What does extraordinary mean? Merriam-Webster defines extraordinary as "going beyond what is usual, regular, or customary" and "exceptional to a marked extent." Many nurses get nominated because they have done something that falls under the first definition. Very few are nominated because they truly fill the second definition. Liz did something "exceptional to a marked extent." It is because of Liz that premature newborn infant survived a very unorthodox birth here in a facility that is unaccustomed to birthing full-term infants and taking care of even one-month-old babies let alone 26-week preemie. I have no doubt that, if it were not for Liz, this baby girl would have died during her first moments of life.
Liz was on call for Trauma OB; yet, when she was called in for a non-trauma OB, Liz unhesitatingly came in anyway. She knew that her expertise was needed. I was alerted to the situation when I saw the incubator flying across that ED. After making eye-contact with Liz, I stepped in to help. What I became part of was nothing short of a miracle.
The patient was 18 years old, supposedly found out she was pregnant 4 days prior and was in preterm labor with a suspected 26-week fetus. The patient was getting ready to be transported via ground to another hospital 45 minutes away. Liz noticed the patient's contractions were one minute apart, stopped the stretcher before it left, and pulled the patient into a room to check her cervix. She determined that the patient was fully dilated and her membranes were bulging; in other words, the baby was coming now. Transport was aborted and the patient was moved to a much larger room that would accommodate multiple staff to care for two patients simultaneously.
The birth occurred within minutes of that decision. Liz already had the incubator set up with oxygen; she had already communicated with respiratory therapy to obtain a MAC-0 and the smallest ET tube available; she had the BVM set-up and knew how to use it. when the baby was born, there was a discussion about not cutting the cord; Liz knew this was wrong, provided the cord clamp, and instructed the cord to be cut so that the baby could be moved to the incubator where she would be intubated.
Once in the incubator, Liz knew to administer oxygen prior to attempting intubation. Once the baby had been oxygenated, she asked me to attempt intubation. After 2 unsuccessful attempts, the baby's heart rate dipped below 60bpm; Liz knew to start compressions. She requested anesthesia for further intubation attempts. Anesthesia obtained an airway. Liz asked for IV access. When the rest of us looked at her with the "not sure how to do that" look, she instructed me how to place an umbilical line. She even remembered to check the baby's blood sugar. After that, she was able to maintain all the tubes and lines and still get a weight on the baby. She continued to ventilate the baby and instructed others on how to do it. When All-Children's arrived, the baby was intubated, lined, oxygenation, given fluids, and alive almost 45 minutes after birth.
Throughout all of this, Liz was calm, cool and collected. She maintained an air of authority and quelled the panic that would otherwise have arisen. Her voice remained low and firm, directing all of us on how to save this child's life. She never panicked, even when things were not going well, she kept at it.
There is no doubt in my mind that this new baby girl would have died before she ever got the chance to live if Liz had not been there. Even after all of this. Liz didn't feel that she had done anything other than what was right and needed for the care of the patient.