Week 6 in the bag.
I’m to the point where shifts left are counted on one hand and I’m getting excited about moving on to the next thing. You know how I am, things are getting a bit too comfortable so it’s time to get going.
Anyway, I’m finding that people have zero understanding of what an L&D nurse does during the shift. I remember before I started I thought this was a cake job. Babies and happiness. People seem to believe that’s what we do all shift; rock babies for 12 hours straight.
Labor and delivery is a speciality for a reason. Speciality implies honed abilities and certifications specific to one thing. It involves skills and experience developed and utilized to care for individuals
Have you ever read a fetal monitoring strip? Have you ever checked a cervix? Palpated a pregnant belly for fetal position? Have you coached someone to push or put them in the right position to get a cervix to open up? Have you looked at a woman in labor and predicted how their labor would go? Have you taught someone to breastfeed? I mean, got a baby who was not nursing on the breast with proper technique and calmed mom down when she was beside herself?
I don’t often get to rock babies during a shift and if I am it’s because mom hasn’t slept for 24 hours, her baby is cluster feeding, and her nipples are cracked and bleeding. I’m trying to give her 2 solid hours of sleep so she doesn’t have a breakdown.
Monitoring a laboring mom requires critical thinking skills which I need certified for. Do you know how stressful and tedious it is to stare at a monitor for 12 hours? To determine when to ask for pitocin because contractions are inadequate? To determine when your baby is giving subtle and not so subtle signs of distress that require immediate intervention?
Have you ever bagged a baby?
What do you think I do during labor? I’m turning people to open up their cervix, intervening in a calm manner when the baby is in obvious distress, keeping the doctor updated from home.
I do most things up to delivering the baby and almost everything after the stitches are placed. I’m determining how low the baby is in the pelvis and how much you have to push, I’m alerting the doc of the right moment to arrive (the baby is under the pubis and I see the right amount of head!), I set up the table, I’m charting, handing over supplies, starting pitocin so you don’t bleed, making sure your baby is doing okay, doing vitals, cleaning the room, charting, getting everyone cleaned back up, teaching, charting, helping breastfeed, administering baby meds, charting, doing fundal/bleeding checks every 15-20 mins for an hour or two… And that’s in the first 2 hours of delivery. I’ve been places where we bathe the baby before transport and get mommy up before transport to postpartum.
I’m usually drenched in sweat after a delivery and probably haven’t had a chance to sit down, pee, eat, or drink anything for the last 4-5 hours.
I’ve pushed with patients for 4 hours before they’ve delivered, spent long moments getting a mom in pain her epidural. And I monitor, monitor, monitor.
This isn’t easy. This isn’t baby rocking every 12 hour shift. This is postpartum hemorrhages, subdural blocks, stat sections, coding babies, and thinking on your feet. Yea, I do rock babies sometimes, but since most places are strict with rooming in, it’s not as often as you think.
To just boil what I do down to that cheapens it. It’s like telling teachers they make coloring pages at work or social workers they hold kids’ hands all day.
Things are a bit more complicated than that. It’s the lack of understanding that makes OB the red-headed stepchild of the hospital. We spend a lot of money doing this and no one understands why. You hold babies all shift, how are you overbudget?? Ah, let me explain the ways…
Nurse C at your Cervix
Travel on, road warrior