presence

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?











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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?



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