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You May Not Believe Me, But...

At work in the ED we have this section of rooms that we commonly call the OB rooms because they are equipped with all of our OB type supplies. Some days when you're working that section you never see a single patient with any OB/GYN concerns, other days it feels like a constant turnover of vaginal bleeding, miscarriage, possible pregnancy, etc. So as you might expect some shifts it can be particularly emotionally draining to work that section of the ED.

Since struggling with getting pregnant, I've had a few patients that have really tugged at my heart. Today I'm going to talk about one that really got to me and honestly I'm not sure why. I've had much sadder and more challenging cases, but for whatever reason on this day this patient stayed with me. Let me just say, it's not at all unusual for people to the leave the ER completely frustrated with staff because they aren't given a diagnosis. Typically this is a great thing. You DON'T want us to find something in the ED because that means you have something serious going on. Understandably when people don't feel well they simply cannot grasp this concept. Anyway, on this particular shift I was taking care of a super nice lady who had been seen the day prior for abdominal pain and told she may be pregnant based on her HCG (or pregnancy) hormone level. She was back on that particular day because she had started bleeding vaginally that morning and by her accounts quite heavily. As per standard best practice we repeated her HCG level which had doubled appropriately and her ultrasound was inconclusive. There was a gestational sac and egg yolk, but at her early stage of pregnancy the fetal pole (which eventually turns into a fetus) was too small for accurate measurements.


This lady would later be discharged with a diagnosis of unknown fetal viability and threatened abortion. Basically, her blood levels and ultrasound did indicate that she was positively pregnant, but based on her vaginal bleeding (which can be completely benign in pregnancy) there was a risk that she would have a miscarriage. While I was discharging her she very fairly expressed her frustration that she would probably be back when the pain came back and that again she was leaving with barely any answers. She didn't know which way was up. Living in limbo for the next few days she didn't know whether she should start grieving or remain hopeful for this pregnancy.


Now, in nursing school they tell you all the time to remember nothing about patient care is about you. Never should I as a nurse make a patient's experience about me. They aren't there to hear my story, but at the same time you also want to be able to relate to your patients to create rapport and a trusting relationship. Sometimes you want nothing more than to sit face to face with your patients and help them to see exactly how much you understand what they are going through. This was one of those situations. I wanted to sit with her and explain that I've gone through the heartbreak month to month every single time Auntie Flo arrives. I wanted to explain that I know the anxiety of waiting on repeat blood work, on waiting for a repeat ultrasound appointment to roll around. I had been there. I had done it. I got it. But sitting there and telling her my story would do nothing to help her, only me. She may not have believed it when I said it, but all I could say to her at discharge was "I know how you feel" and leave it at that.


Morals of the story: please by kind to your care team, we understand your frustration on not always giving you concrete answers, we wish we could, but sometimes we can't. Be patient with your body. There is a significant chance that your body will adjust to pregnancy and all will proceed without complication. If not, lean on those around you. I have no doubt you have the strength to make it through. I by no means want this to come off as my lecturing this patient because this is absolutely not my intention. As a member of a working healthcare team, I can see and have lived on both sides of the equation. As a patient, I want an answer from my doctor, I want her to tell me exactly what is going to happen. However, as a nurse I know this isn't a realistic expectation. So no matter what side of the equation you fall on just know your team is absolutely working to get you the answers you need, but sometimes the only answer is time.


In the meantime, keep running your race. Keep logging those miles to motherhood. The finish line is closer with every step you take!

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