Our own Somewhere In Time...

“Travel is like love, mostly because it’s a heightened state of awareness, in which we are mindful, receptive, undimmed by familiarity and ready to be transformed. That is why the best trips, like the best love affairs, never really end.” 

          ~ Pico Iyer

The "Mighty Mac" aka the Mackinac Bridge

     We recently returned from a 5 day trip up to northern Michigan. When I was in high school my family moved to Michigan and I first traveled to this area. It is a lovely, lovely place, and I wanted to share it with my husband. We drove up there in about 8 hours, and stayed in an inexpensive hotel in Mackinaw City. From there we toured around both northern lower Michigan, the Upper Peninsula, and the straits of Mackinac between the two. We took a ferry out to Mackinac Island, which is located in the middle of the Mackinac Straits. This is the area where Lake Michigan and Lake Huron meet. 

     Mackinac Island is a small island, completely dominated by tourism. There are no automobiles on the island, so travel on it is either by horse-drawn vehicle or bicycle. There is an old fort there, first built in the late 1700's. The town is quite small, but loaded with tourist shops. It is well-known for fudge.  

These handsome guys were pulling a carriage full of tourists.

     The morning we traveled out to Mackinac Island was clear and cool. The ferry ride out was fun because there were two elementary school groups on our ferry. The enthusiasm of the students was catching-- so much so that the ferry boat captain took us on an inpromptu side trip under the Mackinac Bridge and back... something I had never done!  

     Once on the island, we rented bikes and began the 8.3 mile trip around. Both of us were a little unsteady on the bikes at first, but we both agreed it came back to us pretty quickly... like riding a bike?  We biked along the shoreline, and had wonderful views of the straits, including a lake freighter making it's way from Lake Huron through to Lake Michigan-- perhaps traveling to Chicago? Our route was fairly flat, and we managed to handle the few hills okay. It took us about 2 hours to make the trip, including a stop for a rootbeer float!

The view on Main Street-- note there are no automobiles! Just horse drawn wagons and carriages and bikes.

The old fort is at the top of the hill-- quite a hike! But worth it for the incredible view.

This was the view from the fort Tea Room, where we had lunch. That is a lake freighter in the straits and the Mackinac Bridge in the distance.

This was taken on the back side of the island. That is a lake freighter on the horizon.

This is a view of The Grand Hotel from our ferry. This old hotel (built over 100 years ago...) is the most famous landmark on the island and was the place where the movie "Somewhere in Time" with Christopher Reeve and Jane Seymour was filmed.

     We toured the fort, watched both a rifle and cannon firing. We ate at the tearoom at the fort. We shopped and bought souvenirs and the obligatory fudge. And we took the ferry back to our hotel, arriving tired but satisfied at having had a wonderful day seeing new sights and enjoying a new adventure.  

 

What Memorial Day means to me...

Grieve not, nor speak of me with tears, but laugh and talk of me as if I were beside you there. 

          ~Isla Paschal Richardson

     When I was a kid, Memorial Day was the time when we traveled up to Marilla, New York to decorate the graves of our family in the cemetery there. We would travel by car, my grandmother in the back seat with my sister and I, and pick up my other grandparents. Sometimes my mother would buy flowers and put them in pots-- usually geraniums. Sometimes she would pick peonies or lilacs from our yard, both of which bloomed at this time of year in western New York.  She'd pack them in wet paper towels and then wrap them in newspaper.

     When we got to the cemetery, we'd drive up the hill and it usually took a few attempts to locate our family's "row".  My mother and grandmother would place the flowers just so. If there were any cut flowers, my sister and I got to go fetch water, which was attained at an old pump well.  The flowers were placed in these special cemetery metal vases that had spikes on the bottom that were pushed into the ground to hold it there. The graves that we visited back then were just my paternal grandfather, Merton Howes, and my older sister Marsha, who passed away as a toddler from encephalitis when I was a baby.  I remembered my Grandpa Mert, I held no memories of Marsha. But I heard the stories every year of how they got sick and died, stories of when they had been alive... And I heard other stories of other ancestors. Each trip out to Marilla also meant a tour around the cemetery to look for other relatives-- many, many who rest here. There were stories told of them, and I learned about my family and some of its history in this way.  There were always little flags that had been placed on the graves of soldiers too, and I learned of the sacrifice and suffering of those who served our country in the military. Sometimes that led to stories of those in our own family who had served, and a few who had given their lives in service to our country.

     On the way home from the cemetery, my father usually had to stop at the Williston Cheese factory. I loved that old place. The Cheese Factory was just a little shack of a place on a farm, with one room that held (unrefrigerated, mind you...) big blocks and rounds of different cheeses. Dad would order a pound of this and that, and an elderly farm woman with a very thick German accent would carve off a piece of cheese from the bigger block (and usually nailed the weight exactly, or very close!), weigh it on an old scale, and then wrap it in waxed paper that was on a huge roll at the end of the table. Then, she'd reach up to grab string, which was threaded from a very large spool at the end of the table, up to the ceiling, across and down right over where she chopped and sliced up cheese. She'd tie each package of cheese up with this string and bite the ends with her teeth. I remember flies stuck to fly paper hanging from the ceiling in there and wonder now if the Board of Health would allow such a place to do business. Back then, nobody seemed to notice the flies or the lack of refrigeration. The cheese was wonderful...

     The day was a fun one in my young life that I remember fondly. I think of it now, and realize how many more of my family now rest in that cemetery-- my father, all my grandparents. I find myself thinking more and more about them as I try to pass along the stories and history to my own children and eventually to my grandchildren. Not all of it is glorious, either. But it is what makes us who we are.

My cousins, my sister and I, my mother and assorted other spouses and offspring all gathered at the Marilla Cemetery to remember and toast our family! The guy mowing the lawn that Saturday morning must have thought we were a little crazy... (the kids under 21 got orange juice with a cherry, just like we got when we were kids and our parents gathered)

     One weekend about 6 years ago, the summer after my father died, our family gathered as a group in the Marilla Evergreen Cemetery. We had traveled there to bring my mother so she could see the headstone that had been placed on my father's grave-- she needed to see it herself to know it was done correctly and that it was okay. All the cousins and second cousins and some of their kids gathered there-- it was a real feat to get so many family together. We gathered at my father's grave, and as a special tribute to him, we toasted him with the "family recipe" drink called a Manhattan. This is potent stuff for a Saturday morning, but as my dad used to say, "It's noon somewhere!" so we all raised our glasses to him and to my mother, and to the parents of all the cousins,  in a tribute to the love we learned from them. Then we went on a cemetery tour, where my cousin Charlie and I, the family genealogists, were able to present some of our family history to the youngest members of the group. My mother added her own information and commentary about some of the people she remembered. And then, we went out and had some family fun together-- no cheese factory, but I seem to remember some Buffalo wings and Beef on Weck was involved...

Here we are... in all our family glory, right before we headed out to have some more fun. I love them all more than I can express!

     That's what Memorial Day is all about for me-- remembering and acknowledging my ancestors, keeping our history and traditions alive, and having fun with my family. And of course, it is about remembering and thanking those who have served and continue to serve our country so that I can spend the day free to do what I wish. 

Anticipation!

“Well," said Pooh, "what I like best," and then he had to stop and think. Because although Eating Honey was a very good thing to do, there was a moment just before you began to eat it which was better than when you were, but he didn't know what it was called.”

          ~A.A. Milne, Winnie-the-Pooh

     Lanny and I love to travel. Even before we were married, we traveled to some wonderful places... like Vancouver to visit his brother, and New Orleans to visit my best friend. We have a long list of places we want to travel to, and soon we will be traveling to one of them. As always, before we leave,  I must sit down and plan out the trip.

     I get out maps (we usually have a recent Atlas of the US, where each double page is the map of a different state, all placed in alphabetical order.) I have the computer close by too. Depending on where we are going and how we are getting there (flying? or long distance driving? Do we need to rent a car when we get there? If we are driving, what is a reasonable amount of driving for the area we will travel to?) I try to figure out where we will stay and make reservations ahead. I have a great need to plan out the trip, sometimes in great detail, so that we can enjoy our travels without spending time searching for a place to stay. Or worrying there might not be room in the inn. And making sure we take in as many experiences we can.

     We are going to take a short trip soon, so I am in the planning stages for this. I have been spending lots of time on the computer looking up places to stay, planning the route, and even looking up good places to eat. The internet has provided such great resources-- I can find reviews of restaurants ahead of time and figure out which restaurants are worthy of consideration. We have had some real flops too, of course. But usually these problems were caused by a lack of planning...

     The planning phase of each trip is most enjoyable to me too. I pour over maps to plan out each location, and discover what there is to see at each location.  There are wonderful websites devoted to this and I can see photos of scenic areas, read about historical events, discover new places to visit, and read restaurant and hotel reviews. All of this info goes into the planning of our trip and increases the anticipation of the real thing... so much so that I can enjoy each trip twice-- once in the planning of it and again during the actual trip!

     On the other hand, some of the most memorable moments of our travels have been surprises.  Several years ago we drove to New Mexico. This state is marvelous for meandering, and I had looked up all kinds of fun places to visit. We sought out a real ghost town, and drove a couple hours to find it. We drove out to the Zuni pueblo (a pueblo is sort of a town or village where a particular tribe lives, and where they maintain the cultural events and traditions that make each pueblo a unique place and experience) which was a long way off the beaten path, and had a wonderful guided tour of the mission church there and the surrounding town buildings, as well as a great description of some of the sacred Zuni rituals. The woman who gave us the tour also told us where to find the best hand crafted jewelry, all made by local people. This was not a planned activity-- I had just read about the pueblo and that tours might be available, and we ventured out. It was a wonderful morning spent with someone who was culturally very different from us, and we learned a lot.

     We left the pueblo, located in what can only be described as "the middle of nowhere", about 11 am, having spent the morning learning about Zuni customs, seeing sights that not many non-Zunis get to see, and buying some wonderfully crafted pieces of jewelry as souvenirs. It didn't dawn on us how hungry we were until we were an hour or so outside the pueblo. We were driving in southwest New Mexico, and there was not a restaurant to be found. Or a town for that matter. We were not on an interstate. We had a few snacks in the car, but they were not going to fill us up. We drove some more, our tummies rumbling.

     Then, alongside the road, across the street from a horse corral that looked like it belonged on a gun-slinger 50's TV show, we drove past a little low frame building with a red sign out front that read, "The Enchanted Swiss Gourmet Bakery".  Huh? Lanny slammed on the brakes, we turned around and went back. The place was empty except for one other couple, who were apparently locals by the way they chatted with a tall, thin man with a heavy German sounding accent. It turns out he was the owner of the establishment and had emigrated from Switzerland twenty-some years before. He did all the baking, and he made us some great sandwiches. Then he served up a couple pieces of hazelnut torte that were out-of-this-world delicious.  It was so good, and so unexpected, that three years later we still laugh about it and remember the meal.  The rest of the trip was wonderful, but what we talk about and re-enjoy over and over are the memories of the day we experienced the Zuni pueblo culture and ate at the Enchanted Swiss Gourmet Bakery.

     So... the keys to great traveling that we have discovered are:
     1.  Lots of planning will assure that we have a place to stay and take advantage of all each new location has to offer.
     2.  Be aware of the cultural aspects of the places we are to visit and try to be open to new experiences related to them.
     3.  Be open to new experiences and be surprised!

     I'll keep you posted on how this trip goes!

Strong women

“If you meet a woman of whatever complexion who sails her life with strength and grace and assurance, talk to her! And what you will find is that there has been a suffering, that at some time she has left herself for hanging dead.” 

          ~Sena Jeter Naslund, Ahab's Wife, or The Star-Gazer

     My niece posted a quote on her Facebook page and dedicated it to her mother. It was about what makes a strong woman. I found myself thinking about that, and about all of the truly strong women I have known in my life. I realized there are an awful lot of them! As I thought about these women, it dawned on me that they all had something in common-- they all have suffered some kind of tragedy in their lives and overcome it.  For some it was a tragic event, the death of a loved one or the loss of a marriage. For others, it was a long-playing tragedy of living with adversity, poverty or chronic illness. The longer I live, the more of these strong women I get to know, and all of them are my heroes.

     For most of my life I was a stranger to tragedy. I was born to healthy parents who were squarely in the middle class, so we always had enough food and never feared we would lose our shelter. I had adequate health care so I could stay healthy. I received a top-notch education. It wasn't until my divorce that I learned about loss and yearning for what cannot be. I had to deal with a shattered ego too. It wasn't until I had to deal with these things that I found out how strong I really was. And while it was a very hard way to learn, I am a much better person for having learned it. I healed from the grief of the loss of my marriage and in that healing I became a different person. I am certain I am a much better human being because of it.

     I do not believe suffering to be something only women do either. There are plenty of men in my life who have suffered tragedy too.  But I do think women may have a unique way of dealing with tragedy and loss that gives us strength and endurance for it. When I was in the middle of my divorce, and really feeling like I was in a crisis, I found strength and support from my family and close friends, yes. But also from people I barely knew. It seemed that angels came out of the woodwork to help me. And in every case, these "strangers" were women who had walked the same path I was on, who knew the emotional grief and suffering it caused, and reached out to me.  Women, we are told, are natural communicators. And a lot of us are natural nurturers. Their reaching out helped me realize that I was not alone, that this was a fairly common experience and I could see they made it and knew I would too. That took a lot of the fear out of my experience, and without fear I could dig deep and analyze my life, figure out what I wanted and have courage to discard what I didn't. Their cheerleading, along with my family's, helped me realize my own self-worth and begin to see myself in a new way. From grief, fear and anger was born independence, confidence and peace.

     Life cannot be lived without some kind of tragedy happening to us. I learned three things from my own misfortunes. First, that every person has within themselves the ability to cope with these events. It is possible for each of us to not just cope, but to learn and grow and change for the better when we face and surmount challenges. Second, that every person has a story, and very often we don't know what that is. When a shop clerk or waiter is rude to us, or we see road rage happen, or someone on the telephone is not helpful, we need to remember that they may indeed be coping with tragedy or loss. And third, because I experienced help and support from people I barely knew,  I feel it is my responsibility to try to help others who may be experiencing something similar. To "pay it forward" if you will. Sometimes I can help. Other times I can't because that person is not ready for help. I have learned that I must make the offer without any expectation of the other person's response. And I should keep offering.

     The ability to learn from what life throws at us makes us not only wise, but also stronger and more resilient for the next life event. Because women collectively seem to be better at communicating with one another, we are uniquely suited to help one another cope with tragedy. That makes us stronger both collectively and as individuals. Strong women are wonderful examples to our sons and daughters... and to our grandchildren too. And perhaps inspirational to our male counterparts. And when we can face what life throws at us with strength and grace, we will be happier people too.

Here is the quote my niece shared with her mother (Thank you, Kasey!):

A strong woman is one who feels deeply 

and loves fiercely

Her tears flow just as abundantly 

as her laughter...

A strong woman is both soft 

and powerful

She is both practical 

and spiritual...

A strong woman 

in her essence

is a gift to the world...

   Amen! 

Just an ordinary shift...

     We often think of nursing as giving meds on time, checking an X-ray to see if the doctor needs to be called, or taking an admission at 2:00 a.m. with a smile on our faces. Too often, we forget all the other things that make our job what it truly is: caring and having a desire to make a difference.
          ~Erin Pettengill, RN (Missionary serving in Haiti)

     This is the end of Nurses' Week, and I want to complete my acknowledgment of my profession with a blog about the ordinary stuff nurses do. My previous blogs were about a few extreme examples of things I did, meant to show the experiences all nurses have when dealing with patients who are very, very human. Often the job of a nurse is so incredibly ordinary that we forget how much influence we have over the people we care for.

     I remember caring for a labor patient one day shift long ago at the same small community hospital where I cared for Jordan and his mommy.  I don't remember this patient's name, unfortunately. Or the sex of her baby. I do remember it was her second baby. Her first birth had been a good experience, but she had had this nagging regret that she'd been talked into an epidural anesthesia (for those who aren't familiar with this, it is a form of anesthesia that involves the placement of a very small catheter into the back and renders the laboring woman numb from about the waist or hips down.) She regretted that she had not fully participated in the delivery-- the physician had used forceps to help pull the baby out because she was too numb to push. The baby had been fine, and overall she had been thrilled. But she had this nagging feeling perhaps there was more to a natural birth than what she had experienced and wanted to give it a try.

     The physician caring for her was ambivalent about it. They had discussed it, and the patient had tried to express her wishes. The physician had said he was fine with her doing whatever she wanted with anesthesia, but I knew from working with him that most of his patients had epidurals and he would encourage her to have one.

     But, as a woman who had birthed two babies without an epidural, I knew it could be done with the right motivation and especially if the mom was not afraid. The key was lack of fear. To do that, she would need a lot of support. Her husband was very nice, but was unprepared for what a true natural birth would be like. It was my job as her nurse to support them both, but especially her in coping with the labor. And of course, there was the unknown factor-- how long would it take, would she have the dreaded "back labor" where all the pain is felt intensely in her back, how big was the baby, etc.

     So, we started with a frank discussion of all the factors that could impact her labor, and what I could help her do for each one. I also reminded her that she could ask for an epidural at any point and we'd get one for her. That was the "back up" plan. I promised her I would wait for her to tell me she couldn't continue without it and that I would do everything I could think of to help her cope with whatever came along. She was excited and enthusiastic.

     Supporting a patient in this kind of endeavor can be very time consuming. It cannot be done if the nurse has more patients to care for-- it requires that she remain at the bedside of the patient almost all the time. During the course of an hour of labor, the labor nurse must fit in at least 2 blood pressure and pulse readings as well as check the baby's heartbeat. The nurse is also assessing the labor by feeling how strong the contractions are, how close they are and at times examining the patient for progress. The nurse must give the physician progress reports any time the patient's status changes. And in between all of this she is rubbing the patient's back, helping get her in a comfortable position, helping her get up to the bathroom and sometimes helping her do the prescribed relaxation breathing techniques. It can be pretty intense work at times, but I loved it.

     This patient I remember because she did very well. She used the breathing and relaxation techniques she had learned in her childbirth class and with her husband and me to support her, she found coping with the labor quite possible. Then transition hit. Transition is a very short period of time at the end of labor when there is very rapid progress towards delivery. It is usually accompanied by very intense, close together contractions that can be very difficult to cope with. Women who cope with labor up to this point often lose their focus and then their ability to cope with it all. Even minute distractions can cause the woman to lose focus-- so it is enormously important that those caring for her respect her need to focus and help her through it. Often the woman can feel an incredible urge to bear down when it isn't time yet to do so, and this especially can make the woman lose it.

     When transition hit for this woman, having experienced it last time in the blissful state of anesthesia, she was unprepared for how intense it was. With every contraction she tried, but often ended crying and telling me "I can't do this!"  Her poor husband looked frantic and scared. She had coped so well up to this point I hated to even suggest the epidural. So, I cupped her face in my hands and I said, "Don't be afraid! This is transition and it is making you a little crazy! It will be over soon! You can do this! I will help you!" Then, I made her look me in the eye and mimic my breathing. With each contraction we breathed together. I told her when every contraction was at it's peak and when it started to go away. When she started to panic I repeated my chant to her "You can do this! Breathe like me!" 

     It didn't take long - maybe 15 minutes - and she was ready to push. We called the physician to come for delivery. It was his much younger partner who showed up, and this doctor took me aside to ask why the patient had not had an epidural. I told him, "Because she didn't want one" and he shook his head disbelievingly. The patient, with her husband at her side helping her, pushed and delivered a beautiful baby. I don't remember the sex or how big, I just remember that the baby was delivered and we put it to her breast almost immediately.

     And that is what I remember-- the almost Madonna-like mental image of this woman nursing her newborn with tears streaming down her face. "I did it!" she said softly. Dad snapped photos and grinned. "Great job, honey!" he said, and gave her a kiss. I got the room cleaned up for visitors. Eventually I took the baby and did all the normal newborn stuff-- weight, first baby shots, getting the footprints and putting the ID bands on. I took Mom's blood pressure and did all the nursing assessments required. Before the extended family came in to admire the new baby, I was able to congratulate the mother and father. "You did it!" I told them. And the mother told me, "I can't put it into words, but I feel like I could climb Mt. Everest right now... I feel as high as a kite! I DID IT!"

                    

     I am certain this patient thanked me at some point in our conversation. But it wasn't necessary. I was almost as thrilled as she was. I remember the incredible feeling of empowerment that came over me after each of my babies was born too. I think it is something all new moms feel, or should feel. Bringing new life into the world is an amazing feat, no matter how it occurs. For this mom, doing it without an epidural had been very important to her, and my job was to help her do that. That she had been successful felt very good to me, too.

     Nurses do special things for their patients every day. We do our best to customize our care to what each patient needs. Often there are frustrating barriers to this-- too heavy a patient load, or not the right equipment or inadequate training are some of them. But we all want to care for our patients in ways that help them uniquely to cope or recover or remain healthy. When we get it right, the rewards of our patient's success is thanks enough.

     So, here's to all the nurses out there who give so much of themselves every time they go to work. Who work long hours, often without bathroom breaks, and who work with smiles on their faces even when crisis hits at home, and who work all night long or Christmas day or when the weather is awful and school is closed for their kids... Who put up with patients who smell bad or talk bad or refuse to help themselves by following the prescribed plan of care, and families who panic and are too critical of everything or are rude or treat the nurse like hired help, and to physicians and coworkers who are having bad days or night and treat them rudely... whose spouses and families don't understand why they come home too tired to cook or help with homework or go out partying... and whose extended families don't understand how come they have to work on Christmas day... whose feet or knees or backs go out on them because of all the lifting and squatting and bending... and who can't imagine doing anything else for a living because they feel so needed and get more back from their work than they can put into words. God bless you!

The Story of Baby Jordan

After ten years, and many experiences, memories about life and death have been the most profound of all. Although I do not fully understand why, I believe God has a purpose in everything, and allows things to happen for a reason. Patients come into your life for a reason, and God entrusts them in your care. Now, I know why I am a nurse. 

          ~Julie A. Louder, RN

     Nurses save lives every day. Because we are with patients 24/7, we are usually the first ones on the scene when a crisis occurs.  We are taught to observe patients for changes in their status. Early warning signs of stroke or heart attack? Too much blood loss after surgery? Metabolic changes caused by diabetes or electrolyte imbalance? It is probably going to be a nurse who first observes these changes and gets the ball rolling on treatment. In Labor/Delivery, status changes can be very rapid and require immediate response by the nurse. Nurses in this department have special training in OB emergencies. And we all hope we never have to use that training...

     About 15 years ago I was working day shift in L&D at a small community hospital. My assignment that day was a patient who had been admitted for induction of labor. Back then we did an awful lot of inductions. Doctors liked to do them because it made labor a daytime event and allowed them to have a little more control over their schedules. Patients liked them because they could schedule child care for other kids, alert family members (most of whom showed up at the hospital way too early!) and have more control over their schedules. It seemed like a win/win for everyone...

     My patient was a very sweet woman who was being induced with her second baby. Her husband was also very nice. Because these patients are not in active labor at the beginning, it gives the nurse time to chat with them and get to know them a little bit. I thoroughly enjoyed this young couple-- they were excited to be having a second baby, and had brought lots of photos of the first one and shared them with me. As the morning wore on, signs of labor began, and the patient began to have contractions. By lunch time they were fairly regular but still not painful. Mom's physical status was great and the fetus was doing well according to the monitor. I was going to get some lunch. L&D staff usually dine on the unit and watch the fetal monitor strip remotely using a monitor screen in the break room. That was my plan.

     I sat in the break room munching on a sandwich when I noticed a sudden and very deep drop in the fetal heart tracing. Uh oh... I leaped to my feet and headed for her room. As I passed the nurses' station, her call light went on. I heard her voice over the intercom as the unit secretary answered the light say she thought her water had just broke.

     I got to the room and the patient was grinning. "My water broke!" she said, and then apologized for the mess. I grabbed an exam glove, as the fetal heart tracing was still very low. I put the head of her bed down flat and examined her. And my heart pounded as I realized I was feeling the umbilical cord, which had been flushed out when the water broke. This was baby's lifeline, looped down past the baby's head and potentially pinched off by the head. It is an extreme OB emergency called an umbilical cord prolapse and is only treated one way-- emergency cesarean delivery!

     I hit the call light on the bed with my spare hand, praying for a quick response. I got it. "Set up the OR-- we've got a prolapse!" I called to the unit secretary. "Get another nurse in here STAT and get the doc! I need anesthesia!" 

     Until the baby can be delivered surgically, his or her little head had to be held off the cord to prevent it from being pinched off the circulating blood that was bringing it oxygen. That meant I had to remain with my hand inside holding up baby's head. To help further with some gravity, I got the bed into a flat slant with the mother's head lower than her feet.  I looked at the patient now, and saw sheer terror in her eyes. "We have a real emergency here," I said to her and her husband. "I am not going to have time to explain everything to you now, but we must take you to the operating room quickly and get baby out via cesarean section. I promise I will explain everything to you after this is over. And I won't leave you..." With that, and with another couple nurses in the room, we took off for the OB operating room.

     The nurse anesthetist was waiting on us. The physician arrived, examined the patient to verify my findings, and the patient was put to sleep. No time for an epidural, and the position required to put that in was impossible with our situation.  I had to remain under all the surgical drapes still supporting the baby's head until it was delivered. (Those of us in OB refer to this as "shaking hands with the surgeon"...) Out came a screaming, pink and obviously very healthy little boy.

     Because the room was full of staff, once I was not needed to hold up baby's head, I didn't have a role in the surgery team. That meant I was free to go talk to the dad. Because it was an emergency and the patient was going to go to sleep, he had not been allowed in the room. The unit had a back door to the OR and a little anteroom there. I asked the surgeon if it would be okay if I brought the father into this little ante room where he could get a look at and maybe even hold his baby. She agreed.

     When I got back to the patient's room, there was her husband. He was still sitting on the same chair, in the same position he was in when we dashed out of the room with his wife. Only he had his head in his hands. He jumped to his feet when I came in. "Everything is okay!" I said. "The baby is fine! Your wife is asleep but she is going to be fine." He exhaled loudly, looking ashen and stunned. I gave him a brief explanation of what had happened, and then asked him if he'd like to go see his son. He was out the door before I was. I took him in the back way to the ante room where he got a close up view of his new baby son. The baby was pink and screaming-- mad as could be at the disturbance in his world. Dad grinned and then he started to cry. He gave me a huge hug and cried on my shoulder... "I was so scared... I thought I'd lost them both..."

     The patient had a completely normal recovery from her surgery. They named the baby Jordan. I gave them as thorough an explanation of what had happened as possible, as did the surgeon. My work schedule had me working the next couple days, so I was able to care for this family as they recovered and went home. Over those few days, the enormity of what might have happened sunk in and the mother started calling Jordan "my miracle baby".  They thanked me profusely. I was introduced to the extended family visitors that arrived. I felt like part of the family!

     Over time, I heard from this family with photos of Jordan as he grew. I kept a photo of him on my locker door, labelled "Jordan - cord prolapse in Rm 12" to remind me of the bond I had with this family, and also the importance of training and emergency preparedness.  About 2 years afterwards, one evening when I was too tired to fix dinner, I took my two sons out to eat at their favorite restaurant Steak 'N Shake. The "please wait to be seated" sign was up, so the three of us stood there waiting on someone to take us to a booth. That's when I heard a voice cry, "BARB! Oh look honey, it's our nurse, Barb!"  Sure enough, there was this little family. Mom, Dad, older brother who was 4 and a darling, curly blond headed 2 year old boy named Jordan, all having dinner. He looked happy and active. His mother gushed over me, gave me a big hug. Then she said to my two teenage sons, "Your mother saved our baby's life!" 

     I cannot lie. That kind of acknowledgement in front of my boys made me proud. I still am proud-- that I had good training and was able to perform well in this emergency. That gave little Jordan a chance at a normal life, and his parents a whole and healthy family. They trusted that I, as a professional nurse, would perform well in an emergency. It was my responsibility to them to do so. Or, as we so often tell our thankful patients, "Hey, that's my job..."  And what a rush it can be to realize you have had this kind of impact on someone's life. It makes up for all the body fluid exposures, all the cranky, unrealistic patients and families and physicians. I am very, very thankful I was the one that was chosen that day to save a life. It has made all the difference in my own.

The story of Baby Sarah

The best and most beautiful things in the world cannot be seen, nor touched, but are felt in the heart.            

          ~Helen Keller

     It was a normal work shift for me, evening weekends in Labor/Delivery. The usual hustle and bustle of work-week procedures was not there, so it normally wasn't as busy. Sometimes a full moon or a bad storm would bring in more business, but usually the pace was not too busy.

     On this particular Sunday evening, one of our obstetricians called the unit to tell us he was sending in a patient who thought she was in labor. It was her first baby. I was asked by the charge nurse to admit this patient and take care of her. I got out the prenatal file we had for her, and reviewed it. It read like a textbook healthy pregnancy. She was a teacher, married to another teacher. This was going to be a fun evening!

     The patient and her husband arrived, looking a little anxious but excited. She went into the bathroom to put on a hospital gown, so I chitchatted with her husband and got the fetal monitor ready. She bounced out, a little flushed with excitement. I remember thinking they looked like Barbie and Ken, here to have their first baby.

     I applied the fetal monitor and oddly, didn't hear anything. I readjusted it several times, but heard nothing. Not just nothing... there is a gut wrenching kind of silence an experienced OB nurse fears. That was what I was getting. Absolutely nothing-- void of any sign of life. Smiling and trying to speak calmly, I asked the patient when she had felt the baby move last. "Oh last night!" she said. "The baby was very active last night. It was breech for awhile, and I think it might have turned last night."  My heart sunk. Plummeted to my toes. "Well, I am having trouble finding the baby's heartbeat, so I am going to go find another nurse and see if she has any better luck." I said.

     Shaking, I went to the desk and told the charge nurse my findings. "Will you come and see if you hear anything?" I asked, and of course she did. Both of us adjusted and readjusted that monitor a thousand times. This was before the days of portable ultrasound machines, so we would have to send her downstairs to the big ultrasound machine in Nuclear Med. And the physician needed to know. "I am going to go call your doctor, to let him know we're having trouble," I said. I tried to look her in the face, and when I did I could see the mounting panic. Her husband was silent. Much paler than when they walked in the door and no longer smiling. Tears were welling in both their eyes. "Oh dear God..." I prayed. "Help me help these darling parents... " I went out to the desk and called the physician. I know these phone calls are the absolute hardest ones for a doctor to get from L&D. He gave an order for the ultrasound test and said he'd be right over.

     I accompanied the patient to Ultrasound. This was in the days when husbands were not routinely allowed in that department, but I told the tech I was bringing him down to support his wife. The findings from the test revealed the baby's heart was not beating. The baby would be stillborn. The parents could not see the screen, and the tech was not allowed to give them this information. I knew the physician would not want me to give it to them either, but I also knew they weren't stupid. I could not lie to them. Helping them wait for the truth was going to be hard.

     We went back upstairs with me telling them we'd have to wait to hear from the radiologist who would read the test images and from the physician. I told them I wasn't an ultrasound tech, so I wasn't qualified to read the images myself. I told them not hearing the heartbeat was a bad sign. The patient began to cry softly. She and her husband held hands while she wept. Her husband looked devastated, but did not cry.

     It seemed like hours, but was really probably only 15 or 20 minutes before the physician knocked and entered the room. He gave the devastating news to the couple as gently as he could. He said he suspected there had been some kind of "cord accident" when the baby had turned the night before. He told them how sorry he was, but that he needed to take care of the mother now and that he wanted to induce labor so the pregnancy would end quickly. The stunned parents nodded their agreement to his plan. The physician left the room. The patient began to sob openly, and reached for her husband who held her tight. She sobbed and sobbed. There was nothing more I could do at this point, so I tiptoed out of the room. I needed a break myself... remaining professional so I could care for her during what would probably be a long labor was important.

     A hush had come over the unit, as it always does with situations like this. I sat for a moment to compose myself. Several staff nurses patted me on the back and asked if they could help me. The physician was still on the unit, and he looked solemn. "I am going to wait this out back in the call room," he said. "Call me if you need anything."  I got up and gathered the equipment necessary to begin the induction and reentered the room.

     It didn't take as long to deliver the baby as I had feared. Sometimes nature kicks in and helps out in these situations, and she delivered before the end of my shift. She labored bravely, and was supported by her husband. I remember she told me that coping with the labor gave her something to focus on, and while she knew the outcome, she still was trying to remain hopeful. Her husband did not shed a tear during the entire labor. He rubbed her back, stroked her hand. He whispered words of support and love in her ear. He helped her push when it was time.

     The baby was delivered by the physician, and was a beautiful baby girl. Perfect features, round and fat like the Gerber baby. At delivery the physician noted a large knot in the umbilical cord. Cursing quietly under his breath, he showed the parents. "I'm so sorry..." he said, and his eyes welled up. Then he cursed again, and left the room. 

     In the long-ago bad days, a stillborn baby would have been whisked out of the room as if it had never existed. The parents would have been shipped off to another unit away from OB. They would have been encouraged to forget all about this baby, and look immediately to the future to have another. In our efforts to cushion the grief, I fear we did terrible wrong to parents who experienced this kind of loss. No more... medical professionals had learned how wrong an approach that was. I wrapped the baby up in a blanket and gave her to first the mother, then the father. They looked at all her features, and through tears admired them. They stroked her hair. They each hugged her close. They named her Sarah. I remember the father holding his baby, talking softly to her. "Oh Sarah... little girl..." he said. "If only you had made it. We have so much stuff waiting on you at home... You have grandparents who are waiting for you... and friends... and so much love to share with you..." And then he started to cry. Great wracking sobs came from this gentle man. Heart broken, he cried as he carried the baby back to his wife for her to hold. They held one another and cried. And cried and cried.

     That was when I had to leave. My shift was over. I had my own family waiting on me at home, and still had a mountain of paperwork to complete. Despite my need and theirs for me to continue their care, I told them I had to go and that eventually a night shift nurse would come in to see how they were doing. I don't remember, but I probably even brought her in and introduced her. That nurse would have to complete the business side of this event-- funeral home arrangements, etc. That seems to me to be the worst part of grief-- that there is a business side at all to cope with.

     It has probably been 25 years since this happened, and I still think about these people. I hope they were able to have more children and that they could continue to support one another in their grief as well as they did that day. It was a very difficult assignment for me as a nurse, but it wasn't the last time I had to care for people who would not go home with a live baby. Every one of those situations touched my heart, and opened it to the world of hurt and grief that exists. Every time someone learns I worked in Maternity, they respond with "Oh that is such a happy place!"  And that always reminds me of this family. And all the others... "Not always..." has been my usual response.

     Nursing opened my heart to the pain of others unlike nothing else. Images of starving children or natural disaster victims on TV can get to me sometimes, but working one-on-one with people who are hurting, either physically or emotionally forced me to open up and respond in a personal way to each situation. Nursing has made me a better human being. And I hope that what I gave back to these people in some way measured up to what they gave to me.

Happy Birthday, Addie!

When a child is born, so are grandmothers.  

          ~Judith Levy

Grandma Barb meets Addison Nicole for the first time!

     Today is my oldest grandchild and only granddaughter's birthday. Addison Nicole is 4 today. She has a very special place in my heart because she was the first one to open the world of grandchildren to me. When she arrived, I discovered a new kind of love-- and it is wonderful!  I am so glad she lives fairly close to me so I can see her fairly often. 

     To celebrate her birthday, of course I had to take a trip down memory lane with my photos. I am amazed at how much she has grown in just 4 years. She is very much a little girl, and a very smart one at that. And she loves to give hugs to her Grandma Barb. That's my favorite!!

     We will celebrate her birthday on Sunday, but I wanted to note this day as special by sharing a few of the photos I have been looking at! 

6 months old

Addie's first birthday!

All dressed up for a very special wedding!

Age 18 months

Age 2

Age 3 with playdough at Grandma's

Age 3 with ice cream!

Almost 4

Easter egg hung this year, almost 4

      Happy Birthday, Addie. Grandma loves you!!! 

I really have seen it all...

Look for the ridiculous in everything and you will find it.
— Jules Renard

I really have seen it all... I'm an OB nurse!

~ saying found on a coffee mug in a nurses' lounge.

     As a nurse in Labor/Delivery, I learned very quickly that people deal with stressful situations in different and sometimes very odd ways. Birthing a baby is a very stressful event... and our TV sitcoms and movies have all depicted this with frantic fathers-to-be racing to the hospital with their pregnant partners huffing and puffing next to them. In the 37 years I have been a nurse I have seen some unbelievably funny responses to this stress, and have developed a repertoire of stories that are always a hit at parties... or laid-back Saturday nights on the unit when we didn't have any patients, had cleaned the unit storage area and organized shelves and still were looking for stuff to do till the next patient showed up. That's when the story tellers would start to spin tales of OB long ago... or just last week...

      I was working the afternoon shift on the Labor/Delivery unit. I don't remember the day of the week or even the season, but a patient had come in after being seen in her doctor's office for complaints of labor contractions. He had sent her in to the hospital where she was joined by her husband. Once she got all settled into her hospital room, everything sort of... stopped. This happens sometimes, and one way to "stir things up" was to get the patient up walking. After monitoring the fetus on the fetal heart monitor for about an hour, we were satisfied that the fetus was in good shape and so the patient was allowed to get up to walk.

     At this point I need to give you a physical description of this lady. She was almost 6 foot tall, and very, very large. Nine months pregnant, she probably weighed close to 300 pounds. She was elegantly dressed when she came in, but had to exchange her clothing for a hospital gown. The kind that are totally open in the back. I found her a second hospital gown to put on backwards to cover up her backside, and she put on some footies that had treads on the bottom. This attire, familiar to a lot of nurses, is the attire of the ambulatory labor patient. Because things hadn't gotten going much, she did not have an IV. Her husband was much shorter than she was, and much slighter in build. Both of them seemed very pleasant, and were happily anticipating the arrival of their first baby. I walked with them to show them where on the unit they could go, and asked that they come back in forty-five minutes so I could reapply the fetal monitor and reassess her situation.  Off they went, chatting happily.
                                             
     The unit was fairly small, so in 45 minutes, this couple made dozens of "laps" back and forth. Each time they passed by the nurses' station, they would smile and say something pleasant to the staff sitting there. The unit secretary on evenings was a large, boisterous woman who was a little mouthy, but who was always pleasant. She wore blue scrubs just like the rest of the OB staff. From casual observation, it really was impossible to tell who was a doctor, who was a nurse, who was a tech or who was a unit secretary. Anyway, at about the time they were due back in the room for me, they passed the nurses' station again. They chatted briefly with the unit secretary, who joked with them about the stalled labor. "Well, if this walking doesn't work, maybe we can try cartwheels next..." the unit secretary joked. I was on the phone at the time with her physician, who had called in for a status update. This physician was an "old school" doctor, who expected nurses to follow his protocols and to update him often. He was older and quite dignified. He commanded respect, and I certainly wanted to follow his orders... I was quite frankly scared to death of him.  I told the couple to go down to the room and I'd get down there as soon as I could. I told the doctor that I was going to put her back on the monitor and I'd call him back in about 15 minutes with an update.

     When I got down to their room, I pushed on the door to enter and it wouldn't open. I pushed again a little harder-- it still wouldn't open. I had to push quite hard for the door to budge much at all, and when I got it open enough for me to squeeze through the door, the first thing I saw was that all the furniture had been shoved against the walls. The bed, the bedside stand, the overbed table, the fetal monitor-- all were pushed against the walls, making a large open space in the middle of the room. In the corner almost behind the door sat the father-to-be, cowering a bit with his head down. "What the...." if I didn't say it, I certainly thought it... " Then I noticed the patient. She had removed the second hospital gown, so she was wearing only the one, and let's just say the moon had risen that night already. She was standing in the opposite corner from the father-to-be with both her arms raised high over her head. "WHAT ARE YOU DOING????" I asked, and I hope I didn't shout it, though probably I did. "I told you...." muttered the father to the patient The patient stared at me like I was a little crazy.

     "That nurse at the desk told me if walking wouldn't make me have contractions to try cartwheels," she said.  "NO!! NO!!! NO!!!" I cried. "You can't do that!" and then I said what may go down in my personal history as the weirdest thing I ever said to a patient, "As long as I am your nurse, you may not do cartwheels in the hospital."  Then, after replacing the furniture in the correct locations, I completed my nursing assessment in as professional a way as I could and hurried out of the room. I had to hurry for two reasons-- I had promised to call the doctor with an update and I feared I would burst into laughter at any moment. The mental image of a 300 pound pregnant woman doing cartwheels in the hospital was just too funny...

                                
      I made it out to the nurses' station before I laughed. I told the other nurses and the unit secretary what had occurred. They laughed with me, and asked if I was going to tell the doctor what had happened. Whoo boy, I hadn't considered that. Well, if I didn't tell him someone else would so I decided to go for it. When I called the doctor I told him the story and at first there was no response at all. Dead silence on the other end of the phone. Then he said, "Well, sometimes I think I have seen and heard everything... and then stuff like this happens..." That was all he said, but he and I had a much better relationship after that.


     This happened at least 20 years ago, but I was at a reunion of some of the people who had worked on that unit about a year ago and somebody asked me about it. It has taken its place in the legends of the unit. And 20 some years later I am still chuckling over the mental image of that very large, very pregnant woman about to do a cartwheel in the labor room... Hee hee hee .....

Nursing is an art...

Nursing is an art: and if it is to be made an art, it requires an exclusive devotion as hard a preparation, as any painter's or sculptor's work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God's spirit? It is one of the Fine Arts: I had almost said, the finest of Fine Arts.

          ~Florence Nightingale

     This week is Nurses" Week. It is always celebrated in May to coincide with Florence Nightingale's birthday. Happily, it also coincides with Mother's Day. For me, that means a celebration of both my life's avocations. While I am retired from professional nursing, I remain a nurse in my heart and will to the day I die. It is a tough profession-- requiring quick wits, a strong back, incredible tact and patience and most of all, love for the work. I would like to honor my chosen profession with some blogs on the subject. Today I'll tell the tale of my own journey as a nurse. Please note that my own experience was hospital-based. There are many, many nurses working in non-hospital based jobs, or jobs within a hospital setting that are not at the bedside. And there are ever-increasing numbers of men who choose nursing. It is all change for the better for our career and most of all, for our patients!

     I grew up in an era when there were what I call The Big Four profession-wise for women:  Secretaries, Hairdressers, Teachers and Nurses. Back then, very few women worked outside the home unless the family was needy financially. Professional engineers, physicians, lawyers, accountants, bankers, etc were mostly men. Perhaps it was this environment that gave me the inner nudge, but honestly I think it was probably God tapping me on the shoulder and I was young enough to listen. I only know that from a very early age I have always wanted to be a nurse. Or as I used to tell job applicants I was interviewing, "I didn't chose nursing, nursing chose me."

My UM graduation photo-- one of the last times I wore the nursing cap!

     I was educated at The University of Michigan School of Nursing. Fortunate to live in a state that had one of the top five schools of nursing in the country at the time, I applied and was very grateful to have been accepted. My education there was stellar... I went in a somewhat shy, unsure kid and emerged a woman who "thought like a nurse". Though my skills were green, I knew how to think and how to assess a patient and I also knew I had a lot to learn. The first year or so out on my own was one of tremendous learning. I carried books with me to work and kept a pocket medication reference with me at all times. It was terrifying and exhilarating and wonderful and awful... and I absolutely hated some of it and loved other parts of it.

     One of the things I loathed was Med/Surg nursing. Despite my best efforts I simply couldn't enjoy caring for all those old or sick people (imagine... a nurse saying she doesn't like dealing with sick people!). When I was allowed to transfer to OB that all changed. I loved it and from that day forward I stayed an OB nurse. A lot of OB nurses prefer the labor/delivery setting, others prefer the post partum setting, and still others prefer to work with the babies. I loved all three, and worked in all three at some point or other in my career, though I never ventured into the Neonatal ICU area... that still terrifies me!

     Bedside nursing in Labor/Delivery was my favorite. Except during times of very high patient loads, I was able to focus on one woman and her needs. Following that woman through her birth experience to delivery, helping her during the birth and immediately afterwards was something so rewarding it is hard to put into words. During the birth experience a woman's physical status can change in an instant, so it requires constant vigilance and assessment by the nurse. Small changes in her affect, in her vital signs, in the fetal heart tracing can be of huge importance. Staying sharp and yet reassuring to the woman requires a lot of brains and emotional maturity. Dealing with nervous fathers-to-be (and of course the absolute worst creature-- the Grandmother-to-be!) requires people skills to be fine tuned. When I got all that right and the result was a healthy baby and a grateful family, it was awesome.

     I didn't always get it right. There was the family that I found out later referred to me as The Barbarian. My people skills the day I cared for them must have been rusty or my antenna wasn't up all the way... I also delivered a few babies myself because I missed the signals of imminent delivery and didn't get the physician there on time. And there was one time when I did not react to a decline in the fetal heart tracing fast enough... and that one haunts me still.  I have many, many stories I could tell here-- any time you deal with people when they are at their most vulnerable you will see things that make a mark on your heart. Some are funny, others poignant. I will tell a few of those stories in the next few blogs, in the hope of helping you understand why I love nursing so much.

This is me in my later career in my office at Wishard Hospital

     There are a lot of nurses out there-- some are actively working, some have moved on to other careers because the demands of the job were too much, and some are retired like me. If a nurse has ever had an impact on your life or the life of someone you love (and I suspect that is every one of you!) please remember that this week and say thanks to the nurses you know. They are hard working, caring people who give so much of themselves at work!