Coaching style during pushing

shay · Nov 9, 2002

I do NOT count to ten while pushing. It's annoying. Plus, have YOU ever tried to hold your breath and bear down for ten seconds? Do it. Repeatedly. With a giant watermelon in your lady parts. It's next to impossible. :chuckle

I also coach people to breathe, but dang, I do a little breathing coaching, then move on.

I know exactly what you mean by people sounding like they're at a football game. :rolleyes: I try to keep it very calm and quiet with my patients. The last thing they need is an obnoxious nurse yelling "PUSH!! ONE!! TWO!!! THREE!! FOUR!! HARDER!!! FIVE!!..." you get my drift.

Yes, nurses who do that annoy the crap out of me. I want to smack them.

. I can see that it may be necessary for a few, but in general i think it's just plain annoying and unnecessary, especially when the patient is doing fine w/o it. I prefer calm reassurance and encouragment and keeping the mood/ atmosphere a bit calmer.

EXACTLY. You hit the nail on the head.

emily_mom · Nov 9, 2002

I like the men that do the counting. They get it from A Baby Story...it's so obvious!!!

sbic56, BSN, RN · Nov 9, 2002

the baby Story...Argh!!...that has done more harm to the natural birth process than I care to go into!!!

rdhdnrs · Nov 10, 2002

I'm right with you shay!! I hate the build-up of tension that all the noise of counting and hollering causes. My deliveries are usually quiet, controlled affairs, especially if I can keep the residents out till the baby is crowning!!!

**canoehead, BSN, RN** · Nov 10, 2002

I think they push more effectively if they do it when they feel the urge to. I might encourage them to hold it longer if they weren't making progress, but the best thing I've found is to put my fingers on top of the baby's head and tell them when I feel it move. They can feel how they are pushing when it is moving down, what works and what doesn't for them.

shay · Nov 10, 2002

Ahem.....just a comment here, I'm sure it'll ruffle some feathers :chuckle ...I notice that more often than not, the nurses who transfer into my unit from a teaching hospital where the epidural rate is like 99.999% are the ones who sit there and count to ten for their pts to push. I know 'cause it's what I used to do when I worked at a big teaching hospital where the epidural rate was like 99.999% and you know, pregnancy was an illness. :chuckle It wasn't until I moved to a smaller, less interventive hospital where I learned that it's better to NOT count while pushing w/a patient, and then when I went to a Michelle Murray conference she just went OFF about people counting to ten. LOL

I'm serious...have y'all ever tried holding your breath and bearing down for a ten second count? Seriously....do it a few times. See how tired you get. Whenever I have a student I make sure and point that little tidbit of info out to them.

RNMom1969 · Nov 10, 2002

I agree! counting to 10 is annoying at best........ALTHOUGH...recently I had a patient REQUEST that I count for her.....guess she's been watching "The Baby Story" too! I do have to say, once I began counting for her, her pushes FINALLY became effective. I'm sure she would have become effective through another means, but it worked for her. I guess what I'm saying is not to discount the whole idea......if it works for someone, use it. Normally, I like a calm, controlled atmosphere. Using quiet, simple words of encouragement works best....least that's my opinion. I find some of the docs to be very loud "cheerleaders".....some obnoxiously so. Anyone else have that problem? I try to keep my room organized and under control....sometimes they walk in and blow the whole concept to hell.....often! Pt doesn't seem to have any trouble till they walk in!

Joyce

shay · Nov 10, 2002

I find some of the docs to be very loud "cheerleaders".....some obnoxiously so. Anyone else have that problem? I try to keep my room organized and under control....sometimes they walk in and blow the whole concept to hell.....often! Pt doesn't seem to have any trouble till they walk in!

:angryfire Oooooooohhhhh yeaaaahhhhhhhh. Definitely. It drives me nuts. I want to turn around and say, "EXCUSE ME....did you not notice the dim lights, the quiet, calm atmosphere of the room? Oh, no you DIDN'T because your HEAD is up your ASS." Gawd. Drives me NUTS. Why do they not get it?????????

And I agree about the some patients push well w/counting thing, but I only do it (like you) if they ASK, and inevitably they've watched that horrid show A Baby Story. TLC is soooooo on my s**t list for producing/inventing that show. :rolleyes:

OBNurseShelley · Nov 10, 2002

I have found that the cheerleading/counting style really works for some, and others respond well to the calm soft atmosphere, we do ALOT Of epidurals, and alot of people especially primeips can't and will not push until you're practically yelling at them, I'm all about listening to your body and pushing when you feel it, but sometimes the babies have other plans, I pushed 2.5 hours tonight, and the whole time in a very cheerleading encouraging style, my pt said it helped her soooo much and she really appreciated all the help. My point is, what works for some doesn't work for others.......

SmilingBluEyes · Nov 10, 2002

My style reflects the desires of the patient.....I follow HER cues.

sbic56, BSN, RN · Nov 10, 2002

SmilingBluEyes

Zactly what I am saying...