observation

  1. I am just finishing my first year in an ADN program. We are in an OB rotation. I was at a birth yesterday, the unit was jumping. The charge nurse was helping with a birth, primip ready to push, until the other nurse could come in. Well, there are several people in the room getting ready, My clinical instructor was in there, she is an employee there. The OB is at the nurses station just waiting to be called in. She seems hurried and is moving fast, starts coaching on pushing, cheerleader style (lol), and has her hand in this womans vaginal opening doing the stretching sweep. She gets a call on her hospital phone, takes the call and talking while she still has the other hand in fussing, briefly stopping conversation to say "thats it. Pushpushpush....." Meanwhile dad is off in corner. I told him he could go be by her side, he did. This poor woman, legs in stirrups, and at her perineum a woman on the phone in one hand, hand in her vagina with the other. HIDEOUS. I am a doula and was a midwifery apprentice at a birth center. Trying not to be judgemental. I think all these woman working there truly care about the patients, but maybe the pressure and job get to be so great that they forget about the woman giving birth. Your thoughts?
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  2. 15 Comments

  3. by   SmilingBluEyes
    Well you just said it; it was jumping on the unit when you observed the nurses at work. This is the reality of what we do on OB day by day.......This is how it is when all hell is breaking loose on OB---when the "labor bus" has pulled up and we are swamped, left to deal without any additional help on the way. A doula has the luxury and privelege of concentrating on her ONE client; we are often given multiple people to care for as the census rises/acuity increases. We don't have the ability to just "pull nurses/staff out of our hats" when people start filling up our unit.


    We just do the best we can. 12 hours can change everything. We can go go from "zero to 60" in minutes, believe me. I think we do well, given the changes we have to handle to our care planning. Priorities shift, emergent cases present. Still, we have the same number of staff we started the day with---so we deal. And at the end of the day, we do really darn good at it, frankly. We handle it all and yet come back for more ---why? Cause we have a passion for what we do---our roles are different than yours, obviously. We both share a passion for our patients and their wellbeing, clearly. WE have that in common.....

    Believe me: We DO care about our patients; we do want to give our best......but sometimes, just sometimes, things get out of our control, and we are left to cope the best we know how, given the circumstances we are dealing with. Hope you can understand this. Thanks for asking.
    Last edit by SmilingBluEyes on Oct 29, '05
  4. by   Altalorraine
    I think that after people have seen their 100th, 500th, 5000th birth, it stops being a holy thing and becomes just part of the job. It's a shame.
  5. by   chuckc
    thank you for your insight. SmilingBlueEyes, I always enjoy reading your posts, lots of good information. I know it can't be always one on one and touchy feely, but I wish there could be some better solutions. I want to work in L&D when I get out. Just like the women in labor usually have to give up their fantasy labor, I need to give up my fantasy job. I know it is tough out there. I still will advocate for moms as best I can. Thanks for letting me share.
  6. by   SmilingBluEyes
    Quote from Altalorraine
    I think that after people have seen their 100th, 500th, 5000th birth, it stops being a holy thing and becomes just part of the job. It's a shame.
    Gosh I am sorry you have that impression; in my case, you are very wrong. I still cry at the births of my patients, and hug each and everyone after the birth (if they are not freaked out about touch that is---some you can't do this to).

    I do this for EVERY patient and her family members, and have for the last 8 years. Birth is to me, a holy, revered, private, intimate and amazing rite of passage for each family and I want to do nothing But enhance their birth experiences when they are in my care. I feel so priveledged to be part of these experiences in their lives----- and I have learned they remember me for years---- (seeing them years later with a child at whose birth I was an attendant and having them thank me, years later, is beyond precious to me).

    I am sorry you feel this to be true. Please, don't judge us all the same way. No one wants to be put in a "box" of prejudice.
    Last edit by SmilingBluEyes on Oct 31, '05
  7. by   SmilingBluEyes
    Quote from chuckc
    thank you for your insight. SmilingBlueEyes, I always enjoy reading your posts, lots of good information. I know it can't be always one on one and touchy feely, but I wish there could be some better solutions. I want to work in L&D when I get out. Just like the women in labor usually have to give up their fantasy labor, I need to give up my fantasy job. I know it is tough out there. I still will advocate for moms as best I can. Thanks for letting me share.
    You have every right to share how you feel. I respect the passion and drive you feel.

    However, truly, you may NOT like being an OB nurse, feeling how you do. Maybe, being a doula is better----you can concentrate on your client. Or maybe childbirth education would be a good pursuit for you.

    Frankly, Nursing is rife with frustrations:

    Difficult family members/patients (this is a given, but their sense of entitlement is horrible these days)

    VERY difficult and intervention-loving physicians who actually hate natural childbirth cause there is so little "control" there. Yep I work with several that hold this attitude and feel I have to protect my patients' rights to this basic desire. Sad.....

    High risk patient case loads that really make your work hard

    High acuity in the general census that seems to get worse because of increasing diabetes and high blood pressure in young women each year---women are getting fatter, sicker and therefore, higher risk. It's nothing to see a young lady of 22 that is over 300lb---that in itself presents a HUGE risk medically, for her and her baby. It's become an epidemic. Add to that your mix of substance-abusers, homeless, and people never having had any sort of prenatal care, and the like, and you see how hard it can be for us to cope. WE assume liability for them the MINUTE they cross our glass doors, and it is stressful at times.

    Cutbacks in funding for additional staff and amenities in some units.

    Policies and procedures that do not agree with your personal ethics at times.

    Ever-increasing requirements to maintain education on our own time that have very little to do with our specialty---takes a lot of time to do.

    The ever-increasing paperwork nightmares that take us away from our patient's bedsides (if you see a nurse "sitting at a desk doing nothing"---she may be charting--it takes HOURS to chart on just one patient what all we have to do).

    NO time for a basic food or toilet break in some of our busiest shifts. I have worked shifts where I realized, in shock, I did not empty my bladder for over 10-12 hours, due to being that busy.

    Ungrateful and demanding management and administrators who have NO CLUE what we do, putting the yoke on our backs to "do more with less" increasingly. There are so many things "nursing" becomes responsible for---that have nothing whatever do with--nursing.

    It goes on and on. These frustrations are just part of our jobs, but they do get to us at times. I try to see past these frustrations and remember the passion that led me to my calling as an OB nurse, but frankly, it gets tougher each year. We do the best we can and I think most of us perform admirably. I think some credit for this would be nice, but it's long overdue. I have seen many a bright, eager, new nurse become disillusioned in her first year, seeing "how it really can be" for us.

    One more thing that really hurts us all: The ever-present threat of litigation if anything at all goes wrong---despite our lack of culpability in many cases. It's a very dark cloud that looms for each of us and does not necessarily improve the care delivered to the patients---it becomes a lot of CYA, really.

    And the saddest part of our job? Having to help families cope with neonatal/pregnancy loss. I have cradled in my arms many times, the perfectly-formed dead body that was someone's dream, love, everything in their life. I have had to call funeral homes, priests, preachers and social workers to help such people in their insurmountable grief, sharing it and crying with them all the way, yet maintaining my professional bearing.....

    Have you any concept how hard that is? And then to be expected to suddenly "switch gears" and rally for the new labor patient you received and be joyful and happy for HER situation? It's horribly hard, particularly for those of us who have ourselves endured losses, let me tell you. But it is part of the job.

    But despite all of this: I love my job, I love my patients and the babies. If I could change ONE thing it would be to allow me the time to do care for them the way in each one deserves to be cared for. They are like my mothers, sisters and friends to me---each a human being who deserves the best.


    So next time you see a tired, cranky or apparently-disillusioned nurse, maybe you can remember these things and have a little compassion for those expected to carry such compassion for everyone else.

    So sorry this is so long, and preachy, but apparently, you touched a nerve in me. No personal offense here.
    Last edit by SmilingBluEyes on Oct 31, '05
  8. by   SmilingBluEyes
    Before I forget, I wish you well in your decisions and career pursuits. If you need anything at all, feel free to ask.
  9. by   Altalorraine
    Quote from SmilingBluEyes
    Gosh I am sorry you have that impression; in my case, you are very wrong. I still cry at the births of my patients, and hug each and everyone after the birth (if they are not freaked out about touch that is---some you can't do this to).
    I was talking about the doctor who was on the phone with her hand in someone's vagina.

    Altalorraine
  10. by   Altalorraine
    I didn't see any mention of nurses in the original post at all. I didn't take it personally because I think that everyone can use the reminder that what we do is more than a job. I appreciate the opinions of an outside observe such as the original poster. And as for judging "us", well, I am one of the us.

    Altalorraine
  11. by   SmilingBluEyes
    Altalorraine:

    There was mention of nurses AND doctors--the general environment of the floor very much includes nursing and our behaviors. I am just explaining an average life from a nursing perspective. And when someone does say "we" lose our perspective after 500, 1000, etc births, I do feel called to defend those of us who still have the passion and drive to do our best by our patients. Not all of are like that, as you know, since you are a nurse, right?

    And while I do very much appreciate the opinions and viewpoints of so-called "outsiders" (which they are not to me---doulas are part of the team in the birth situation)-----I also feel these same folks would benefit from our point of view, as nurses, as well.

    And I am sorry if you disagree, Altalorraine. I thank you for the opportunity to explain my point of view on this very touchy subject.
    Last edit by SmilingBluEyes on Oct 31, '05
  12. by   SmilingBluEyes
    Quote from Altalorraine
    I was talking about the doctor who was on the phone with her hand in someone's vagina.

    Altalorraine
    that is disgusting and reportable. I would not attempt to answer from a doctor's point of view, however, since I am a nurse. I would definately report this, however, since it's highly insensitive, not to mention, a real infection-control issue.
  13. by   Altalorraine
    I think you've taken the posts entirely too personally.

    Anyone who has worked on the floor for any length of time knows that there certinly *are* people who could use the reminder that in the middle of a crazy 12-hour shift there are patients who are undergoing a profound life event. I humbly appreciate the reminder.

    Altalorraine
  14. by   SmilingBluEyes
    And then again, maybe, there are some of us who feel we don't need to be reminded, really....maybe we feel a need to be heard and appreciated when issues like this come up.

    You are so right, Altalorraine; We all have our perspectives, and I respect yours very much......

    But, as you can see from my impassioned posts---- I also want "outsiders" to know, there are some of us who never forgot why we entered nursing to begin with, and still care enough to give our best for each person/family in our care. I would hope such people feel reassured, knowing so many of us GENUINELY care. And always will.
    Last edit by SmilingBluEyes on Oct 31, '05

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