Three Little Ones

This clinical shift was a busy night full of laboring down, pushing, and a change of plans.

The first patient I took on with my preceptor was a first-time mom who was dilated 10 cm,

100%effaced, and at station -1. Since this was her first birthing experience, orders were to have

her labor down and see how far contractions and gravity would move the fetus. I performed a

cervical exam to feel the head of the fetus and no remaining cervix. The time came for

this patient to finally push and soon meet her little guy. After about 2 hours of pushing with only

some progress, the physician finds the baby to be posterior, explaining the little progress in

decent of the fetus. A vacuum assist device was placed on the baby’s scalp to pull while the

patient pushes. The reward for pushing was granted 30 minutes later when a precious, baby boy

let out his first cry. The baby was taken to the bed warmer for a quick assessment, but I remained

by the patient’s side to make sure she was doing alright. I could see her emotions of joyous tears

forming in her eyes. She had done it, she had become a mother to a healthy little boy. The birth

was over, but our work had nearly begun. We continued with uterine rubs and infant vital sign

checks. We helped the patient attempt to breast feed during the 2-hour recovery time until she

would be transferred to the Mother Baby Unit. Unfortunately, the baby was not interested at first

and later had difficulty latching on. After giving the patient a bed bath, we transferred her to the

other unit where they were successful with her breastfeeding. On our arrival back to the Labor

and Delivery Unit, my preceptor gained another patient.

According to the fetal heart rate and uterine contraction monitor, this patient’s fetus was

in distress. There were multiple variables and late decelerations with an absence of uterine

contractions. She was only dilated to 1 cm. This was looking like it would have to be a C-
section. The physician came in and gave the news to the patient. She was so disappointed, it

seemed she did not want to have a C-section. I experienced a moment of sadness for my patient

as I watched her receive this news. My preceptor and I prepped the patient for surgery and as we

were about to wheel her to the operating room (OR), she asked for her cervix to be checked

again, hoping that by some miracle she was progressing. To her dismay, it was the same news,

only dilated to 1 cm. We wheeled her into the OR. This was my first C-section to witness so I

was stoked to watch. The time was about 2:00 in the morning and the patient and her husband

were exhausted. The surgery commenced, and a little boy was born and taken to the NICU for

observation. The patient wished so much she could hold him right away, but due to his condition

and her surgery, that time of bonding was put on hold. She was transferred to the PACU for

observation as well. She progressed from consuming ice chips to eating applesauce and toast.

Food helped with the nausea she had felt, and pain medications were given to help her get

comfortable. An hour into recovery, the NICU was ready for the dad to see their new son. He

was taken to the NICU by another nurse while my preceptor and I stayed with the patient to

monitor her pain and bleeding. Thanks to technology, our patient was able to see her new baby

via FaceTime. Our patient was finally regaining sensation in her legs, enough to where we could

get her cleaned up and into a wheelchair. The time had come for her to, again, meet her little

guy. Off to the NICU she went where 40 minutes was filled with mother-baby bonding. The

night was coming close to an end, but our work was still not done. On top of making sure

everything was charted, my preceptor gained one last patient for the night. She came in earlier

that morning dilated to 7 cm and was now 9 cm. This was her third baby, so we knew this

would be a quick delivery. Six o’clock came and her water broke, but my preceptor could not
find the fetal heart rate. She sent me to have someone call the physician for him to come to the

unit fast. We handed off report to the day-shift nurse taking over. When the physician arrived,

another baby boy was born within 20 minutes, with a healthy heart rate. In only 12 hours and

30minutes, three little guys were born to three healthy mothers.