I was working in West Virginia at Roane General Hospital Emergency Department in Spencer. One afternoon in December, Sierra and I had a patient come into the department who was in active labor. The patient was evaluated in the department and was recommended for transfer to another facility capable of handling obstetric patients, but had refused transfer and signed out against medical advice. Upon reaching her car, the patient had a spontaneous rupture of membranes and was brought back into the department. It was found that the baby was delivering at that time and that there was a breech presentation with only the baby's left leg as the presenting part. We were able to get the baby. delivered, and it was found after delivery that the baby was in severe distress, not breathing, and had a severely low heart rate.

Sierra immediately began CPR and worked to resuscitate the baby while other members of the medical team gathered for the resuscitation. Sierra continued CPR for the duration of the time that it was needed, and the team was able to successfully resuscitate the baby. Following the resuscitation, the baby continued to need continuous care from a nurse at the bedside. Sierra stayed with the baby for the entire duration of her 6-hour stay in our department, providing continuous monitoring and support to the infant while also supporting the operation of the other medical team. Sierra could've easily left the baby after the initial resuscitation in the care of an RN and gone to attend to other patients in the department; however, she remained for the duration of the visit.