One Day, One Shift, One Year
Submitted by Maria Hatter, RN, BSN, CCRN
It was June 3rd, 2006; I had officially been an RN for one year. Yeah! That morning I arrived full of enthusiasm to start my shift as per usual. My excitement was due to the fact that I LOVE being an emergency room nurse. In my mind every shift I worked brought me one step closer to my goal of being a trauma nurse.
On this particular morning, the wind was about to be taken out of my sails- I just did not know it yet. Prior to the start of our shift, the charge nurse wanted to review dress code and professionalism with the nursing staff. This was the direct result of a patient feedback- someone who also happens to be a staff nurse in our hospital. In short, we were told that we were not professional or polite to our patients. I took this talk personally- despite the fact that I had not been involved with this particular patient.
That being said I went about my day as I would any other day. I was assigned to the GYN area in the ED. I was responsible for five patients, two of whom I had just received from triage. I was quickly completing nursing protocols in an attempt to stay ahead of the doctors and in an effort to expedite the patients’ flow through the ED when patient number six rolled through the door on a stretcher escorted by a paramedic rescue crew. As I scrambled to clean and put linens on the stretcher in the hallway the paramedics allowed the patient to use the bathroom. When suddenly I heard a blood-curdling scream emanate from our tiny hallway bathroom. I grabbed a pair of gloves and rushed in. The patient was hovering over the toilet, half undressed with a fetus hanging down in between her legs. I was calm, patient and kind to the patient.
Another nurse had seen me rush in to help the patient and he came to the door to ask if I needed help. I stated that I needed a general instrument tray, a washbasin, and a doctor. He returned with the equipment that I had asked for and an ER resident. Unable to allow the doctor into the bathroom due to the lack of space, the resident talked me through what steps I needed to do-clamping the umbilical cord, how to cut it, placing the baby in the wash basin and securing the remainder of the cord so that it did not draw back up into the patient. Then I assisted the patient to a room that had been cleared for her. I assisted the obstetrics resident to deliver the afterbirth and helped clean the patient all the while educating this young patient about the nature of labor and delivery; managing to keep her calm and as comfortable as possible. I explained to the patient what steps we were taking to help her and why certain interventions were essential to her care. I offered her the opportunity to say goodbye to her infant as a means of closure without pressuring her. The patient declined. She had not wanted this pregnancy initially and now she remained true to her convictions. I was her primary nurse until she left the emergency department to go to the floor. I assisted the obstetrics resident to complete all the necessary paperwork. Then, I cleaned and walked the infant to pathology.
In the quiet that comes after the storm, I was able to discern that the patient had been attempting to terminate her twenty-one week pregnancy at a local clinic but had left the facility prior to the completion of treatment. Although the life of the fetus had been terminated at the clinic; she had walked out of clinic in the middle of having her labor induced because she was having pain that she felt was not addressed by the medical staff taking care of her. A rescue unit had been called by the clinic. The rescue unit was told that the patient was a female with abdominal pain. She was picked up a few blocks away from the clinic walking towards our hospital to seek treatment for her pain.
At the end of the day, I was appreciative of the fact that my forty-minute commute home allowed me the opportunity to decompress and transition back into my roles of a wife and a mother. I reflected on everything that had transpired that day- I had surprised myself! I was able to stay in the moment. I had been calm, patient, and empathic towards my patient. I was non-judgmental, supportive and kind. I had behaved like the kind of professional I had aspired to become. Despite my own personal moral beliefs against abortion, I was able to care for the patient in the best possible manner. And to put the proverbial cherry on the sundae, the obstetrics doctor that I had worked with that day appreciated my demeanor and professionalism so much that she took the time to inform my managers and staff both verbally and in writing.
Now with my sails re-inflated I maintained my course to become a trauma nurse.
Maria C. Hatter, RN, BSN, CCRN