“Now caught up in my own personal funk, I felt like a trapped animal.”
ICAME TO WORK tonight with a bad attitude. I brought irritations and squabbles from home with me and did not manage to leave them in the dressing room where I changed into scrubs. My assignment was to a labor room with two patients in early labor. I introduced myself in Spanish and told the two women to let me know if they needed anything. I hoped they didn’t ask me for much because my heart simply wasn’t in it tonight.
As the night progressed, our chronic short-staffing left all the labor nurses confined to their rooms. Merilee, who was making a valiant effort to get to each of us for a half-hour respite, was repeatedly called back to cover emergency deliveries. Usually, I accept this situation with grace. It’s the reality of working here. Now caught up in my own personal funk, I felt like a trapped animal.
So it was no smiling angel of mercy who greeted a sixteen-year-old brought to my labor room at about 2:00 a.m. The transporter informed me that the ER resident had checked this young lady and found her to be four centimeters dilated. I asked Jackie, my new patient, to move from the stretcher onto the labor bed. Cursing furiously in Spanish-inflected English, she inched over onto the bed. That about ended her cooperative spirit. It seemed I had a patient with about the same temperament as her nurse, only Jackie felt freer to express her emotions.
I tried to get the leads for the fetal monitor attached to Jackie’s tight little abdomen. She thrashed about and could not, or would not, cooperate. At the same moment, Vanessa Cordova arrived to see our new patient. The beautiful Latina resident observed the trouble I was having eliciting any cooperation from the fidgeting teenager and did not lose a moment in getting tough.
“Now look at me, young lady. You’re going to stop that kind of behavior. You’re going to let the nurse put those things on your belly so we can see how your baby is doing. In a minute, an intern is going to come and put an IV line in your arm. Right now, I’m going to examine you to see how far along you are. If we can, we’ll give you some pain medicine. If you’re old enough to get pregnant, you’re old enough to behave like a grown-up.”
Accepting a glove from me, Vanessa approached the bed to do a vaginal exam. Jackie continued to pitch and toss in the bed. She would not open her legs to allow the slender, raven-haired resident to do the exam. Vanessa put her free hand on Jackie’s knee to nudge the girl’s legs apart. Jackie proceeded to smack her hand away.
That did it.
“I don’t have to put up with this, you know,” Vanessa informed her new patient in a disgusted tone.
“I didn’t want to come to this dump anyway,” responded Jackie contemptuously. “I’ll get my boyfriend to take me down the street to _________Memorial.”
“Fine,” commented Vanessa sarcastically. “Let Memorial have the pleasure of your company. We’ve got all the business we can handle without you.” She then stripped off her glove and left the labor room without a backward glance.
My former irritability had fled somehow in the midst of this little drama. I scanned the room to exchange saddened looks with Angelique, the midwife on duty this night. Vanessa’s behavior was not helpful or therapeutic in this situation. I wished that she could have scraped up a little psychological savvy in dealing with this admittedly difficult teenage patient. We were all a lot older and a lot better educated than this tough young woman.
I waited for a bit until a nasty contraction subsided and then, in a calm voice, I coaxed her.
“Look, Jackie, I know you’re in a great deal of pain. You can go to __________Memorial if you like. But realistically, they won’t be able to do anything different for you. You’re in hard labor now, and if I am right, things are moving along pretty quickly. Won’t you let us help you?”
The now teary-eyed Latina looked up at me through a tumble of dark curls. All her former bratty attitude appeared to crumble.
“I’m just so-o-o scared,” she wailed, again gripped by a whopping contraction.
I went out to the resident desk where Vanessa was working on charts. I told her about the turnabout in our patient’s sentiments. Vanessa had calmed down by now too.
“OK.” She sighed. “Get an intern to do her IV. I’ll come back to check her in a bit. If she’s far enough along, I’ll order some Demerol. Maybe an epidural would even be better.”
Things were to proceed along distinctly different lines from that point on. There was to be no IV, no Demerol, no epidural. Unlike most first-time labors, Jackie was dilating almost by the minute. When I checked her, I could feel no cervix in the way of a hard little head. Instead of the hour-long period of pushing one might expect with a first baby, Jackie went on to bring her baby down in three to four contractions. Soon, a fifty-cent-sized view of baby’s dark hair was visible.
As the intern and I were pushing Jackie’s bed out of the door to take her back to delivery, her boyfriend arrived. Informed that only minutes remained before he was to become a father, he complimented Jackie affectionately:
“M’ija (my dear little one), you done good!”
Jackie looked at me with self-conscious eyes, and we both laughed. “Yes,” I commented to both, “she did great.”