The Shift From Hell

What does a reunion of retired nurses talk about? Of course…the shifts from hell. Most nurses can come up with many through their careers, but there’s always the one that stands out above all others. This is certainly the case for me.

I was working the night shift at a 20-bed hospital in Cozad, Nebraska. Back in the late 70’s they staffed the night shift with one RN and two aides. Occasionally, an LPN would be scheduled instead of an aide. This was the case this notable night…which in many ways was a blessing because the LPN could pass medications and chart where the aides could not. At the beginning of the shift, I anticipated an easier night than usual because of this. But then….various formidable patients began arriving through the unlocked ER entrance. (Had it had a lock, I would have been tempted to use it before the night was over.)

The first one to arrive was an expectant mother, second time around. No big deal, except OB was my least favorite department. (I tended to get diarrhea when I would drive into the parking lot for my shift and see the labor and delivery lights on.) My confidence in this area left something to be desired. But in a small hospital in the seventies, you had no choice. The RN was responsible for all the areas – Med Surg, ER, ICU, and OB. So whenever an OB came in, I’d try to smile, say a desperate silent prayer, and get on with it. This second time mom was sprinting along fairly fast in her contractions….but not delivering before the second OB walked in. Ugh. The nurses had all heard about this particular mom that would be coming in at some point. She had a bicornuate uterus, meaning it is divided partway or all the way by a septum of tissue down the middle. She would be considered high risk when she came in. Her doctor had informed us that she would likely go into labor early. She followed the text book and was checking in tonight at 7 months.

Normally, I would have had my aide or LPN to help get her to bed, allowing me to stay with the first mom. But they were both in the nursery, feeding 5 hungry, crying babies. This many, by the way, was a capacity unknown to our small hospital. I don’t specifically remember, but I have to wonder now if it wasn’t a full moon. Nurses believe in such things.

Unfortunately, I wasn’t the only one under stress. Because I was tied up with the two active OB’s, Marcella, my LPN was now in charge of everything else which included the nursery, the already delivered moms, and the fifteen patients on the med/surg floor. That’s a lot to deal with, even before the emaciated, elderly woman fell out of bed. The stress triggered Marcella’s lungs to protest and immediately sent her into a severe asthma attack. After the aide helped Ms. Crandall back to bed, and determining she was only mildly shook up, she ran down the hall to inform me that Marcella was off duty for a while puffing on a rescue inhaler.

In the meantime, my first OB delivered a thriving baby boy. I was now in the throngs of post partum care – massaging a boggy uterus, taking vital signs, foot-printing the newborn, etc. It had been a while since I’d been able to check on Risky Gal so I scurried down the hall between uterine massages to do just that. This weary Mom was hoping for a report of significant progress following the check. “No change,” I hated to inform her, but secretly glad I would have some time to chart. I stayed with her a few minutes before rushing back down the hall. After witnessing the strength of contractions, I elected to call her physician and give him an update. He ordered an xray to rule out cephalopelvic disproportion, ( too small of a pelvic opening to accommodate the baby’s head.) Back in the seventies we weren’t doing routine sonograms on OB’s in our area. Once the xrays were processed, Jerry, the tech, came to me and said, “Did you know she was having twins?” he said with a very straight face.

“You’re kidding,” I looked for any indication that he was, but couldn’t find it. He ushered me into the radiology department to see for myself. Oh no, I mused. This woman has a bicornuate uterus and a baby on each side of the septum and she’s only seven months along. I could only imagine how small these two babies might be. “Why me, Lord, ” I sputtered. “I don’t even like OB.” 7:00 a.m. wasn’t going to get here fast enough! And wouldn’t you know….now her cervix was beginning to do what it’s supposed to do.

The next call was to the doctor. I knew what he’d say. “Get the Kearney Neonatal Team notified that we are sending her their way.”

That was all fine and good, but that cervix wasn’t having it. She was now 8 cm’s and too late to transport without risking delivery in route. My only saving grace would be the morning shift arriving. I glanced out the window to a welcoming sight. I could make out the houses across the street. Maybe Risky Gal will hold out until reinforcements arrive.

I decided that morning, that Risky Gal deserved to be put in my will. She not only waited for the day shift to arrive but for the Kearney Neonatal Team as well. What’s that verse…oh yeah….weeping may last through the night, but joy comes with the morning. Amen! I sighed with relief because high risk OB is really not my thing. The delivery room was in plentiful and very capable hands. I slipped out to do my night’s charting, and for once I wouldn’t complain about the paperwork.

Until next time, keep on readin’ and I’ll keep on writin’.

Those twin boys would be right around 45 years old now. They had no long term effects from being born early and coming from a bicornuate uterus.

Marcella recovered from her asthma attack soon after using her inhaler and finished out the shift.

The author recovered after a couple of good nights’ rest.