Ok, she's all delivered, I'm home...

and what a night!!

You know what's really funny? I was right.. as soon as I said I was the doula, they all just seemed to want to roll their eyes. Three nurses tonight, and as the father pointed out when we were in the mother/baby unit, all three of them were not receptive to me. I am not a loud person, I don't make suggestions that are opposite what nurses/medical staff say, etc. So I don't know why it happens. BUT!! I am getting totally thick skin and I just keep on smiling.

I told mother and father when we were alone in the mother/baby unit, that we are all there for HER(and dad) and what's happening to them, it's not about bickering with people or who likes who, it's about mom dad and baby. Period. I am there for them just as everyone else is, and I don't care what goes on so long as mom and dad are comfortable with what is going on, and there is an overall satisfying outcome. Maybe those aren't the right words to use, but you all get my point!!

Sometimes I really wish I could work with a lot of you I see post, for some reason in my part of the world, these nurses are anti-doula. Mom told nurse before I got there that she had a doula, and Nurse says "Well why? That's what we do" -- that's all the proof I need!

Anyways, I got great evals and I CAN USE THIS ONE FOR CERT!!! 1 out of 3, WOOHOO!! That doc was great. I am overall happy because of how happy mom and dad were in the end and they kept thanking and thanking me.

Ok I just got home ,I'm so sorry this is a friggen book -- even if no one reads it just feels SO GOOD to get out!! THANK YOU!!!

love,

Tiff

[mark_LD_RN]

keep up the good work all that matters is the patient. some nurses will come around once they get to know you and some wont. just keep your eyes on the prize:)

[mark_LD_RN]

keep up the good work all that matters is the patient. some nurses will come around once they get to know you and some wont. just keep your eyes on the prize:)

and as far as the nurses saying why use a doula thats what they do. thats not totally correct. I know when i am real busy i can not spend as much time with my patient as i would like. and a good doula can focus just on the patient and her needs. no other distractions. I welcome a good doula as long as they let me help to:)

[anitame]

Congratulations. I agree with Mark that in time many of the nurses will come around. You will get a reputation and it will follow you. Some nurses tend to eat their OWN young, these same nurses will probably take a lot longer to be receptive to you. It sounds like you're doing a great job and I'd love to have you helping my patients!

[Brownms46]

Hi Tiff..:)

It's seems you made two people very happy... And that was the whole point anyway ...so congrats...and don't worry about the rest!

[SmilingBluEyes]

I think many nurses feel "threatened" by the doulas...some are on a total POWER TRIP and this doula actually makes them feel like they have to give some of that up. I personally feel a doula is a HUGE BOON to my work, often giving familes nurturing and time I cannot always devote myself due to MOUNDS of paperwork that are heaped upon us. My advice? Do what you are doing; ignore the ones who upset you and don't worry. The familes are what are important here; not the staff and their issues. As long as you don't attempt to act out of your scope of practice, you will be JUST FINE! Congrats on a job well done!

[bagladyrn, RN]

Be a little sympathetic Natalie - you're getting to do a lot of the stuff some of us would love to be doing if we could get out from under the d*mned paperwork. Most of us are just glad you're there so it is provided anyway though.

P.S. - once you're established have you thought of making yourself occasionally available to be called if they get one of those girls, scared to death with no family or friends? Those are the ones who benefit the most from the support, and the reason I most frequently end up staying after shift to do paperwork.

This could really endear you to the regular staff!

[at your cervix]

I agree. You are doing a great service to your clients. There are, however, a lot of doula's out there that seem to convince their pt's that they are there to protect them from all of the evils of the medical staff. These types make our job very difficult because the pt's doubt everything that we try to do for them!!! Just give it a little time and I am sure that the nurses that you work with will soon see that this is not your intention. It just takes time. Where I work we have very few doula's, in fact just one up until recently. The one that we had was just as I described. She would tell her clients to write extensive birth plans because there were so many "unneccesary" medical procedures performed that would cause harm to their babies. The pt's were very skeptical. I even had a pt who refused antibiotics for group b strep because she said that an IV was an unneccesary medical intervention that prevented her from walking in labor. I explained the risks of not getting antibiotics and she still refused. I offered a hep lock so that we could disconnect the tubing between doses, and explained that she could push the IV pole with her in the hall. She still refused, explaining that the doula had told her that it was an unnecessary procedure. I could not make them understand. So, from then on, I was always skeptical of doula's, however, after working with them a few times, I have found that the newer ones are much more reasonable and are a great help to the pt and in fact to me for that matter. So, I hope that this may give you some insight as to why you are being received the way that you are and I hope that the nurses soon see that you are doing a great job, while letting them do their job. GOOD LUCK AND KEEP UP THE GREAT WORK!!!!

[mother/babyRN, RN]

I agree with the above postings. I know it can be disconcerting for nurses who have patients bringing in doulas, not only because it in some way detracts from the care the nurse would normally be giving, but it can be confusing to the staff. And, they are acutely aware that you are being paid what I hope is a good sum , to come in and coach the pt. Personally, it took me a little while to figure out what I , as the nurse was supposed to be doing...I kind of felt as though I was a bit out of the loop and just there to do the clinical things. That made me feel as though I wasn't really truly involved with the family I was supposed to be helping. Probably much as you feel...When ever I asked the patient and her family if they needed anyone, I included them all in as one unit. We arranged breaks for her and tried to work it out so that we were both responsible for physical AND emotional support. Some times, when doulas are involved, the nurse can feel as though she or he has been left out of the emotional component of laboring with the pt and her family..I approach them all, introduce myself, welcome and congratulate them, ask the name of the doula , and kindly let the family know that we will be working together to facilitate as special an experience as possible. I make it clear that we are a unit and try to adhere to that...Nurses, much like the patients we greatfully and happily ( mostly) serve, bond. It is not unusual for me to remain with a patient who is nearly delivered when she has been with me all night and is attached to me. I don't want her to feel as though one of her sources of comfort would leave at such an important and poignant moment. And, I don't want to leave because I want to be there at the outcome, as much as possible.

Doulas and nurses can and do work together. The trick is to establish guidelines and outline them at the onset.

Natalie, perhaps you could approach the nurse privately and just say, Hi, I know whenever a doula is involved, it might be natural to feel a little weird . How about working together so we can BOTH take care of the pt and her family...Then, thank him or her for taking the time to talk with you and go back in the room...I have found establishing guidelines and a down to Earth introduction does wonders. After all, no nurse wants a pt to feel uncomfortable. Sometimes you don't even know why you feel that way, but I personally don't feel it is usually about feeling threatened. It is just a case of trying to figure out where you, as a nurse, fit into the scenario. Mentioning to the family with the doula present that both of you have coordinated things so that you will arrange breaks if necessary, when possible, and that one of you will spell the other, that is one of you will be with the pt and your goal is to work together....Congratulations to you. The very fact that you are asking us the questions indicates you are an extremely caring person and doula.......

[Natalieboo]

Now I am really more understand about the nurses appearing defensive. One of them in particular just made me a go-fer for the hour she had my client as a patient. Not that I mind but her attitude was like "good, a doula! let's see how can we get her out of the room" :chuckle I'm just kidding, that probably wasn't her intention.

Anyways, I'm not being paid for any of these clients. I'm volunteering for now. My husband hates that, because sometimes I am gone long. I think I'll be asking for reimbursal for parking and childcare though. This last time I almost had to call a babysitter. It seems when I get the nurse alone, I tell her I'm a volunteer.. then their whole attitude changes!! They get nicer and tell me I am doing a wonderful job.

For those of you that suggested I make myself available to be called for people who come in with a lack of support.. I have called both of the hospitals in my area and told them I would do this. One L&D nurse said "Well, you can't do that.. whose insurance would you be under?" I just didn't argue, and hung up. Pretty sad that she thinks a doula needs insurance

Then the other one I called, I spoke to the mother/baby wellness center. That nurse was all happy and told me to drop off some cards/flyers.. but when I went to a birth there, and I told the nurse that since I was there and I wouldn't be leaving for a while, I could support another patient if she knew someone that would need it. She just kind of laughed me off and didn't even bother to check.

I read stuff put out by doulas that have been doing this for 10+ years.. and they all say to "volunteer at a hospital doing support shifts" but none of my hospitals have this, and everytime I call and ask if they have someone in L&D that would need the extra support.. they act like this is something that cannot be done and I am insane. Any suggestions?

[bagladyrn, RN]

Natalie - why not sit down and write up a sheet or pamphlet explaining your service and role with the laboring couple/woman make copies and take a day to take them around and drop them off at the local hospitals and perhaps to the local OB's or CNM's.

You could add a note to this with a contact number, stating you would be available to volunteer for patients they feel could benefit from this support.

[mother/babyRN, RN]

The nurse supervising the patient you are assisting is responsible for whatever you do with regard to the patient. That is, they may not be eager to have to account for your actions. Not that any of your valued work would result in a problem, but if you are working specifically with a family, make it clear that you are there in the capacity of coach....I would think, at least in my state, that the pt who refused antibiotics on the advice of the doula could and would have a case against the hospital (and therefore the nurse involved) if something negative ever happened with the baby...This is a gray area for certain, as, on one hand, the pt is responsible for decisions she makes, however, there could be a case made for her being unduly influenced by the doula (not you, the other case described)....Sounds as though you are doing all you can to be available to patients, and it isn't easy working with some nurses. I applaud you.....You will do it because you have the patience...Perhaps you could contact the clinical nurse managers on the units you serve and make an appointment for an informal meeting..If they are receptive, maybe they could bring up your willingness to serve in a laywomen way, at a staff meeting, in which the nurses are familiarized both with you and your wonderful intentions..Nurses (many of us), are like anyone else..Change is scary......I welcome you to the fold, so to speak, and would love working with you...Course, you definitely would have to relocate....I think that is a great idea to want to be available to women without labor support....Perhaps calling or becoming familiar with someone who runs pre natal classes might be an option, OR look into teaching them. I bet you would be wonderful...