I recently took my infant son to an emergency center in a larger city about 30 miles from where I live. While I was waiting (and waiting, and waiting, and waiting…) a woman, standing in a different line, kept staring at me. She finally asked if I was nurse, and when I confirmed this, she asked if I remembered her…she had abrupted at 25 weeks and had to have an emergency cesarean section. Her baby had been transferred to the hospital I was now at. She said I was her lactation nurse (I was actually her postpartum nurse) and she remembered how helpful my mom, who is a nursery nurse, and I had been. It made me feel so good to know that she remembered me as a nurse who was helpful.
Remembering her story made me think of all the crazy things we see working postpartum. So many times throughout the years I have heard people say how fun postpartum must be. I’ve even heard other nurses say “when I’m tired of labor and delivery, I’ll just work postpartum.” When people think of a postpartum or a mother-baby nurse, they usually think we’re playing with babies all day!
One time, when I was working on an LDRP unit, I walked out of triage and saw everyone running towards a postpartum room at the end of the hall. I could hear all this yelling and commotion coming from the room, even from the end of the hallway. I immediately turned and ran the other way. lol I will never forget that. I kept thinking, this is Texas…someone might have a gun! It ended up that two guys were fighting inside the room and one was literally trying to kill the other one. This super unassuming, super tiny, GIRL postpartum nurse stepped right in between these two men and grabbed the guy’s throat with her fingers. She let go when his eyes started to roll into the back of his head and his knees went all weak (or so the story goes!). Another nurse grabbed the guy and contained him until the police arrived.
At the beginning of every shift, we have to figure out a way to introduce ourselves to the patient and her family, and then shortly after perform a head-to-toe assessment. This includes massaging her fundus (and we’re trying to get her to like us) and looking at her vagina to ensure her repair is approximated. And then, as icing on the cake, we have to ask them to turn over or lie on their side so we can check for hemorrhoids. And that’s just at the beginning of our shift. We pass out the same meds, give antibiotics to some, give Tucks and Epifoam to others, and encourage everyone to ambulate. We make beds, we get tea, we fluff pillows. Our backs are sore from constantly bending over (has no one thought to make an open-crib that can be raised?!?). We talk about the importance of pain control, ask if they’d like something for pain, they say no and then five minutes later, after they’ve had time to mull it over, they’ve decided that yes, Motrin sounds good. Only now you’re pulling down someone else’s mesh underwear to check her stuff or trying to gobble down your breakfast. We get c-section patients up for the first time, and I’m sure all of us have had our share of women who pass out…and it always happens when the PCA has left the room, when there’s no family around, or when there’s A TON of family around to watch you struggle to safely get the patient to the floor. We get people ready for tubals, the entire time thinking “I hope someone told you this is going to HURT.” For such a tiny little incision, BTLs must be brutal, because no one complains like a post tubal ligation patient. I always want to whisper in their ear “just get Essure.”
And postpartum has their share of complications! Of course there are the bleeders, but there’s also the dehis, the postpartum hypertensive patients, infections, and any family drama. So many hospitals don’t have lactation consultants, especially 24 hours a day, 7 days a week, so the postpartum nurse fills this role. We constantly check labs, ensure adequate output, assess bleeding, monitor incisions, listen to lungs, listen to bowels, and listen to heart sounds. We look at this nipple, look at that nipple, look at latch. We check this laceration and that repair and check every vagina. And we basically have to do all of this with one facial expression, because we have to look like nothing surprises, confuses, or scares us! Every mother expects that labor will be painful, but no one thinks about the immediate postpartum period, so postpartum nurses are constantly trying to manage pain….on top of exhaustion. Postpartum nurses do all of this, and usually with 6 patients.
I love labor and delivery, and I love postpartum and mother-baby care. But one thing is for sure…I can’t remember the last time I went to work and “played” with a baby 🙂
Until my next delivery ❤