What Hurricane Barry Taught Me about Obstetric Nursing
A week ago we were preparing for hurricane Barry here in Baton Rouge. The local news was full of reports about how high the Mississippi river was. People were filling up their cars with gas and stockpiling bread and fresh water. Some people evacuated. My husband bought propane and dug the camping stove out of storage. At the hospital, we updated our department phone tree, prepared to have staff sleep on site if necessary, and we made a plan to help all of our discharging patients fill their prescriptions. And then…the worst of the storm went around us.
As it became clear that Barry was not going to be the catastrophe we had feared, we started to laugh at ourselves. Our social media pages filled up with hurricane jokes and memes about the dangers of eating all the hurricane snacks.
But three years ago, we had catastrophic flooding in Baton Rouge. We weren’t prepared then. And it has taken some of us months, even years to recover. That flood taught us that if you want to avoid disaster, you have to be prepared. But there is something about human nature that makes us second-guess that vigilance when the disaster doesn’t actually materialize. Most of the time, when it rains the city doesn’t flood. But sometimes, it does. If you want to avoid catastrophe, then you have to prepare for the worst every time.
I’m struck by how my job as a clinical case manager for high-risk obstetric patients is a lot like hurricane preparedness. I spend a large part of my day providing discharge education to women who have hypertensive disorders of pregnancy. I provide written, verbal, and illustrated information about postpartum preeclampsia. I provide blood pressure machines and teach women how to use them. I encourage them to be complainers, to let their physician know if they experience any of the symptoms we discuss. Most of the women that I talk to? They do fine. But some of them will develop postpartum preeclampsia – but they get the treatment they need because they know what to do. Because I have prepared them. Most of the time when postpartum women have blood pressures as high as 160/100, they don’t seize or have a stroke. But sometimes they do. Most women with significant edema don’t develop pulmonary edema. But some do. Most women won’t die as a result of childbirth. But some will.
I know that some of my work colleagues see me as overzealous, maybe even ridiculous. I’m ok with that. Because if you’re going to embrace the #notonmywatch ethos, then sometime, somewhere, somebody is going to think you’re being too careful, maybe even ridiculously careful. That’s ok. I am the hurricane Barry of obstetric nursing!