Please tell me they are not all like this...
- 0Mar 14 by SwampCatI'm a birth fanatic. I love it. I am a major breastfeeding proponent and do plan on being IBCLC eventually. Had two kids of my own; helped out with two home births... this is my passion, no doubt. I was SO PSYCHED to do my OB rotation. Now, half way through the rotation I am feeling completely underwhelmed. 95% of the nurses at my site (Connecticut) sit at the station and watch the fetal monitors. Go in, check on the patient, return to cushy chair in front of monitor. BS with doctors, eat copious amounts of junk food, laugh about someone's hairy nipples. That other 5%? I haven't seen them yet, but I'm truly hoping they exist!
I had visions of educating and empowering patients during their labor. Suggesting positions, rubbing feet, telling her she is the most awesome woman ever and she can do this even if it is hard. And now I'm so disappointed. I have yet to even see one do a vag exam... they let the ob/cnm do them. I have yet to see anyone's second stage in a position that doesn't involve holding a leg and having them sit there. Was I completely naive? Is this L&D? Please tell me it's just this hospital!
I did have one good day of helping a mom go from "I give up, give her a bottle!" to breastfeeding like champ... which was nice since the RNs here regurgitate the breast is best mantra but have a bottle in the kid's mouth before they even finish the sentence.
- 5Mar 15 by klone, BSN, RNNo, they're not all like that. Some facilities are better than others, and even among the bad facilities, there are always some nurses who believe in natural childbirth and breastfeeding and are skilled at helping these women who want that type of birth. And even if every other single nurse at a facility was like what you described, there are patients who want something different, and you can be the one nurse on the unit who is willing to provide that. When you get women coming in in labor and they request you by name because her friend told her how awesome you are and how well you treated her, that's a pretty nice feeling to know that you made that much of a difference.
- 1Mar 15 by ChristineNI was very discouraged by my nursing school OB rotation as well. If you have a desire for a job in this area, there are always other ways to help promote a more natural childbirth including being a lactation nurse, working as an RN at a birth center, or getting your CNM. While some CNM's work with physician groups, I have always seen ones for myself that have private, CNM owned and operate practices that are able to advocate for less interventions, including a birth center or home birth.
- 1Mar 15 by RunBabyRN, BSN, RNI was disappointed (though not surprised) at the number of epidurals, inductions, and the like on the unit where I did my clinicals, but sadly, this can be hospital L&D. I think what you're seeing is kind of the extreme, but then, I think this also varies by geographical region and hospital culture.
Advocate for your patients, and learn from this experience. Whether good or bad, each little piece is a learning experience. I went into my own labor wanting as little intervention as possible, and ended up with every intervention under the sun, including an emergency c-section. After mourning the loss of my "DREAM" birth, I realized that I take that with me when I am working with moms (for better or worse), and I learned a lot from it. I have since learned more about those interventions, both good and bad, and can speak to them when educating patients. As someone who plans to be a CNM, I see a lot of value in all of this.
Are you looking at this area of nursing for your career? I would assume so by your post. I haven't seen nurses rubbing feet, necessarily, but I have seen and experienced coaching moms, holding moms in positions, encouraging squatting in second stage, teaching dads efflourage, performing vaginal exams, and teaching breastfeeding.
Again, learn from all of this, good and bad, and take that with you moving forward in your education and career. You can also look at working for other hospitals, or even advocate for changes at this one, should you end up working there.
- 21Mar 15 by babyktchrI am sitting here struggling to collect my thoughts enough to repsond to this rationally and intelligently. Ok. So, here goes...
What you describe is probably every "born to be a labor nurse" nurse dreams of OB being. There are some places that actually allow natural birth, spontaneous labor. There are happy, drama free patients who actually know who the father their baby is AND want to be proactive and beat the I AM WOMAN drum. There are places that are untouched by the spoils of modern technology, where childbirth can be celebrated and cherished and not a ridiculous spectator sport where cheetos and mountain dew are involved.
Thanks to the Joint Commission, CMS, ACOG, Magnet, the Baby Friendly Initiative,the Meaningful Use Act, and any staff memeber of the law offices of Dewey, Cheetam and Howe (and oodles more too numerous to mention) nurses now have the incredibe opportunity to bond with a computer for 8 our the 12 hours they work, making sure every box is checked, every bubble is bubbled, there is a growth chart charted on a 19year old laboring patient, every medicine ever taken is documented and what diseases the paternal great great great great grand grandfather may have had and what year they died. Instead of making sure bonding happens when that baby comes out, we are scrambling to document FHT's q5 mins during second stage (which can be a long long time), making sure we document skin to skin in 5 different places to appease the baby friendly gods AND be crowd control over the gazillion family members all ignoring the poor mommy who just pushed a bowling ball out of her body, trying to get facebook coverage of a resuscitation. Labor is now a circus of medical intervention because women are just unhealthy these days. Complications lash them to a bed, to a monitor. with IV this and that. And by golly, someone out there told someone and they told someone, and they told someone else that labor is supposed to be PAINFREE, so not only do we have epidurals, we need to have complete and total numbness because our makeup may run if we sweat a little. Um...whoops. I do digress....
Please don't generalize your observations. Not all units are like what you have experienced, but I am sure there are far more than we care to admit. Nursing has changed and I am not sure it is for the better. Study after study shows that actual bedside time for the nurse is less than 2 hours total. How sad is that? I know that I didn't become a labor nurse to sit at a desk. But honestly, with the amount of documentation that is now attached to every patient, when is there time to actually care for the patient? This goes for any specialty. I cannot even begin to imagine having an assignment of 6 patients and having to chart these days. Yowza.
Nursing, medicine for that fact, has become CYA driven thanks to the litigious society we live in. THis is not an excuse for poor care. Maybe not even a reason. But it is a reality.
The minority are the patients who want no intervention. Who really want to do the natural thing. I am sure depending on geography, you may see this more, but I am sure there are more that live in city and suburbia who will tell you that patients arrrive in full makeup demanding and epidural upon admission or a csection more than they see a woman show up and say please I don't want anything.
There are days I can honestly be proud of the care I gave. That I made a difference. That I will be a memory in the birth of someone's child. There are also days I cannot remember giving this or that, or did I chart that or man, what happened here? My real world version of childbirth would be so much different than what it is 50% of the time, and that is being generous. For now, I have to find contentment in doing my best, trying to navigate rules and policy and giving my patient the best experience possible. Its always frustrating knowing I can't.
I know this probably doesn't hit the mark for your post, but I guess what I wanted to say ultimately is that appearances aren't always what they seem, and make assumptions that this is how it is all over, and please don't give up on 'the dream'.
- 1Mar 16 by MAtoBSNBabyktchr, I can't stop laughing at "spectator sport where cheetos and mountain dew are involved"! I know these families all too well, as i worked in a private peds office for ten years. Those cheetos and mountain dew (and sometimes a full meal-I've had a mom bring in barbequed scallops to her appt) follow them to their 1 week peds check, and then the poor kid is munching on them by their one-year check!
- 4Mar 16 by babyktchroh, I forgot. The OB or CNM is the provider. Its their job to do vaginal exams. In the absence of the provider, the nurse CAN examine the patient. Certainly nursing doesn't 'let' them do the exams. In most teaching facilites, everyone but the nurse gets to examine the patient. Too many exams if you ask me.
Ok, I am done. I think.
- 2Mar 18 by SwampCatThanks, all. I guess I have some thinking to do. I originally wanted to go the CNM route, but being newly divorced and having two kids relying on me, I don't know if I can hack another 2 years of full time classes/clinicals (maybe in the future). I'm on the mad hunt to find an alternative birthing center (not a 2 hour commute away) that I can pimp myself to in hopes of not having to choose between being in the field I want and being the nurse I want to be.