“Yeah, and he’s peed, but hasn’t pooped. I haven’t done the bath or the newborn assessment yet.”
“No problem,” I say. “Is that it?”
“The dad’s name is Turk,” Lucille replies, hesitating. “There’s something just a little…off about him.”
“Like Creeper Dad?” I ask. Last year, we had a father who was flirting with the nursing student in the room during his wife’s delivery. When she wound up having a C-section, instead of standing behind the drape near his wife’s head, he strolled across the OR and said to the nursing student,Is it hot in here, or is it just you?
“Not like that,” Lucille says. “He’s appropriate with the mom. He’s just…sketchy. I can’t put my finger on it.”
I’ve always thought that if I wasn’t an L & D nurse, I’d make a great fake psychic. We are skilled at reading our patients so that we know what they need moments before they realize it. And we are also gifted when it comes to sensing strange vibes. Just last month my radar went off when a mentally challenged patient came in with an older Ukrainian woman who had befriended her at the grocery store where she worked. There was something weird about the dynamic between them, and I followed my hunch and called the police. Turned out the Ukrainian woman had served time in Kentucky for stealing the baby of a woman with Down syndrome.
So as I walk into Brittany Bauer’s room for the first time, I am not worried. I’m thinking:I’ve got this.
I knock softly and push open the door. “I’m Ruth,” I say. “I’m going to be your nurse today.” I walk right up to Brittany, and smile down at the baby cradled in her arms. “Isn’t he a sweetie! What’s his name?” I ask, although I already know. It’s a means to start a conversation, to connect with the patient.
Brittany doesn’t answer. She looks at her husband, a hulking guy who’s sitting on the edge of his chair. He’s got military-short hair and he’s bouncing the heel of one boot like he can’t quite stay still. I get what Lucille saw in him. Turk Bauer makes me think of a power line that’s snapped during a storm, and lies across the road just waiting for something to brush against it so it can shoot sparks.
It doesn’t matter if you’re shy or modest—nobody who’s just had a baby stays quiet for long. Theywantto share this life-changing moment. Theywantto relive the labor, the birth, the beauty of their baby. But Brittany, well, it’s almost like she needs his permission to speak.Domestic abuse?I wonder.
“Davis,” she chokes out. “His name is Davis.”
“Well, hello, Davis,” I murmur, moving closer to the bed. “Would you mind if I take a listen to his heart and lungs and check his temperature?”
Her arms clamp tighter on the newborn, pulling him closer.
“I can do it right here,” I say. “You don’t have to let go of him.”
You have to cut a new parent a little bit of slack, especially one who’s already been told her baby’s blood sugar is too low. So I tuck the thermometer under Davis’s armpit, and get a normal reading. I look at the whorls of his hair—a patch of white can signify hearing loss; an alternating hair pattern can flag metabolic issues. I press my stethoscope against the baby’s back, listening to his lungs. I slide my hand between him and his mother, listening to his heart.
Whoosh.
It’s so faint that I think it’s a mistake.
I listen again, trying to make sure it wasn’t a fluke, but that slight whir is there behind the backbeat of the pulse.
Turk stands up so that he is towering over me; he folds his arms.
Nerves look different on fathers. They get combative, sometimes. As if they could bluster away whatever’s wrong.
“I hear a very slight murmur,” I say delicately. “But it could be nothing. This early, there are still parts of the heart that are developing. Even if itisa murmur, it could disappear in a few days. Still, I’ll make a note of it; I’ll have the pediatrician take a listen.” While I’m talking, trying to be as calm as possible, I do another blood sugar. It’s an Accu-Chek, which means we get instant results—and this time, he’s at fifty-two. “Now,thisis great news,” I say, trying to give the Bauers something positive to hold on to. “His sugar is much better.” I walk to the sink and run warm water, fill a plastic bowl, and set it on the warmer. “Davis is definitely perking up, and he’ll probably start eating really soon. Why don’t I get him cleaned up, and fire him up a little bit, and we can try nursing again?”
I reach down and scoop the baby up. Turning my back to the parents, I place Davis on the warmer and begin my exam. I can hear Brittany and Turk whispering fiercely as I check the fontanels on the baby’s head for the suture lines, to make sure the bones aren’t overriding each other. The parents are worried, and that’s normal. A lot of patients don’t like to take the nurse’s opinion on any medical issue; they need to hear it from the doctor to believe it—even though L & D nurses are often the ones who first notice a quirk or a symptom. Their pediatrician is Atkins; I will page her after I’m done with the exam, and have her listen to the baby’s heart.
But right now, my attention is on Davis. I look for facial bruising, hematoma, or abnormal shaping of the skull. I check the palmar creases in his tiny hands, and the set of his ears relative to his eyes. I measure the circumference of his head and the length of his squirming body. I check for clefts in the mouth and the ears. I palpate the clavicles and put my pinkie in his mouth to check his sucking reflex. I study the rise and fall of the tiny bellows of his chest, to make sure his breathing isn’t labored. Press his belly to make sure it’s soft, check his fingers and toes, scan for rashes or lesions or birthmarks. I make sure his testicles have descended and scan for hypospadias, making sure that the urethra is where it’s supposed to be. Then I gently turn him over and scan the base of the spine for dimples or hair tufts or any other indicator of neural tube defect.
I realize that the whispering behind me has stopped. But instead of feeling more comfortable, it feels ominous.What do they think I’m doing wrong?
By the time I flip him back over, Davis’s eyes are starting to drift shut. Babies usually get sleepy a couple of hours after delivery, which is one reason to do the bath now—it will wake him up long enough to try to feed again. There is a stack of wipes on the warmer; with practiced, sure strokes I dip one into the warm water and wipe the baby down from head to toe. Then I diaper him, swiftly wrap him up in a blanket like a burrito, and rinse his hair under the sink with some Johnson’s baby shampoo. The last thing I do is put an ID band on him that will match the ones his parents have, and fasten a tiny electronic security bracelet on his ankle, which will set off an alarm if the baby gets too close to any of the exits.
I can feel the parents’ eyes, hot on my back. I turn, a smile fastened on my face. “There,” I say, handing the infant to Brittany again. “Clean as a whistle. Now, let’s see if we can get him to nurse.”
I reach down to help position the baby, but Brittany flinches.
“Get away from her,” Turk Bauer says. “I want to talk to your boss.”
They are the first words he has spoken to me in the twenty minutes I’ve been in this room with him and his family, and they carry an undercurrent of discontent. I’m pretty sure he doesn’t want to tell Marie what a stellar job I’ve done. But I nod tightly and step out of the room, replaying every word and gesture I have made since introducing myself to Brittany Bauer. I walk to the nurses’ desk and find Marie filling out a chart. “We’ve got a problem in Five,” I say, trying to keep my voice even. “The father wants to see you.”
“What happened?” Marie asks.
