New Year, New Lives

January 4th, 2012

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By , BSN, RN

Stephanie Posada, BSN, RN, brought in 2012 with a cry—a baby’s cry. Posada is part of the Labor and Delivery team that helped bring Houston’s first baby of the year into the world. Born at 0045, the infant arrived via cesarean section into the waiting arms of her family and the skilled medical and nursing team who does this kind of thing every day and night.

”I’ve been a nurse now for 15 years. I was three years in Cardiac and Med/Surg then I just fell into OB (obstetrics). The little hospital I was working at needed a nurse who could float to OB—burp babies, a pair of extra hands, by no means birthing babies. The unit was growing so fast anything was a help, even just answering the phones. They offered me an internship after my second trip over there. I liked it so much, there was so much teamwork, I immediately said yes.”

Did you take part in a nursing internship?

”In three months I was trained. You just weren’t trained in OB and L&D (labor and delivery) either. You were in the nursery, in post partum, sometimes you did all of LDRP (labor, delivery, recovery, post partum) with your patient. It was baptism by fire. This was a tiny hospital that tripled in size in a very short time. “

So it was pretty different from being a Med/Surg floor nurse, I guess?

”I quickly realized how specialized it is. It is so much fun dealing with healthy moms. It had been hard for me on Med/Surg. There was a trick to dealing with the elderly patients. And, patients died each week. They were dying, they were old; they came from nursing homes. I stopped crying because it was so routine. It makes you hard.”

I bet there are a lot of great stories, do any in particular stand out?

”There have been a couple of bests. The most recent was the day after Thanksgiving. This mom came in all big and pregnant, her water had broken in the middle of the night and she had her 4-year-old and 7-year-old with her. She and her husband had nowhere to take them and all their help had left after the holiday.

”I only helped out with this birth so I said I’d help with the kids. The 4-year-old wouldn’t wake up for anything. We put her in a recliner in the room and she stayed asleep. The 7-year-old was another story. She was, “What are you gonna do now, are you gonna start an IV on Momma, then what?”

”When Mom was ready to go I put the 7-year-old in a chair facing the window. “Tell me when I can turn around; tell me when my sister is here,” she kept saying. I was standing at the warmer, which was next to her chair and I kept telling her, “Once your sister comes out you can help.”

”The baby’s head crowned, she started crying and the 4-year-old was still asleep. We caught the baby, she was fine and the 7-year-old turned around all excited. “Oh, that’s her,” she said sounding disappointed. The baby was still all cheesy and bloody, but after I cleaned her up she said, “Oh, that looks more like a baby.” It was priceless. I let her put the cap on and help with the foot printing and listen to the heartbeat. The Mom just kept thanking us and all I could say was, it was great; you have great kids, no problem. And, the 4-year-old was still asleep.”

This all sounds very busy, what are the simple pleasures of being an OB nurse?

”Deliveries that are a complete surprise—boy or girl? They just want a healthy baby. And, the one’s who don’t know and don’t want to know until the baby is born; they are usually OB nurses themselves.”

You stayed at your first hospital several years, then what?

”Most of my moms were the same, pretty healthy, pretty straightforward births. I was looking for a challenge so I started to travel. First I went to Austin, TX. Then, I found my challenge when I went to Albuquerque, New Mexico. After I got there I found out the hospital I was at was the number one trauma hospital in the state. My first day was like a scene from ER. It was crazy but organized. I was hanging around orienting when everyone’s pagers went off; there was trauma case coming. It was an MVA (motor vehicle accident) where one driver hit a pregnant mom and her kid in their car. All I did was watch. We all ran to the ER trauma room and a couple of doctors gave her C-section right there and then. The baby was alive and preterm. It wasn’t even a sterile and the OB doctors did it all in two minutes. “

That sounds exciting and like a real learning experience.

”Being at UNM (University of New Mexico Medical Center) was great. They were all about teaching. Half the nursing students who came through there were on the BSN track or headed into midwifery. On the [OB] unit half the hall was art lines and Swann Ganzs, patients with pre-eclampsia. I had found my challenge.”

We have talked about lots of great things but there must be some bad days, what’s that like?

”My first day at UNM was a trauma and my last day there was hell. We lost a mom and a baby. You don’t really see that these days. In our world of medical knowledge, computer and technical knowledge, that's just not supposed to happen. And, you can’t prepare for it.”

Posadas related to me the loss of the pre-eclamptic patient who was transported for three hours to UNM. She described to me how the patient came through the door seizing, then went into DIC, a code was called, and she was rushed to the main operating room where she died.

”It was my last day of work there and I was supposed to be leaving for home immediately. I had to stay to talk about the case and I didn’t know when or if the lawyers would depose me. “

What do you tell nursing students who are considering going into OB?

In order to love OB, to love L&D, you’ve got to love the law. Eventually you will meet a lawyer. The longer you do this, you will be hit with a deposition. The family who loves you and has plans for their kid to go to Harvard will turn on you in a second. “

And, why are you an OB nurse, why are you doing this?

”The happiness—you get to share with these families the best moments of their lives.”

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