First Night duty in labor room

First of all, let me give a short description of where I am from. My native country is Nepal and this story is about the my first night duty in labor room of a very small hospital situated in rural part of Nepal.

After finishing student life in nursing, this was my first duty in labor room by myself. Because of very limited staffs in the hospital they used to schedule maximum two staffs at night, and that night I was alone because the other staff was in sick leave for three days. Although, I had informed the nurse in charge that I don't have experience in labor room she assigned me alone and said that I can get help from staffs in Med/Surg ward which was pretty close to labor room. In addition, I was just transfered to this hospital so I was new to everybody including clients.

My duty started at 8pm, I took handover from the evening staff. There were 10 antenatal mothers with three of them in active labor. The ward had both ante and post natal mothers in separate rooms. I was trembling with both fear and excitement. I tried to recall necessary procedures and theory needed to take care of antenatal mother and delivery. Along with me was one lady attendant who was working there for several years. I tried my best to be calm and confident in front of her and visitors. I started attending mothers in active labor, listened fetal heart sound, took vitals, provided support to mothers and visitors. I had almost forgot to do pelvic examination and evaluate the result, but I did my best and stabilized the situation. I saw fear and confusion in patient's party in the ward seeing new staff alone, but I made them convinced that I could handle it.

The ward was running smoothly, all of a sudden I heard noises and rush coming towards the duty station. There were four, five man with a lady carrying another lady in a stretcher who was moaning . I could not understand what they were talking, one of them asked me for the ward night staff. I said its me, they looked each other and asked if there was any mature lady who could take care of the lady in labor. I told I am the only one staff available for tonight and will be taking care of the lady. I didn't know what they were talking , but looking at the lady in stretcher I knew that she is in severe pain and needs immediate care. I told them to let me examine her but they were confused. In the mean while, the ward attendant arrived, as soon as the visitors saw here they started talking with her. I thought being old staff they knew her. The attendant was one of the local people who knew them so she made them understand the situation and we together took the lady inside the labor room. After the examination, I found she was fully dilated and ready to deliver. The attendant helped me prepare the instruments and client for delivery and I forced myself for self preparation too. I made sure that FHS was present and mother's condition was stable. According to the hospital policy I went to the visitors to take consent for the patient where I saw some more people outside the nursing station making noises. They started asking me about client's condition and demanding another staff who was old enough and experienced in labor and delivery. I explained them everything honestly and asked one of them to fetch some necessary medicines. That guy seemed little bit understanding to me so I asked why they were not trusting me. Then, I knew that those people had a believe that delivery should be done only by old staff who had self experience and I was young unmarried girl who don't know about the labor process. Due to this superstition they were hesitating to let me take care of the lady. For their mental peace I called one old staff from med/surg department and told the visitors that delivery will be done under her supervision. This made them calm and we deliver the baby with no complication.

As this case was solved and everything was stable, it was 11 pm, I moved in the ante natal room to check other mothers. One of them was ready, I rushed her in labor room and prepared for delivery. This case was little complicated because it was primi gravida with Breach presentation. I was trembling on my feet again in the same way as my client was with pain and urge to push. I recalled the process for Breach delivery and followed accordingly. With lots of difficulties a cute little baby was born. But to my unfortunate, she had a big tear and she started bleeding terribly. I had not seen anybody bleeding that bad which made me nervous, and shaky. Now my situation became worse, I couldn't stop bleeding despite giving pressure against the pelvis and meanwhile I was about to pass out because of the fear and dilemma. I told the ward attendant to call on duty doctor while trying to balance myself. When the attendant went to call doctor, I delivered placenta and put some dressing pads inside the pelvis with some hope to control bleeding. I saw less bleeding now, so I removed gloves and examined mother's vitals sign. I also injected the standing order medicine to stop bleeding. When the doctor arrived bleeding was much controlled, she gloved and examined the tear, it was second degree. I assisted doctor to suture when she taught me and let me suture under her supervision. At this moment, I can't explain how I felt for the doctor who remained calm throughout the time and helped me and the mother to relaxed. When everything was finished it was 2 am. I was exhausted by now with hunger and sleeplessness, then I remembered there were two more clients out there for tonight. I had no time to rest, I rushed to them to check and found another lady ready.

One after another I assisted both ladies to deliver and thank God that previous two cases had made me much confident by now. This was one of the most worst experience in my life till now. I passed that night standing for almost 11 hours with no rest at all. When the morning staff arrived at 8am, I was buried in paper work of all those clients which took one more hour. I left the hospital with no energy, but I was satisfied for what I did.