In Kenya the line between witchcraft and nursing was crossed decades ago. No matter how deep in the sand our heads are buried, there is no escaping from the fact that things need to change.
Thursdays and Fridays are the most understaffed days in my work station and this Thursday was no different. I get to work at 7.15 am just in time for the handing over. I received one client in active phase of labor. A primi_gravida, twenty years old with no history of any chronic illness although she was a little overweight.
After the brief pleasantries, the client and I went through the do’s and dont’s of labor. I was certain that my shift would end without incidents. The client was a delight to work with. She was quite the chatterbox, despite the very painful contractions she was experiencing, She talked about her unborn baby, husband and anything else that crossed her mind.
An hour and a half later, I requested her to accompany me to the examination couch for a repeat vaginal examination . During the assessment I noted that her cervix was completely dilated and the baby’s head had descend perfectly. The fetal and maternal heart rates were within the normal ranges, so was her temperature and urine readings. I however noted that her blood pressure readings were significantly higher than the readings I had recorded a little over an hour before. At 140/80 mmhg, with no other sign or symptom of pre_eclampsia, I reasoned that it was probably due to the fact that my client was anxious and experiencing very severe contractions. I called the doctor, and reported my findings to her. She assured me that she was making her way to the delivery room from the outpatient department. I was confident of conducting a quick spontaneous vaginal delivery despite the setback.
Twenty five minutes later the baby had not been born. There was no obvious reason for the delay. Apart from the slightly increased blood pressure the other parameters were okay. I decided to call the doctor to come back and as I was ungloving, the room fell into a deathly silence. The client who was writhing and screaming in pain had suddenly gone mute.
The events that transpired thereafter will forever be etched in my mind. My client was about to have a convulsion and I wasn’t prepared for the eventuality. Her body shook violently, she froathed as her eyes rolled into the back of her head. I was torn between holding her down to avoid a fatal fall from the delivery couch and running over to the cupboard, a few feet away, to fetch the emergency tray. I was scared. I Couldn’t fathom a maternal death during my shift. My heart raced and my brain pulled a rudisha move on me. I envisioned all manner of persecution ranging from expensive lawsuits and the notorious shaming by the media.
I don’t know how a loud scream involuntarily escaped from my mouth, all I know is that it was loud enough to be heard by the deputy nursing officer incharge. She left her office running and answered my distress call. She knew what to do the minute she saw me desperately trying to keep the convulsing client from falling off the couch. It seemed like an effort in futility, the bed rocked as another
convulsion started. The arrival of two more nurses was a comforting sight.
We managed to administer magnesium sulpate injection on her thighs and anxiously waited for the client to stabilize. The nursing staff, the doctor and anesthetist decided, after an all inclusive brief consultation that the client would be safely delivered through a caesarian section in the nearest referral hospital. The twenty minutes ambulance drive to the referral hospital was the longest, most scary and uncomfortable ride, even though the client was fully conscious and in stable condition.
The handing procedure at the referral hospital was brief, the theater staff were waiting for her. We were informed of the safe delivery of a live baby girl three hours later. The news was like music to my ears. Our sacrifice had borne great success. The injured wrist, headache and fatigue were worth it.
I am eagerly waiting for the day, the relevant authorities will realize that quality nursing care is unachievable with the current understaffing in the public hospitals. It’s like draining a lake into a pond. This is witchcraft, the patient is the voodoo doll and the unfortunate nurse is the broom straddling ‘witch’ .