a busy emergency department (ED). It was the only job I was offered out of school, and I jumped on it. I felt shocked and privileged at the opportunity, and although I faked composure, the chaos of the day-to-day work felt overwhelming to me. It took me 3 months in the ED to stop feeling completely useless, 6 months to feel like I wasn’t the worst ED nurse on the planet, a year to feel like I was good at my job and 2 years to know I needed to leave. My co-workers in the ED were tough folks. They could keep their cool during codes and look at nasty wounds without blinking. But whenever there was even the suggestion that a birth might happen in the ED, my friends would freak. The same way my heart would race when
*All names in this essay have been changed.
540
© 2014, AWHONN
life12169.indd 540
Emily Fitzgerald someone was dying, theirs would race when someone was being born. It was around that 2-year mark that a woman was wheeled into my ED room on a stretcher with a fetus’s head stuck in her cervix. At first, when I looked between this 19-year-old woman’s legs, I didn’t recognize what was coming out of her vagina. “Is that her uterus?” I thought. I wasn’t thinking clearly. Her approximately 17week fetus’s body was red and breech, and halfway out of her own. As what seemed like dozens of staff members flailed around the room grabbing blood pressure cuffs and tourniquets, as is their custom, I looked into this beautiful teenager’s eyes and asked her if she wanted her partner and her mother with her. They’d been left on the other
continued on p. 539
http://nwh.awhonn.org
03/12/14 12:28 PM
continued from p. 540
life12169.indd 539
on Women’s Health
December 2014 | January 2015
Reflections
side of the curtain when it was pulled by a panicky staffer. The woman nodded and I guided her family to the head of the bed. They kissed her and held her hands as her uterus contracted involuntarily. A moment later, the resident guided the fetus out and quickly put it into a little bucket, just like a fish. It looked like a bright pinky-red frog, no more than 10 inches long. When things calmed down and the ED staff left the room, I told my patient that she could decide if she wanted to see the baby. She didn’t respond definitively. Later I asked her again and she said that she did. I told her that the baby was very tiny and very red. I wrapped the fetus in a tiny blue drape from the delivery tray. It felt so delicate, I was afraid a limb would come off if it wasn’t supported. So I placed it in an emesis basin, and wrapped the basin in another drape. I brought the tiny bundle into the room and gave it to its mother. While her own mother and the baby’s father looked on, she unwrapped the drape and looked at her baby. “It’s a boy?”, she asked me. I nodded. I stood there for a moment, expecting them to need some explanation from me, or some comforting. But they simply examined the baby quietly, so I left them. They appeared calm, accepting. After 20 minutes or so, the woman’s mother came out and said, “She’s ready.” I carried the makeshift bundle to our lab. I slowly, carefully, picked up a fetus with my gloved hands and put it back into the small bucket, like a Tupperware container, with the woman’s name on it. I looked at the fetus for a long time, never having seen one before—at least not like this. Then, I closed the lid and left it there next to the tubes of blood and cups of urine. As the woman and her family left the ED, they said “Thank you.” I’m not sure how to
I needed to get closer to what brought me to nursing in the first place—the drive to care for women and to be reminded of and fascinated by where we all begin describe how I felt. I’m not sure I know how I felt. Not grief, not trauma. But nor did I feel nothing. Perhaps it was simply an urge to demand dignity and to execute utmost respect. I went home that morning knowing that the time had come for me to leave the ED. I needed to get closer to what brought me to nursing in the first place—the drive to care for women and to be reminded of and fascinated by where we all begin. NWH
Emily Fitzgerald, CNM, is a recent graduate of the University of Illinois at Chicago and lives in Minneapolis, MN. The author reports no conflict of interest or relevant financial relationships. Address correspondence to: [email protected]. DOI: 10.1111/1751-486X.12169
Nursing for Women’s Health
539
03/12/14 12:28 PM
