A Nurse’s Perspective By Heidi Cifelli

Ihave been a nurse for the past 33 years, and currently work at Stony Brook University Hospital. For the last 21 years, I have used playing tennis and competing in USTA leagues as my outlet. I was devastated when the tennis season got put on hold due to the COVID-19 pandemic, but even more devastated about the changes that have happened at the hospital recently to try protect me and my patients from the devastating effects of the virus.

I’m a labor and delivery nurse, and I’m so tired of the way this specialty is viewed by other people, including even by healthcare workers who work in other specialties. I’m talking about the things I’ve heard since this virus has turned our worlds upside down; I’m tired of family and friends making comments such as, “well at least you just work in labor and delivery.”

So let me educate you about labor and delivery.

When a woman is pregnant, her entire body goes through many changes. Pregnancy can exacerbate or mask different diseases. When it comes to the coronavirus, most laboring patients are asymptotic during labor and don’t show any signs or symptoms until postpartum. This means that a positive patient can have a negative screening. We can be around positive patients for days and have no clue… that alone is terrifying. But as everyone knows, life in Labor & Delivery is a little different. We can’t always social distance, we can’t always think of ourselves before our patients. We are treating two patients in one body and we have to make sure at the end of the day we have a healthy mom and a healthy baby.

When a patient comes in through the Emergency Department and is about to By Heidi Cifelli

deliver, she is quickly brought to us. Because of that, she may or may not have slipped through some COVID-19 triage questions, but when she gets to us, our top questions aren’t, “Have you had a fever? Have you been short of breath (I mean of course she has, she’s pregnant)?”

Our questions are, “What number baby is this? Were your other babies vaginal deliveries or C-sections? Were there any problems with those deliveries like bleeding after, any complications with this pregnancy?” Nurses and nurse’s aids rush in to set up a table, warmer, start an IV and do as much as we can in two-to-four minutes. Grabbing our mask isn’t always our first thought.

When a 17-weeker comes in and her baby doesn’t have a heartbeat, it may be her first, second or third loss, and her and her husband are crying and want to know why. They want to know what they did wrong. We don’t stay six-feet away; we sit with them, we hold them both and we cry with them. When a baby’s heart rate goes down during labor, we rush into the room, sometimes forgetting about our double mask and PPE. We do interventions to get it back up, but when it doesn’t come back up, we call out for delivery. Nurses rush in, we call the doctor, and everyone is doing what needs to be done to safely deliver the baby and be prepared for resuscitation if needed. We have to stay close to our patients, we comfort them while they’re hurting and waiting on an epidural; we hold their other leg because they now only have one person with them; we take pictures of mom, dad, and baby because there is no one else there to capture these once-in-alifetime moments. We do all of this sometimes, not even knowing our patient is positive with the virus... and we gladly do it because we LOVE WHAT WE DO. So the next time you think it is all baby cuddles, rainbows, and virus-free on L&D, just remember our patients are at risk too!

So, to many, it might not seem like I and my colleagues are working on the frontline, but I go to work every shift not knowing what will come through our doors. I have to wear all the protective equipment to protect myself and protect my patients from this virus. I can’t see my patient’s face, because she has to wear a mask, nor can she see mine, during these intimate moments of having a baby. But even under these circumstances, I can’t imagine not going to work and giving it my best every shift.

Tennis has been my outlet, where I can leave the work behind and just have fun playing the game I love.

Heidi Cifelli is currently a nurse at Stony Brook Hospital, and has competed in USTA Leagues for more than 20 years.