Vicki received a patient a couple days past her due date for a rule out labor check. The patient was hopeful that she was not in labor since it was the birthday of her older child. The patient mentioned this quite often throughout her observation period.

The patient was not in active labor and the physician was prepared to send the patient home. Vicki noted subtle changes on the fetal monitoring during the observation. Vicki advocated for the patient and requested the patient remain for further observation. The physician trusted Vicki and valued her clinical judgment and agreed to observe the patient further.

The patient continued to struggle with the idea of having her baby on her older child's birthday. Vicki supported the patient. She redirected the patient to the well being of her baby. Vicki was compassionate and non-judgmental.

Over the next hour, it was decided to induce the patient's labor. The patient's labor progressed and within a couple hours the patient delivered a healthy baby. However, at delivery the baby was found to have a true knot in her cord. The physician shared with the patient that it was a good thing we delivered her that night or we could have had a completely different outcome.

("True knots and false knots can form in the umbilical cord. True knots occur in approximately 1% of pregnancies. True knots have been reported to lead to a 4-fold increase in fetal loss, presumably because of compression of the cord vessels when the knot tightens.")

Vicki's expertise and confidence to advocate for her patient provided the best possible outcome for this family. Vicki was compassionate and nonjudgmental and provided holistic care coupled with sound clinical judgment.