Tuesday, February 7, 2012

The Patient I Failed - L&D Version.

I knew the second she rolled onto our unit that the broad wasn't in labor. Heck, I'd seen corpses in more pain than what she "appeared" to be in.

This wasn't my first rodeo, so her well-rehearsed "hee, hee, hees" and "hoo, hoo, hoos" didn't have me fooled for second. I was all too familiar with her type... the kind of dame who dresses up for labor like it's some sort of beauty pageant or cakewalk— makeup meticulously applied, hair lacquered into place with so much hairspray that it would require an act of God to dishevel it, and perfume so pungent, its scent would haunt our halls for a fortnight to come.

Her husband pushed her wheelchair as if he were racing to a finish line that was way out of reach, but, really, it wasn't out of reach at all; they had been assigned to room 252, which was only a few feet away.

I sighed at the despicable sight of them, these labor wannabes, and I was disappointed that they were about to waste my valuable time. Concealing my disdain, I introduced myself and politely instructed her to change into a gown.

It wasn't until I was tucking her into bed that I noticed she seemed despondent, detached if you will. As I applied the monitors, I could see, from the corner of my eye, a lone tear roll down her cheek as it etched a trail of smudged makeup in its path.

It was at this precise moment that something inside me shifted—an awakening of sorts, per se. I could feel it as it relentlessly surged through my veins, its presence reminding me that it was during moments like this that I must suppress my ego and channel my natural calling.

Without further hesitation, I pulled up a chair and sat next to her bed, for I knew that in order to gain her trust, I had to bring myself down to her level. I grabbed her perfectly manicured hand in mine and looked deep into her eyes.

"I know. I get it," I said, hoping to convey a sense of commonality between us—anything to bring her to the safe place she so desperately needed to be.

"You can speak freely," I gently encouraged. "I am here to help."

Her husband sat on the other side of the room, his head buried in his hands. I realized that this was his pain, too, so I beckoned him to her bedside, hoping that this small gesture would emancipate him from his painful solitude.

I waited patiently for her to speak, knowing that if I pushed too hard, she would withdraw.

When she finally broke her silence, I braced myself, even though I was already aware of the confession she was about to impart. I had heard this exact confession countless times before, and let me tell ya, it never gets any easier.

She inhaled deeply. I inhaled deeply. Her husband inhaled deeply. It was like an orgy of oxygen-deprived souls.

She exhaled slowly, and riding on the air that escaped her lungs were the six words she was so terrified to say.

"I've..." she hesitated, fighting back the tears.

"I've lost...  my...  mucous... plug!"

(Okay, five words, but in all fairness, I didn't know she was going to use the contraction "I've." Ironically, it was the only contraction she had during her entire "labor" check.)

These words pierced my heart like an army of a thousand swords. As I fought back my own tears, I squeezed her hand. Stay strong, I thought, you must be a pillar of strength for your patient. 

Being the extremely level-headed but empathetic and compassionate person I am, I frequently find it difficult to separate "the nurse" in me from the human of raw emotions that is my heart and soul.

She began sobbing. I began sobbing. Her husband began sobbing. It was like a ménage à trois of guttural catharsis.

After we were done crying and I had composed myself, the nurse in me overtook the human in me.

I grabbed a pencil and notepad and got down to business.

"Listen," I spoke with purpose, "I, myself, am no stranger to loss. Now, granted, I have never lost a mucous plug, but I have lost family members, and let me tell you, grief is like a beast of burden; it burdens you like, well... a beast. So I totally understand what you are going through."

She listened attentively, hanging on my every word.

"I don't want to seem insensitive, but I need to ask you some very difficult questions."

As painful as it was for her, she seemed willing to cooperate.

The following is a transcript of our discussion:

Me: What were you doing when you lost said mucous plug?

Her: We were watching T.V..

Me: What were you watching?

Her: Um, I don't know, it might have been Glee.

Me: Listen, I need you to focus. It's important you try to remember because we've noticed a pattern as to when these mucous plugs go missing... it tends to happen during really shitty programming.

Her: Let me think... yes, it was definitely Glee.

Me: Okay, that makes total sense. Now, was there anyone with whom your mucous plug may have been angry, someone worthy of a grudge? An obstetrician who was too rough during a cervical exam, perhaps? Or someone who may have talked you into a little somethin', somethin', if you know what I mean? *This question was indirectly directed in the indirect direction of her husband.*

She exchanged a look with her husband, who sat quietly with a sheepish look on his face, his complexion turning a deep shade of crimson red. I immediately knew the answer and felt it futile to pursue the matter any further. I scribbled in my notepad, Horny husband angered mucous plug through act of  self-serving and unnecessary intercourse. 

Me: Did said plug leave a note?

Her: No.

Me: And there's been no contact with the plug since it went missing?

Her: None.

Me: Did you alert the police?

The look on her face indicated she had not. This wasn't good, as I knew that time was of the essence.

Me: Look, I'm going to be totally honest with you: statistically, if a mucous plug isn't found within two minutes of its disappearance, the case usually goes unsolved. Those two minutes are the most crucial minutes in these cases.

I didn't have the heart to tell her about the stack of charts in medical records that had long become cold case files, never to be opened again.

Me: I'm sorry, I don't know what else to tell you, except, mark my words, I will put up the good fight; I will continue to search for your mucous plug, leaving no peripad unturned.

Given that my patient was not in labor, I discharged her home later that night. As we said our farewells, I assured her that we would soon meet again—under happier circumstances—when they would return for the birth of their child.

In the weeks that followed, I searched diligently for their lost mucous plug, even going as far as petitioning my local congressman to pass a bill that would mandate a nationwide alert when mucous plugs go missing. The bill for Code Cream-Colored-Gob-of-Goo-With-the-Consistency-of-Snot is still in its infancy period but should hopefully be passed sometime early next spring.

I have made it my personal mission to ensure that the search of a missing mucous plug does not end with the birth of the baby it so vigilantly protected in utero. To raise awareness of this issue, I have taken it a step further:

Fellow Americans, I implore you to get involved. As you begin your day around the breakfast table with your family, please pay close attention to the picture on the milk carton. You never know, you might be instrumental in reuniting a family with their long lost mucous plug.



Thank you,
CS



8 comments:

Bretthead said...

Can you help me too? I seem to have lost my mind.

Consciously Sedated/Rachel Paul said...

Bret, maybe I can help:

1) Let's start at the beginning. When you were a fetus, did your mind fully develop? Don't answer that. I think I already have a pretty good idea.

2) Do you think you left it in Vegas? Sometimes minds stay behind to help bury dead hookers in the desert.

Where ever your mind may be, I really hope you find it before Burning Man. What good will the shrooms be if they can't eff up your mind?

Hope this helps,
Csxo

Bretthead said...

Rachel,

This was sort of not very helpful at all. What kind of nurse are you besides the booty shaking kind? We didn't kill the hookers - we just left them fuzzy handcuffed to the bed.

Consciously Sedated/Rachel Paul said...

How noble of you;)

Sandra said...

Ok, that was hilarious! And very very well written! And so unexpected....her mucous plug...and this is why I still don't know what area of nursing to go into...

Consciously Sedated/Rachel Paul said...

Thank you, Sandra. As far as what area of nursing you choose to pursue, I find that there are "above the waist nurses," and those who prefer below the waist. That is, some of us do okay with lochia and crap, while others do better with puke, sputum and snot. It's a delicate balance, but one that can definitely make a difference with the happiness you find in your career. Thanks for reading and best of luck.

CS

A Beer for the Shower said...

Bravo. You got me. Halfway through this, I was thinking WTF is a mucous plug? Then I realized that your absurdity is very deft and clever. Nicely done.

Consciously Sedated/Rachel Paul said...

Beer: How deft and clever is it of me if I had to look up the definition of "deft?" I guess I was a little confused because my mother frequently called me "daft."