[mother/babyRN]

I was just wondering what everyone says to their patients to calm them down.
I usually will tell them I understand how nervous they are because it is probably the first time in their lives they have no plan B..(usually no matter what happens there is a way around it).
That usually relaxes them a little. Then I try to get them laughing. I tell them right up front that it isn't easy for a guy to watch someone he cares about being in pain because he can't fix it....That usually gets some relieved response from the husband or significant other...Then I teach him how to read the monitor so he can have something to do.
I tell her that however dialated she is or isn't, just because that number doesn't change a lot when the contractions do, doesn't mean a whole lot of progress hasn't taken place. Then I mention that the cervix changes, the head comes down, etc...
I tell them up front that delivery is the only place in the world where women are in charge AND allowed to be crabby (usually smiling by then). And, if the guy is nice he can stay....
Also some how throw in there that if there is a discrepancy between mom and dad over baby name or vasect vs tubal, we defer to the patients as they are in charge....
By this time I am near the point when I have to do a vaginal exam and will mention that we are now going from being acquaintances to intimate friends. Bringing your own personality into the situation is so important, don't you think?
When people tell me how frightened they are I say, " I hate it when they let you humans in here.!"
Humor is a big part of my bonding with my patients. Was just wondering if you all would like to share some of your own methods and approaches. Now this night nurse should try and rest. Have 3 toddlers awaiting me!

[MickeymomRN]

I have so many things that I do for my pts. b/c each are different.

But I always, turn off almost all the lights in the room and leave just a lamp on. I welcome her to "her room" and give a quick tour of the room by saying "this is your..." and if it's not an immediate delivery that's obviously imminent, I leave the room as I say "get settled in, I'll be back in a few". I leave so they can get used to the room and the unit. I don't like to rush into the medical stuff and scare them. All who give birth, humans and animals (not that we're not part of the animal kingdom) will do so in an environment that they feel safe in. I try to convey a home atmosphere so that they will feel safe. If I do need to rush things along, I explain everything and keep asking them if they have any concerns. Then I try to ease their fears. It depends on the pt on how I do that. Either I explain things furthur or I just give them a warm touch. I guess this all boils down to that I try to make them feel safe and all they have to do is concentrate on getting thru the ctxs.

[mother/babyRN]

I try to do all those sorts of things too, especially getting them accustomed to "owning " their room because there are so many other things going on. Do you find that they will be concerned with "not bothering " the nurse, ie you? I try to help them feel empowered and remind them that we work for them...For the time they are with me, I try to remind them that I am there for them. Thanks for sharing your thoughts. They are pretty special, aren't they? Glad I am not the only one who feels so protective of my patients!

[Nursz-R-Awsm]

Humor does work well. It eases them into talking at times and changes their focus. I really like the intimate friends comment! I know many women appreciate a little tenderness when going 'down under'...I find some tell me "Oh, nurse 'so and so' was rough, thanks for being gentle." This thread is a good idea.

I find sometimes touch works well also....depending on the patient. Sometimes just wiping the mascara-stained tears from around one's eyes or softly touching their arm/leg while looking into their eyes when they are afraid means lots in the middle of all that is going on.

[mother/babyRN]

Hi there,
I really enjoyed the "en mi casa" regarding your location.
I agree with the touch aspect and find myself doing that all the time. I think it bonds us, and have to say it soothes me to know that such a small thing is helpful.
I love to practice the square breathing/relaxation techniques with people and just get everyone involved. With my patients I always let them know that we realize this is the first time many of them have felt they have no plan B....Anyway it happens, they have to go through it. Anything I can do to ease some tension helps me help the patient.
Often, depending upon the situation or personality of the patient/family, I will up front inform them that labor is the only place in the world where women are truly in charge and the patient is the boss. I also try to throw into the conversation that I might have to tickle them if they even once think they might be bothering me..As my dad once reminded his cardiologist, "We work for the patient" and we WANT to be there on the night shift...
It is neat sharing ideas and fun for me when I mention to people (all of these pt's I describe are not yet in hard labor, you understand...) that if it's a girl, the house rule is you have to name the baby after your labor nurse... The eyes usually open wide and 95 percent of the time the pt will tell me they already have a name while the fob/significant other/husband will apologetically say the same. And, to me, as I tell my patients,
Natural childbirth is any way they get here safely....Thanks for your ideas and allowing me to put my own "2 cents in.: Just got back from work (the night before the full moon, I might add) and left 2 patients in labor who arrived at the same time, active and all that goes with it. This with me as the ONLY delivery nurse on...Thank goodness there is God in delivery!

[Cameron67]

In my case I work in LTC so the fears vary greatly. If is a res that is A&O then I explain how things work there, and that someone will be around all night and how to use the call light for assistance. If it is someone who very confused much of the time, and think for example that their family doesn't know where they are then I tell them something like "your family knows you are here, they said it is ok for you to stay with us and thay are all home sleeping". They always say reorientate a resident, but you can't with a alzheimers res or someone with senile dementia, it just makes them sadder/angrier/or even more confused. So Itell them what they need to hear and that works everytime and they calm down.

[mother/babyRN]

Thanks for sharing. I remember when I was a patient being so frightened and feeling that I had no control. We are wonderful, we nurses, aren't we? Even something as simple as explaining that a blood pressure cuff will get really tight will help....

[Angel Baby]

Once I get my patient settled in I like to talk about the fact that she is in control of her pain management--I won't push drugs on her and I won't withhold them, either. I discuss imagery as a relaxation technique during contractions and remind her that this is a natural process and her body was meant to do this. The pain is an inconvenient side effect that can be managed.

Then, I talk about interventions for the baby right up front. I tell the family that the placenta is like a car with 2 gas tanks. During contractions, the second gas tank helps support the baby. If I see signs of problems, the things I can do for the baby includes oxygen (more for Mom means more for baby), repositioning Mom (even in the middle of a contraction--when it is not convenenient, etc) and giving Mom a bunch of IV fluid (more fluid in Mom means more fluid to the baby's gas tank). Then, I tell them that if I can't fix the problem with these three interventions the doctor will be make a decision that might include a C/S. I also explain that about 85-90% of labors require these interventions at some point--that what we do most of the time is preventive. I tell them that I'll let them know when they need to be nervous--because I'll get nervous, too. Humor is probably my biggest advocate--when placing an epidural I instruct the Dad not to pass out--after all, there's only one bed in the room..........

This has been tremendously well received--most patients have had, or know someone who has had a bad experience in labor--this includes "Pitocin makes labor more painful". My mantra for this is that most of the time they are home, nesting while cervical ripening and early labor are happening. When we induce, they have nothing to do but sit in the bed and anticipate the next contraction. I also tell them that contractions still last about 45-60 seconds, generally get stronger as labor progresses, and that Pitocin is the same hormone in her own body that helps initiate or maintain labor.

Of course, not all patients are receptive to this, but it's my usual format (especially for elective inductions). Oh, and I always tell them that all babies are eventually born......................

[mother/babyRN]

Angel Baby,
I often utilize a variety of the same interventions and approaches you all use. I absolutely agree regarding the humor aspect and loved the gas tank story...Might have to "borrow" that one...I mention, when someone is particulary frustrated, that even on Star Trek when they can beam people out , they STILL require those people to delivery vaginally! That usually elicits some laughter and easing of stress...
Don't you all think that individualizing your care without sacrificing your approach, such as with tailoring and fine tuning the same information to people who are diverse culturally, emotionally or otherwise, is a big part of what we do?
Thanks for sharing! Hope everyone had a wonderful Easter!

[nurseshn]

You guys are soooo....great I can't wait to become a L&D Nurse.

Thanks for always being positive.