Just the Worst Doula in the World

I heard this story from a doc...not sure when or where it happened.

The patient, who also happens to be an unwed mother, needs a blood transfusion because she has been bleeding. A lot. However, she belongs to a religion which forbids blood transfusions. At this point it is not yet an emergent situation but it could totally go that way. The doc is explaining the possible outcomes of different choices that the patient could make and the patient is explaining back to the doctor that, because of her beliefs, she doesn't want a transfusion.

Everything is very civilized.

And then the patient's sister, who is sitting in the corner of the room, pipes in:

You're already going to hell, you fucking whore...go ahead and get the blood so you can live to raise your own baby.

Not an ideal support person to have in the room, really.

Head? Vagina?

I worked December 23rd, 24th, and 25th. We had all planned a party on the 23rd -- which included awesome items like my salsa and P's fried chicken. However, when we got to work on the 23rd, we saw that someone had put up a sign informing us that our actual party was going to be on the 25th. Now, most of us were working these same three nights in a row. And we had kind of shot our catering wad by preparing whatever it was we brought for the 23rd. And, here in the shallow south? Lots of places where you could buy food are actually closed on Christmas morning. So, right off the bat? No one was expecting a whole lot from the 25th party. We ended up with homemade salsa and chips, taco soup (the kind where you throw a bunch of different cans of stuff together with some browned meat and it tastes surprisingly good) and various Chinese food entrees ordered from a place that, amazingly, was willing to deliver on Christmas night. At about one in the morning, after a fairly uneventful first half of the shift, we sat around and ate these items with a relative lack of holiday cheer -- and serious misgivings about how much gas we might be having later in the shift.

Then we get the call from admissions:

There's a lady up here who feels a head coming out.

Shit.

S and I grab a stretcher, gloves, precip basin and start for the front.

We should really run, we say to each other as we continue to walk fast.

My foot hurts, S tells me.

My taco soup and Mongolian beef are churning, I tell her back.

We start a modest jog.

Have I mentioned that it has been really slow ALL night? I have? Then imagine our surprise when we burst into a lobby FULL of people at 2 in the morning. None of whom, by the way, appear to be anywhere near pushing a head out. So S and I are running around the lobby with a stretcher asking people:

Head?

Head?

Do you feel a head?

Is there a head coming out of your vagina?

Head?

NO TAKERS!

Finally, we find this teenager around the corner talking on her damned cell phone. Are you the one who feels a head coming out. we ask her? She puts up her hand in the universal signal for, don't interrupt me I'm on the phone...

That's the one, we hear D from admissions say.

Rule #1: If you can still talk on the phone, delivery is probably not imminent.

Unusual Bleeding

The other morning I was admitting a patient fairly close to shift change -- about 0600. She was scheduled for a c/section in about 2 or 3 days, but her water had broken during the night, so she came in and we started getting her ready to have a c/section that morning. Several of us were coming at her from different directions trying to get her admitted, hydrated, labs drawn, ted hose on, preop antibiotics given, shaved - you get the picture. We were trying to get her in the OR before shift change so that we wouldn't end up having to delay a scheduled case. I was asking her questions and putting her baby on the monitor when I notice bright red blood on her abdomen. Not a lot, but enough to make me curious, plus it was all over my hands. Are you bleeding? I said, maybe a little bit sharply. A little, she told me, it started when my water broke. Hmm, probably that isn't where this is coming from, I thought. I excuse myself to wash my hands...which is when I noticed the huge gash in my left thumb. The cheap ass belts that hold our monitors in place sometimes have sharp edges...