L&D floor nurse to CNM....Am I ruining my faith in women?

Selke · Jul 29, 2008

You'll get over it.

epiphany · Jul 29, 2008

I graduated in Dec. and went right into a regional hosp. where we handle extremely high risk pt. we get regular labor pts too. I am very grateful for the experience and i love the pt care. I am just worried it will ruin me to my dreams of being a midwife. I have been on both sides and i can already say I hate Pit.
Anyone have any comments?:thnkg:

Same happened to me. I felt that it was very bad idea that I went to L&D. Now in school, I'm exposed to a different paradigm, and I can see the difference it makes to outcome of a healthy laboring woman to the setting that she is in.

Although I had the same anxiety, it did not ruin me for this reason: I realize that there is a self fulfilling prophecy in the hospital. There are two ways that you affect this woman

1) you make her physically unable to labor effectively because you tether to her bed in 10 different ways.

2) you treat her like she's sick, she going to be sick. The mental status of the women - the way that she faces her birth makes a huge difference to outcome. One is physiological - the anxiety that produces and changes hormones in her body will protract her labor. One is the human psyche - a woman undaunted and supported with love and laughter and guidance will labor more efficiently.

Put her in the right environment, and the outcome will improve. I have seen the difference, so I continue to have faith. It's like recognizing the enemy enough avoid them. As you said, you've already been on both sides. When you are in school, you should ask for as much natural birthing experience as possible.

The fact that you recognize that this as problem makes you an analytical person who will come to right conclusions. Although I still think that a year in L&D is a year lost where you can be in midwifery, I believe it's going to be all right for you just as it was for me. Just get out of the pit pool as soon as possible.

Best of luck.

zahryia, LPN · Jul 29, 2008

You'll get over it.

I'm not sure how to read that answer, but I doubt it was helpful to the OP.

OP, I'm in a similiar position that you're in. I'm concerned about the birth culture but at the same I plan to do whatever I can do within my scope to work with the laboring mom.

Remember, it's not all or nothing for the mom (or at least it shouldn't be). It's a spectrum of an experience, so just focus on what you have the ability to do. I'm sure over time you'll discover ways to 'get around' things without jeopardizing your job or your license.

tntrn, ASN, RN · Jul 29, 2008

I disagree with the poster who said your experience in L & D is a wasted year. As a 31 year labor nurse, doing both very natural births in a hospital setting and high-risk (whether real or manufactured), you need to know as much about everything as possible. To know only one side is cheating yourself and possibly a patient in the future who you may NEED to transfer. Without a solid knowledge of what will go on in the hospital (and I don't mean the horror stories, I mean really) how can you give that client the information to enable her to confidantly go?

epiphany · Jul 30, 2008

I disagree with the poster who said your experience in L & D is a wasted year. As a 31 year labor nurse, doing both very natural births in a hospital setting and high-risk (whether real or manufactured), you need to know as much about everything as possible. To know only one side is cheating yourself and possibly a patient in the future who you may NEED to transfer. Without a solid knowledge of what will go on in the hospital (and I don't mean the horror stories, I mean really) how can you give that client the information to enable her to confidantly go?

I'm not saying that L&D has no value. I learnt how to admit pts, give pit, put in IV's and read strips. In one year, my instincts would have paled compared to your 31 year experience. But I am saying that the one year that you spend in L&D takes away the one year that you could be a CNM.

I mean no disrespect for L&D nurses and I think a good nurse is makes the difference if you have to have a hospital experience, but having been put through clinicals that require that I make decisions that I have to be accountable for, I can compare it with my L&D experience and know just how much more I'm learning in the short time.

If I had started CNM right away, I would have started by fumbling and asking the L&D nurses the first year, but by now, I would have been much further along on the learning curve.

When a decision making is on your dime, you learn pretty darn fast. You still look at the experienced nurses for cues, but these instincts possessed by someone with 31 years of experience do not happen in a year or two of L&D. That's why it's a waste. It's economy.

tencat · Jul 30, 2008

Ummm, correct me if I am wrong, but shouldn't one have some L and D experience BEFORE becoming a nurse midwife???? Going straight to a CNM without any experience seems kind of risky to me.

Belinda-wales, RN · Jul 30, 2008

Ummm, correct me if I am wrong, but shouldn't one have some L and D experience BEFORE becoming a nurse midwife???? Going straight to a CNM without any experience seems kind of risky to me.

Could not disagree more - and I will correct you as you are wrong I had no L&D experience prior to undergoing my midwifery training and it is not risky at all - in fact it it helped me view cases clearly.

epiphany · Jul 30, 2008

Could not disagree more - and I will correct you as you are wrong I had no L&D experience prior to undergoing my midwifery training and it is not risky at all - in fact it it helped me view cases clearly.

Glad to hear from someone who can speak from the CNM side. I feel like nurses tend to feel that it's important to have the L&D, but not to offend them, but I think they are speaking from the galley and they are not the ones going through the experience.

Further more L&D makes you scared of everything, which is not the point of the midwifery model.

zahryia, LPN · Jul 30, 2008

Glad to hear from someone who can speak from the CNM side. I feel like nurses tend to feel that it's important to have the L&D, but not to offend them, but I think they are speaking from the galley and they are not the ones going through the experience.
Further more L&D makes you scared of everything, which is not the point of the midwifery model.

I was just thinking about that the other day. The nurses who seem to have a problem with it are the ones who are NOT CNMs (or studying to become one).

Also consider, many lay or CPMs have no L&D or nursing experience and they do just fine.

Personally, for me, I chose to go the L&D route, but I'm approaching it more from an 'anthropology' perspective than a 'what to do when I become a midwife' perpective. Meaning that I really want to understand the ins and outs of the hospital experience and understand what women like and what they don't like about the experience and use that to shape my CNM practice.

I'm sure there are studies out there, but I sometimes wonder if they reach a diverse population and I would suspect they don't.

Also, I get to advocate for these women during my time there. Unfortunately, not everyone has access to a CNM and quite frankly not all doctors are evil. There are some great OB/GYNs out there that I would love to learn from.

In Maryland, CNMs need a physician agreement anyway. I just might find that person during my time as an L&D nurse.

Belinda-wales, RN · Aug 3, 2008

The trouble is that you get scared from the medical model even if you try not to - for me I can see the difference- I come from place where child birth is normal until proven other wise the midwifery model being the norm - here midwives have to defend the midwifery model in the environment of the medical model- this is not a critisum just an observation as soon I hope to be a midwife fighting the medical model- but it is just that a fight where as in other places in the world it is the norm. So back to the point sometimes the L&D experience coloures (U is the english spelling) the midwifes vision.

Belinda-wales, RN · Aug 3, 2008

I
quite frankly not all doctors are evil. There are some great OB/GYNs out there that I would love to learn from.
.

They are not evil - they are doctors experts in ill health and surgery- they do not know any different -they however are not experts in NORMAL low risk pregancy and birth they have not been trained in this and many have not seen a home birth or an entire labour for that matter -they have know understanding of laten phase or tranision how could they all they see of labour is crowning or "protracted" dilation or prolonged second stage everything else happens with the nurse. I have a good friend who is an OB she is a lovely patient doctor who repects women and birth but she still dose not understand the whole process of birth how could she - you have to be there for hunreds of labours ( we use the u in uk) and births with women to understand and have respect for birth be there for the three + hours with a primip pushing out an op baby in every postion known to man- be there when a woman going through tranision thinks she is going to die- sit there patiently as a woman dilates slowly because she is scared trusting her body. Doctors do not get this exposure.