No one grows up thinking they want to be a labor nurse. When I was little, I wanted to be a nursery nurse like my mom, so I could hold babies all day (lol) and on my days off I was going to be an ice cream truck driver 🙂 True story. When strangers ask what kind of nurse I am, and I reply that I’m a labor nurse, my words are always met with excited oohhhs and awwwws. I have to admit, even with all the junk we see, OB is a pretty cool gig. Every day you go to work and you do not know what the day will bring.
I remember one of my first experiences working triage, a woman came in complaining of suprapubic pain. I remember thinking “ohh this will be easy!” and I was excited that I’d get to mix Rocephin with Lidocaine and I’d get to give an IM injection. As I placed the fetal monitors on her belly, I didn’t even have time to adjust the straps. My preceptor and I could hear the “thump-thump. thump-thump. thump-thump” of the baby’s heartbeat. I tried so hard to keep my poker-face, but my hands were trembling. My preceptor and I didn’t speak, she just steadily look me in the face. But her eyes told me everything. I walked out and got IV fluids. Another nurse at the nurse’s station had immediately seen the strip and picked up the phone to call anesthesia. Her physician was called and was literally at the bedside in a minute (OBs are kind of like superheroes. We never know how they suddenly appear when we need them, but they do!) By the time I returned with the IV fluids, the patient was on her hands and knees with a non-rebreather on her face and there were five other nurses at the bedside. I will always remember what that room looked like when I walked in… all these women surrounding a patient, each of them performing a specific, unspoken task, and everyone focused on the same mission: to save this baby. When the baby was pulled from it’s mother’s abdomen and cried, it took my breath away. I looked down at the patient, who was under general anesthesia, and thought of how peaceful she looked. I remember thinking that I wish she was awake to hear her baby’s cry, to see all the nurses and physicians working so hard to make sure she delivered safely. And that was it. OB and it’s adrenaline drug had me hooked.
Most of the times mom’s deliver without any sort of complication. But even though most deliveries are free of drama, something strange happens to almost everyone in labor. Even though most people act completely normal in real life, when a patient gets to a labor and delivery unit there’s usually some sort of switch that goes off. They walk through the door and suddenly–it’s all become real. It’s like they’ve suddenly grasped the idea that they’re about to push a baby out through their vagina or someone is going to open up their abdomen and pull their baby out through the sunroof (as one of my favorite doctors likes to say). And even though they have probably prepared for this day for 9 months or so, suddenly they become nervous and anxious and a little scared. It doesn’t usually matter if this is their first baby or their fifth. They thought they had a high pain tolerance, but suddenly, suddenly they begin to question everything they thought they knew. And people handle this in different ways. Some people get mean, some people get crazy, and some people become very focused. and p.s. I’m not even going to lie, I kind of like it when they get a little crazy. It cracks me up watching “the change” after delivery, when patient’s go back to their normal selves 🙂
Our OBs and our anesthesiologists are soooo important. We rely on their knowledge and skills to guide us. They have to know a lot of information about a lot of different people, and we expect them to know every bit of everything, and we expect them to know what to do with that information! But the nurses are at the bedside. We use our nursing judgement. Sometimes a patient looks like a stable patient on paper, but when you look at them you just know something is not right. We’re the one’s holding the patient’s hair back as she vomits, we’re assessing how much bleeding we’re presented with after each fundal message (that’s a gift I’d like to give back!), and we know by our vaginal exam if the patient is going to have a fever an hour later.
Physician’s are vital to us, and we’re crucial to them. We’re at a point in nursing where we make decisions, we influence and guide the plan of care, and we help develop process and procedure guidelines because someone finally realized that our nursing judgement has merit and directly influences patient outcomes. We can’t just think of this as a 9-5 job (or a 7a to 7p one). We now have the power to initiate change, we are no longer limited to just influencing the care of our patient. We have to think bigger, be bigger, strive for bigger things. How can we change our practice? Our unit? Our hospital? Our community? A population? Florence Nightingale was one person. Look at all one nurse can do 🙂
Until my next delivery ❤
Ice cream is still my favorite dessert.