November 18, 2018
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Night Shift: Waiting for babies at EMMC L&D

Sarah Smiley | BDN
Sarah Smiley | BDN
Sarah Smiley

It was snowing again when I went to cover this month’s night shift, and because I was headed to Eastern Maine Medical Center’s Labor and Delivery (L&D) floor I hoped that would mean a lot of babies would be born. According to the old wives’ tale, more babies make their entrance during full moons and low pressure systems. Reality, of course, is a different story, and much like the emergency department, Labor and Delivery nurses never know how each night will go.

The halls were quiet as I met Jennifer Wickett just outside the nurses’ station. Wickett, who effortlessly blends nurturing (“I’m like a mother bear [protecting my patients]”) with no-nonsense education (“If your baby’s not happy, I’m not happy. Happy baby, happy Mom.”) is like a favorite aunt you’d want in the delivery room with you. She is spunky — even at midnight — and clearly experienced, with more than 14 years as a nurse, often in the OBGYN operating room.

When I mentioned the stillness around us, Wickett told me the floor operates “like a ship on the ocean at night.” She meant that the team operates without the ancillary staff they are accustomed to during the day, but suddenly I had a visual of the rest of the hospital falling away, and the L&D floor rocking gently under a star-filled sky to the soft blips and beeps of fetal monitors.

Peaceful, isn’t it? And with the ever-present reminder of babies — babies! — all around, it’s hard not to feel peaceful on the L&D floor. I caught myself swaying from side-to-side many times, as if I was rocking a baby.

In the middle of our talk, however, Wickett had to dash off to help with an urgent medical issue in a patient room, and I was reminded again that this is, in fact, a hospital, not a Pampers commercial, and sometimes things don’t go as planned.

A patient named “Amanda” falls into that category. On bedrest for 9 weeks, the L&D floor is her pseudo-home for the next couple months. If you are having trouble imagining being pregnant and living at the hospital for 9 weeks, Amanda seemed surprisingly settled-in. She gave credit to the nurses — especially the nighttime nurses — for making her situation more comfortable.

“[The night nurses] come in and chat with me,” she said. “They don’t come visit me as much during the day.”

Amanda’s nurse, Wendy Hafford, explained that much of this is due to the amount of shift changes during the day. (Amanda estimated she has three to four different nurses during the day and only one at night.) But Hafford agrees it takes a different personality to be a night nurse.

For 20 years, Hafford has only worked nights. “I like the people,” she said. “There’s more camaraderie, we work as a group, and the night gives us more of an opportunity to be 1-on-1 nurses.”

Hafford and Amanda already seemed like old pals. They had a comfortable banter with one another, and as I left the room, Hafford was headed out to get ice cream for her patient. She already knew what flavor she’d like.

“During a 12-hour shift, we are our patients’ constant,” Wickett said later. During the day, nursing is interrupted by meals, cleaning, and doctors’ rounds. But at night, when there are no visitors and no regular staff, patients like Amanda rely on their nurses for support — both mentally and physically.

“We get to be nurses more at night,” Wickett said. “Nurses get into nursing to be at the bedside, not at the computer.”

Over on the postpartum side of the floor, I met Dawn Andrews, a 25-year veteran of working the night shift. When I asked “why nights?” she cupped one hand around her ear, and said, “Just listen.”

Silence.

Andrews smiled. Then she added that during the night, with less interruptions, patients talk to their nurses more. In turn, the nurses get a better feel for how the new mother is doing. There is more time to answer questions. And with serious, sometimes invisible, issues like postpartum depression, it’s important for nurses to have that time to check-in with their patients.

Unlike when Wickett first joined L&D in 2003, postpartum depression is now written into the care plan and education. “Women are talking about it more and nurses are talking about it more,” she said. And much of that “talk” happens when the rest of the world has gone to sleep.

From a desk behind Andrews, Tricia Collins, who has worked nights for 18 years, pointed out that most patients’ first experience with a hospital stay might be when they have a baby. That means the nurses on L&D have the added responsibility of being the patients’ first impression of nursing care. Andrews and Collins both take that seriously.

It was early in the morning now, and still no baby had been born. I did get to see some newborns in the nursery, and that was devastating to my middle-aged ovaries. And then, just as Wickett and I rounded a corner, I saw a dear friend’s husband rushing down the hall. His wife, my friend, was in labor.

The next day, I woke up to their happy announcement on Facebook, and I knew my friend was in great hands for the rest of her stay at EMMC Labor and & Delivery.

Maine writer and columnist Sarah Smiley’s writing is syndicated weekly to publications across the country. She may be reached at facebook.com/Sarah.is.Smiley.

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