Monday, November 24, 2008

on being born

Yesterday I explained birth to a pregnant woman.

Well, at least part of the process. Me, a guy with no kids and no chance of becoming pregnant. How, I ask myself, could I possibly be qualified to teach a pregnant woman
anything about having a baby? In the past three weeks I've seen one vaginal birth and one Cesarean, and have done assessments on a few newborns and new moms. I doubt if I could even get a small part on Gray's Anatomy with that resume.

As I've mentioned here before, nursing school has thus far, for various reasons, ranged from being disappointing to discouraging to despairing. I've been disappointed in the quality of the school and of the clinical experience. I've been discouraged about not being inspired by my experiences in the hospital (although I've really enjoyed the occasions when I was able to get to know my patients). And I've felt despair at the prospect of my experience never changing, that I would never become passionate about nursing.

And then I saw my first birth.

For those who have witnessed this miracle, you know that words cannot do it justice. I've tried to describe it to friends, but it's been like trying to describe God or Goddess or maybe even chocolate. One is appropriately humbled by the attempt to get one's mind around birth, the human manifestation of creation. Sure, we can come up with all sorts of polysyllabic words to help us think we understand what's going on here, but I think we're only fooling ourselves.

It is not the understanding which inspires such awe in us, it is the feeling that comes with witnessing the phenomena of birth of which I am speaking. It is this feeling that allows us to know that something amazing and incredible and beautiful has just happened. Beyond words. Beyond art. Perhaps it is our connection to the experience of birth, our most shared experience, that has kept us from really messing things up. Perhaps, conscious or unconscious, this connection is the real source of our hope.

The power of birth isn't just about the new life of a child coming into the world. It's about
the unbelievable strength and courage of the mother, bearing such pain as she has never known, and knowing the deepest of love. It's about a man learning what really matters. And it's about the love of friends and family, coming together to support this mother and welcome this baby. All of this is part of what has made my one weekend working in labor and delivery the only time I have been truly excited about becoming a nurse.

The very first patient I was with in L&D needed a cesarean section. They were clearly disappointed at this dramatic change in their birth plans, but also grateful for the technology that would be safely bringing them their baby. I worked with the Advanced Life Support (ALS) nurse, a women passionate about her job and eager to teach me. The baby was immediately brought over to us, quickly cleaned and evaluated. The father of a child born via c-section gets to see the baby before the mother, and this dad was right there with us, speaking to his child. I was amazed that dad's voice immediately caused the child to stop crying and turn in
the direction of his father. Newborns cannot see, yet this child seemed to be looking right at his father, his familiar deep voice a beacon of comfort amidst the noise and lights of the OR.

Prior to starting this rotation, I had wondered if women would be comfortable having a male nursing student take part in their delivery. I remember thinking that at least I would be able to connect with the fathers. I couldn't have been more wrong. During both of the vaginal births I attended, the mothers and her family were completely welcoming and appreciative of my presence. When I left, they gave me lots of appreciation and compliments, telling me I was going to be a great nurse. But not the dads. They barely spoke to me, but I don't think it had much to do with me. They seemed to be in shock. But once that baby was in their arms, they lit up and even smiled at me.

This past Sunday a few of us sat in on a class for expecting couples. All five of the couples were having their first child, full of excitement and questions. The nurse educator led the class in exercises to try out some of the possible positions for labor and we, the nursing students, were encouraged to work with the couples during the activity. I worked with two couples, and much to my surprise and delight, was able to answer all of their questions. I felt completely comfortable and confident talking with them about the birth experience, and left knowing that I had done my little part in supporting them.

What makes all of these positive experiences even more meaningful is the fact that in one weekend I had more excitement, enthusiasm. and inspiration than in the entirety of the program up until then. I am no longer discouraged about having chosen to pursue a career in nursing, and am really looking forward to my upcoming weekends working in labor & delivery.

I used to think that the only significant way to really "make a difference" was to save a rainforest or stop a war or reverse global warming.

Who coulda known?


Saturday, November 15, 2008

holding the flashlight

Today I was splashed by a baby.

She didn't mean to splash me. It just happened. This beautiful little girl was too busy being pushed out of her mommy to even notice me. But I noticed her.

I first met her when the doctor asked me to reposition the overhead light. It was only the very top of her curly-haired head, wet with fluids and mineral oil the nurse had poured to help the delivery, but it was her. Mom cries, "Pleeeease just pull her out of me! Please!" We tell her she's doing great, that the baby's almost here. The next contraction comes. Mom grabs my shirt and almost pulls me onto the table. I give mom my hand, plant my feet and help her hold her leg up.

Push! The little girl's head pops out, this time for a few seconds before retreating back into mom. Grandma and sister and aunt are cheering. Dad, looking a bit faint, is fanning mom with a bandage. "Push again! We're almost there!" the doctor yells. Mom screams, "Mama!", puts Grandma in a headlock (no kidding), and becomes a mom with one final push. And then, the little girl splashed me.

With one final mighty push from her mother, this little marvel of life enters the world in a storm of fluid and blood and squeals and you can just feel the love and oh my god she's here and I'm here and wow and the baby looks good and give her to mom and dad needs to sit down and the baby's crying and we like that and where's that nipple and Grandma says "That's (grandchild) number 13!" and sister's taking pictures and I'm standing there watching the placenta come out of the mommy and up to the baby and give dad the scissors and he's not really sure what to do and snip!

that's one
cute baby girl.


Saturday, November 8, 2008

back in the game

I have officially turned the corner, in more ways than one, with nursing school. This auspicious occasion is due mostly to the children I met this past weekend, some big ones, some little ones, and some really, really tiny ones. I'll call this my "Florence Nightingale" moment, which lasted the entire weekend.

Our first day of the weekend rotation, Friday, was spent meeting our clinical instructor for supervision.
While my first two supervisors were extremely nice and supportive, I can't tell you how happy I am to finally have an instructor who is truly an educator. Her lab coat even says, "Nursing Educator." We took a tour of the hospital, met some of the maternity nurses, and I left feeling excited about returning the next day. This is no small event for me; during my three rotations in adult med-surg, I often woke up not wanting to go to the hospital.

I was not disappointed on my first day. I was assigned to the NICU, the Neonatal Intensive Care Unit, mostly filled with children born prematurely. My nurse was a cheerful and helpful mentor the entire day. She loved her job and it showed! Each nurse in the NICU has two patients, and both of ours were in good shape when I met them. One was recovering well from surgery; her mother had not left her side in many days. They were hopeful about leaving in a few days, and mom had been preparing well for the transition home. The nurse had been teaching her how to take care of her baby, and she passed on her motherly wisdom to me.

Our other patient slept the entire day, which at first wasn't the greatest learning experience for me. Around 10am the mother showed up with "big sister," who was very excited to see her very little sister. They didn't speak much English, so I got to practice my Spanish most of the morning. Spending time with this five year old filled me with a joy that reminded me why I'm becoming a pediatric nurse. That was much needed medicine for this guy.

On Sunday I worked in the postpartum department, where moms and dads bring their fresh, new babies. I was assigned to another fabuloso nurse. Before we entered our first patient's room, she told me that she wasn't going to explain anything to me in front of the parents, and that I should act like I knew what I was doing. This was the exact opposite of my entire time in med-surgery; most days it felt like I was standing on the edge of the pool afraid to jump in. It really helped to have someone push me in! So five minutes later I've got my hands on this woman's stomach assessing the size of her fundus (uterus). Wow!

Our next mom and dad ended up both being school teachers, so I was able to really connect with them, which helped the macho nurse fit right in during the breastfeeding teaching. I later heard that other students (of the female variety) had actually done hands-on teaching of the art of breastfeeding. Not sure if that's in this male nurse's future, but we'll see. I was incredibly aware of being a man as I stood there next to the father, watching his wife breastfeed his new baby. We smiled at each other as his wife and son bonded in a way that he and I will never know.

This coming weekend I'll be working in labor & delivery. I'm hoping to see a vaginal birth, and hopefully catch the baby ;-)

But I'll be happy if I get to hold the flashlight.