Saturday, December 6, 2008


Sunday was the final day of our maternity rotation, of which I spent the last few hours in a rocking chair, holding a tiny baby boy, as he drifted in and out of sleep. Baby Stan (not his real name) was all boy, five pounds of boy to be precise. And that's a week after he was born and brought to the NICU, or Neonatal Intensive Care Unit. The NICU is where I've spent the past two weekends of my time in the maternity ward. It's been an incredible experience. But first, a brief reflection on my recent time in Labor & Delivery.

After having witnessed my first birth the previous week, I was seriously considering switching my preceptorship (internship) from pediatrics to L&D. The intensity and passion of the delivery experience had been intoxicating, and it was the first time I had seen nurses connect with their patients in a manner that resonated with me. In the following week I spoke with my clinical and classroom instructors about my new interest in L&D, and received strong support. I also met with my adviser, who happened to be the only male nursing instructor in the program. I knew he had spent his nursing career in public health working with families, but had forgotten that he had actually been an L&D nurse for a few years. So it was with great enthusiasm that I entered my next weekend in the L&D ward.

When I arrived on the unit, I was assigned a patient who was almost fully dilated; her first baby was only hours away. My nurse and I introduced ourselves, and mom and dad said they were fine with me taking part in the delivery and care. As I was examining her cervix, I was surprised to feel the fuzzzy little head of her baby. Woah. I can still feel the thrill as I write these words. She had taken great care of herself during pregnancy, but had not been to any prenatal classes. The nurse taught her how to push for about fifteen minutes, which she did like a mother of four. She did so well that the nurse turned to me and said, "Call the doctor. This baby is ready!" Picking up the phone and speaking those words to the doctor once again sunk in the reality that nursing is becoming my world.

The first delivery I had experienced was intense, like a volcano of love. The mother had been screaming and writhing on the bed as the family rallied around her, and when, after six hours of intensity, that baby came out and rested on mom's breast, nothing else existed in the world. Well, this pregnancy was different.

It was a beautiful birth. All ten minutes of it. This mom, who had not been pregnant before, pushed just three times and birthed a perfect 10 pound baby boy. Not only was this child beautiful, but he looked like had just had a bath! He cried for about ten seconds, spent a few minutes on mom's chest, immediately latched to her breast, and "passed" our assessment with flying colors. Within an hour plans were being made to transfer the family to the postpartum unit to heal and bond. A perfect hospital birth.

Since things went so smoothly with mom, I helped assess the new baby. He was as cooperative as he was beautiful, and by the end of the assessment, I realized that I was much more drawn to caring for him than for his mom. I soon became aware that all this time during my maternity rotation I had, in a way, begun working in pediatrics, which is why I became the Macho Nurse in the first place. I've loved just about every minute of both my classroom and clinical experience in maternity, and now I get that it's really because I'm finally working with children, my true calling and passion. That night I sent my clinical supervisor an email requesting that I work in the NICU the rest of the weekend. No one else was scheduled there, so she gave me the green light.

Saturday morning I walked into the serenity of the NICU, excited to finally be working with children again. I was assigned to work with a cheerful and helpful nurse. She was explaining the histories of the two babies we were caring for when a team of nurses burst through the door pushing an infant resuscitation bed. They rushed past us and my nurse told me to go watch what they were doing. As I was standing there observing, a nurse called out for some tape, which no one had, except me. I handed her a strip of tape and was promptly given another task. I spent the next four hours working with this team to get the baby ready for surgery. It was an incredible experience working with them, and ended with my gowning up for the surgery, which was amazing. The child was born with gastroschisis, which means the intestines had herniated outside of the abdominal wall and actually developed outside of the child. The surgery entailed putting the intestines, and in this case the stomach as well, back inside of the child's abdominal cavity. The surgeon explained the entire procedure to me. After the surgery, the nurse and I wheeled the baby back to the NICU. I spent the next day taking care of this child. It was an incredible weekend!

Back to Baby Stan. Rocking this little guy was the perfect way to wrap up my two weekends in the NICU. We worked well as a team, Stan and I. His tiny head fit perfectly in the small of my arm, the rest of his bundled body tucked up against my chest. His nostrils gave the slightest hint of his breathing, the flicker of his eyelids evidence of his dance with sleep. He breathed; I breathed. While rocking my new friend, I became aware of how long it had been since I had meditated, since I had really slowed down and been still. It had been a long time. Nursing school can do that to a guy. Stan breathed. I breathed. My little five pound yogi.

During my two weekends in the NICU, I was fortunate to experience the vast range of this unique and powerful world. Be it rushing a newborn to surgery or holding a baby until mom arrives, it's all about being in the moment, being present to the needs of the child. Being with these new human beings has reminded me again of the precious gift of life, its sacredness, its strength, and its frailty. Being present to all of this can be both daunting and exhilarating, but as one of my mentors once said,

What else do you have to do?