New here, anyone had a pt with a Doula?

  1. Hi, I've been nursing for 10 years, in labor and delivery for 4. Last night we had a pt come in with her doula. I work in a smallish hospital and I nor any of the other unit staff on had worked with a Doula before.

    I felt really insecure! The Doula was great. Very smart and was great with pt but I guess I didn't really know my "place" if you kwim? I pretty much just spent my time in the room charting. At one point pt literally had her husband by the throat begging him to help her and crying and asking why nobody was helping her. Just about the time I was wondering how long I should let her beg she was complete thank god.

    Anyone else work with Doulas? What's our role in labor support? My gut told me to just do my job and let the doula work around me, but that was difficult to do with someone else in the room who was "calling the shots" so to speak.

    Any tips for next time?

    Kat
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  2. 10 Comments

  3. by   CrunchyLaborRN
    I have done a few deliveries with doulas present and I really don't conduct my nursing care much differently. Usually, if they have a doula, they have a birth plan. I go over that with mom and dad and set the presedence that I am willing to accomodate their plan as much as policy allows and work with them. I want them to trust me and my judgement. The doula is a great extra set of hands/eyes/ears and I love working with them, but I have to sign my name so therefore I call the shots.
  4. by   vandermom
    The bottom line is this is your licience. You must follow policy and doctor's orders. If the patient refuses then document it fully.
    A doula is specially trained to be the woman's resource in labor. She will have a multitude of ideas to help her client have the type of birth she wants. As a L&D nurse I decided a few years ago that it would make me a better labor nurse if I had some of these "tricks". I took the course and became a doula. Though I did not go on to be certified what I learned has been an asset to me.
    We have had a couple of doulas with patients. One was fantastic and her patient did wonderfully. The other was not the best and her patients strayed from their birth plans quite far. I highly recommend taking the doula course to all labor nurses.
  5. by   RNmama05
    Quote from northwoods6pack
    Anyone else work with Doulas? What's our role in labor support? My gut told me to just do my job and let the doula work around me, but that was difficult to do with someone else in the room who was "calling the shots" so to speak.

    Any tips for next time?

    Kat

    I've worked with patients with doulas. I just did my job as I normally would. I offered support and suggestions when needed, but was respectful of what the doula was doing. I was grateful for her help. When I asked the patient if she wanted the baby on her chest after birth, the doula said, "We're so lucky you're our nurse today." It was like she expected me to be Evil Nurse. What she doesn't know is that many of the nurses on my unit are former doulas and many are midwives in training. At least where I work, we're not the enemy.
  6. by   babywearingdoula
    I'm a doula and aspiring labor and delivery nurse. I absolutely love working with the nurses. I find that most of them have no idea what I do and that's totally ok. Unfortunately, there have been many militant doulas that give us a bad name!!!
  7. by   PRESLA
    ]I have only had a few deliveries c a doula and most of the time they are great , but then there are a few that I would like to pinch their heads off. Not supportive, would sit in the chair and watch TV, and when the pt would ambulate in the hall she would go and take her smoke break. Sometimes it would remind you of a non-supportive spouse or boyfriend (sperm donor).

    Lisa
  8. by   alianeco
    I usually love working with doulas. Since most of my patients get epidurals and sleep through their labor, I find that working with a doula is a good learning experience.

    That being said, some of them are very intrusive and couterproductive. I had a patient once trying to get herself mentally and emotionally prepared for a cesarean because of fetal distress. She was asking questions about how things would go, and if she would be able to hold her baby. The doula told her not to "go there" (mentally) yet. I wanted to scream at her! I wanted my patient to be emotionally ready for this and I felt like the doula was working against me. She wanted to go in to the OR too! Like the patient was going to choose the doula over her husband!

    But like I was saying, usually I really love working with them.
  9. by   ElvishDNP
    We don't have a lot of doulas where I am, but by and large they really are a help when they're there. The most outstanding one I can remember was one who helped a young primip (19-ish) through a 24-hour labor med-free, delivered a 9+ pound baby on an intact perineum. Man, I wanted to clone her.
    Last edit by ElvishDNP on Jan 1, '08 : Reason: typo
  10. by   MarathonGirl
    I had a doula with my birth (a vbac) and I didn't think it interfered with the nurses job.
  11. by   JaneRNBSN
    Quote from purpsurfer
    i have done a few deliveries with doulas present and i really don't conduct my nursing care much differently. usually, if they have a doula, they have a birth plan. i go over that with mom and dad and set the presedence that i am willing to accomodate their plan as much as policy allows and work with them. i want them to trust me and my judgement. the doula is a great extra set of hands/eyes/ears and i love working with them, but i have to sign my name so therefore i call the shots.
    i'm a staff doula and i work under the nurse's supervision; ie getting pt out of bed, to the br, i always ask before i do that. our common goal is the safety of mom and baby. everything else is just "fluff":typing
  12. by   PRESLA
    janernbsn,
    i have only had a few deliveries c a doula and most of the time they are great , but then there are a few that i would like to pinch their heads off. not supportive, would sit in the chair and watch tv, and when the pt would ambulate in the hall she would go and take her smoke break. sometimes it would remind you of a non-supportive spouse or boyfriend (sperm donor).

    lisa picon_roll :typing:thnkg:

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