OB Nurse in a Small Rural Hospital

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. Nurses Announcements Archive Article

OB Nurse in a Small Rural Hospital

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 "Como se dice esto en espanol?" ("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 breastfeed 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.

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Specializes in L&D, QI, Public Health.

I came by this article accidently. What a lovely article!

Specializes in Gerontological, cardiac, med-surg, peds.
I came by this article accidently. What a lovely article!

Thank you. This little hospital was my first employer and I learned so much. We truly were jacks of all trades! I'll never forget those experiences and the wonderful camaraderie I felt working there.

What a difference from the NY hospital I did my clinical OB rounds as a student.

NY has a large Hispanic population that speak little or no English. One day, the nurse on the floor was exasperated by her inability to communicate with her patients and lost her cool. I will never forget how she screamed at her patient, "Go back to your country! You only come here to have your babies and make money, and then you run back!" I was horrified.

I work in a border town as a L&D nurse and I am ALWAYS trying to pick up the spanish OB lingo. Great story.

Thanks from another small town rural nurse who did OB, ER and med/surg . . . . and we had that buzzer too! steph

Oh been there done that. My small town hospital also had a buzzer for the ER. Went to answer the door one night and there sat Non-English speaking hispanic women and her 8 year old SON for her translator. Boy did he look at me fun when I wanted "Has your water broke" translated.

Specializes in Gerontological, cardiac, med-surg, peds.
oh been there done that. my small town hospital also had a buzzer for the er. went to answer the door one night and there sat non-english speaking hispanic women and her 8 year old son for her translator. boy did he look at me fun when i wanted "has your water broke" translated.

“¿se le rompió la bolsa de aguas?” lol

you bring up an important point. it is always best practice (especially in today’s litigious climate) to use a certified translator or one of the designated facility translators. if there is no on-site translator, then staff often rely on family or friends of the client to translate (especially in emergent situations). since children have such marvelous language abilities, they will pick up english much faster than anyone else in the client’s extended family. the downside to this is that they may be asked to translate subject material that is not appropriate for children. they (as well as any other family member or friend/ acquaintance asked to translate) also may be exposed to confidential client health information.

in my experiences, the cases frequently were emergent with no time to call in anyone to translate. i’m not sure we even had phone translation services back then and these wouldn’t have helped much anyway. and sometimes, out of desperation, we did rely on children to help translate. we did have an episcopalian priest (“father nick”) who was our designated facility translator, but he lived quite a distance from the facility. this made the practicality of calling him nil in an emergency.

Specializes in Gerontological, cardiac, med-surg, peds.

Some other helpful Spanish obstetrical phrases (which I picked up over the years):

¿Es usted alérgica a alguna medicina o comida? Do you have allergies to medication or food?

¿Cuándo fue su última regla? When was your last menstrual period?

¿Cuándo va a dar luz? When is your due date?

¿Cuándo comenzaron los dolores de parto? When did your contractions start?

¿A cada cuántos minutos vienen sus dolores? How many minutes apart are the contractions?

¿Cuánto tiempo dura cada dolor? How long are they lasting?

¿Usted le va a dar el pecho o botella? Are you going to breast or bottle feed?

Terrific story. Your presence in that community was a real blessing to the random Hispanic patients who wandered in for health care.

Have you written your high school Spanish teacher to thank him/her? S/he would get a kick out of your letter!