Bribing Nurses: It’s How the World Works – Sept ’06

Last month I was the new intern on the OB ward. Naturally, while there my goal was to deliver babies. When things went well, I got to talk with the new mom-to-be, manage her progression through labor, and ultimately deliver the baby. When they went really well, I’d get to sew up any lacerations that formed and I’d get to continue following the newly enlarged family until I discharged them after their stay at the hospital.

Even though I was SUPPOSED to be there however, I was never assured of actually doing anything. Sometimes I’d just sit on the ward with nothing to do. Since my main attraction to residency is that I get to actually DO things – rather than just watch them or read about them – I get very unhappy when I mostly just sit around doing paperwork. Days like this for me are the emotional equivalent of chewing on industrial-grade wall insulation. If it happens while I’m in OB, all I can do is sit at the main desk outside the labor rooms and listen to the ward while I “read” something informative. And listening to an OB ward – if I’m not a part of someone’s care – is, frankly, an acoustic disaster. Anywhere from six to eight women, occasionally in unison, wail and moan and screeeech for hours as the mortal pain of labor ebbs and flows. It’s a cacophonous sound-collision of sick elephants and blaring boat horns all mixed into one unbelievable noise.

And who determines if I’ll be enjoying my day or hating it? That would be the nurses. Here’s how it works:

When I arrive on the ward around 7am, the first thing I do is look at a dry-erase board. THE dry erase board. Envision this board as a little altar with incense and candles and effigies of cute, small humans on it. Me – the obedient little worshiper – bows in ardent reverence to the lofty board every morning, hoping it will be bring me good fortune.

The board shows what’s happening on the labor ward. It shows which rooms have laboring women, how far along they are, and most important, it shows who their nurse is. It tells me which nurses I need to charm, dupe, cajole, hex or hoodwink into letting me be manage the case with them.

“Dry Erase Board, Dry Erase Board, on the wall…are there any fair nurses today at all?” I intone, tossing shots of whiskey behind each shoulder as I light the tips of my hair with a candle.

“Not really, you sorry punk.” Is the usual response from the impassive board.

Most nurses are respectable professionals. The ones on the OB ward are highly trained and are occasionally willing to let me get involved in a labor and delivery. But to really get good experience, I need them to help me get more than an occasional delivery here and there. I need their active support. They are the ones who persuade the patient to let me get involved. They’re often the ones who tell the attending doc – the patient’s doc – that I want to be included in the case.

And no, I quickly learned that whatever brilliance, good looks and stupefying Jedi Mind tricks I may have are no match for a seasoned, tired nurse who isn’t much interested in a bumbling intern who wants to “help”. In general, it’s tough to get in on more than an occasional delivery.

A week into my first OB rotation and I was getting desperate. Too many days sitting at the desk “listening”. In full “mayday” mode, I embarked on a search deep into the secret tomes of nurse-influence lore. Dabbling in the Dark Arts of Nurse Magic, I eventually found a numinous means to garnering energetic OB nurse support; a pathway to the inner sanctum of nursehood. It’s a simple dictum, really:

The fastest way to a nurse’s heart…is through cheesecake. And chocolate. Cookies help, too.

At first, it was just some cookies. Pretty good response. I think I picked up a delivery out of the deal. Then I brought a veggie tray (with some trepidation, fearing a health-food backlash). It went over fairly well and I might have picked up 2 or 3 more deliveries than I would have.

My last week on OB, though, I went for broke. I brought a cheesecake. 15 bucks and – worse – a time-consuming trip to a grocery store. But it was PAY-DIRT. I couldn’t keep ‘em off me. It was like Matthew McConaughey at a …teen-girl sleepover.

“Yoooooo Hooo, Dr. Ankeney,” I’d hear down the hall, “There’s a patient in Room 4 if you’re interested. She’s 3 cm dilated and I’ve already told her all about you. She’d be HAPPY to have such a polite and considerate resident helping her have her baby.”

Thank you, ma’am. And a cookie for you.

Same thing from Room 2. And 3. And 6.

Each time as I gowned up to catch the baby, I’d hear someone whisper some version of, “thanks for the cheesecake, it was amazing. Did you make it yourself?”

“AbsoLUTELY.”

Well, I bought it myself, anyway.

Got 25 deliveries that month. Not bad at all. I delivered my own little village. All thanks to some gratuitous badgering and a little cheesecake.