This hospital doesn’t have a labor and delivery department — if she’s here, it’s an emergency

T

he ER is physically demanding at the best of times. At the worst of times — say in my eighth month — both feet are screaming in agony long before the end of my shift. Today, though, my feet are aching before I even start. Restricted caffeine intake (hello, strict OB-GYN who feels that two cups of coffee a day is more than enough?!) isn’t helping matters.

Pushing through a thick haze of fatigue, I head to my computer and log in to assess the caseload waiting for me. A few clicks, and I can see the online board showing which patients are in which rooms, along with a few lines of information from the triage nurse. A typical day — looks like a deep laceration is waiting for me in room 4, while a baby with persistent fever is next door.

“Hi, Jess,” I say cheerfully to the nurse in charge of room 4. She’s one of those nurses who knows how to be kind and firm at the same time, and her patients are always calmer and easier to deal with — just what I need right now.

She nods, dark curls bobbing. “Looks like a full day today, Ayala!”

“Wouldn’t want to get bored!” I remark wryly, and then waddle as quickly as I can to my first patient.

The next hour passes in a blur as I sew up a laceration from a piece of glass, send the baby with persistent fever for testing, prescribe medicine for a bad ear infection, order a CT scan for a young man with severe abdominal pain, and care for an older woman with an ugly compound fracture, the result of an unfortunate fall.

I need a moment to breathe, so I slip back to my computer and idly open the case board. My name is next to a new patient, a woman in labor. I frown and open the triage nurse’s assessment. This hospital doesn’t have a labor and delivery department — if she’s here, it’s an emergency, and something is probably wrong, or we would have transferred her.