OB Nurse in a Small Rural Hospital

Jan 08, 2009 11:17 PM

9 comments 1736 views

by VickyRN

Staff

A long time ago in a hospital far, far away, I was the sole obstetrical nurse covering my night shift. In this small, rural facility, I also had a regular medical-surgical assignment (usually eight to ten patients) and also helped “take care” of the emergency room at night, after the regular ER crew retired at 11 PM or 3 AM. Yep, “wonder nurse” I was.

This particular hospital had a “call bell” system in place for the ER. After the regular ER crew left for the night, a patient would ring the “doorbell” in the back to summon service. The bell would buzz abruptly in the nurses’ station to let us know that there was someone in need of help. All nightly ambulance calls would also filter through the nurses’ station.

I had many interesting and varied experiences in the middle of the night working in this small community hospital in Eastern North Carolina. Some of the patients who would present to our back door were transient Hispanic farm workers, who could speak very little, if any, English. To make matters even more interesting, there would often be a woman in active labor, surrounded by an assortment of relatives and friends. The lady in the center of the crowd with the gravid abdomen was my one clue as to the nature of the visit. In addition to not being able to speak English, the mother-to-be often had no prenatal records, as she had not been seen by a doctor during her entire pregnancy.

I had to rely on my rudimentary high school and college Spanish skills to get by, as we had no on-site translator. Of course, when someone is presenting at the back door 10 centimeters dilated and ready to push, there is no time to call in anyone to translate! In fact, one of my initial communications was always “¡No puje ahora, por favor!” (Please don’t push!)

The next few moments were a flurry of activity, as I hurriedly transported the patient by wheelchair to the birthing suite, helped her change into a gown, and started my initial assessment.

The birthing room was surprisingly posh and well-equipped for such a small, out-of-the way facility. It featured a state-of-the-art birthing bed, a "closet" full of IV fluids and IV supplies, a well-stocked newborn warmer, and an electronic fetal monitoring unit. It was large and spacious with a "home like" atmosphere.

To say I learned obstetrical Spanish in a hurry would be an understatement. One of my favorite phrases was “¿Cómo se dice esto en español?” (“How do you say this in Spanish?”), as I pointed or gestured. I quickly learned to say (in Spanish), “Are you allergic to anything?” “Is your bag of waters broken?” “When was your last period?” “How far apart and how strong are your contractions (dolores)?” “Do you have any health problems?” and “Are you planning to breast feed or bottle feed?”

Over the course of time, I became semi-fluent with obstetrical Spanish. My patients were my teachers and I was their eager student. I also studied words and phrases on my days off, by breaking out the old textbooks and Spanish dictionary. I was eventually able to carry on short conversations to cover the basics of postpartal care for the mother and newborn care. I even wrote a short manual on common Spanish expressions for the healthcare worker and gave brief seminars at my former hospital and the local health department.

Through it all, I found that the most effective universal method of communication is a smile and a caring attitude, and this transcends even the most formidable language and cultural barriers.

zahryia · Jan 09, 2009, 03:54 PM