I'm coming here as a student nurse who just spent a couple days in L&D/triage. Before nursing school I was training to be a doula and had seen and supported several births of different kinds (epidural, natural, home, etc). I am an advocate for the patient's needs and wants and I see a place for epidurals for some patients and will not pressure them one way or the other.
When I was starting my rotation the instructor said don't tell them you were a doula, that will close doors for you. Many L&D nurses do not like doulas at all.
So . . . today in triage a woman came in having cx. She had been in several times earlier and had been labeled as a "whiner", a "screamer" and a "frequent flier." She had been sent home several hours earlier and returned with very minimal changes and was not ready for admission yet. She was having cx and they were hurting her, and she was writhing around in the bed unable to get comfortable, however had not made huge progress. They said they would give her an hour and if no progress was made they would send her home again. This pt had some emotional issues going on, which was immediately evident. She was also very tired because of the cx not letting her get any sleep the last couple of days. I asked the nurse if I could spend some time with her and work with her a little bit. The nurses in the past (in other areas of the hospital) had appreciated that I had the time to work with the "high needs" patients and makes them less likely to push their call buttons every 10 minutes to get their pillows fluffed, KWIM? This nurse said sure, see if you can get her to walk.
So anyway, I asked the pt if she was willing to try some things to get her labor maybe going a little more-- and that everyone was different so it may or may not work, but did she want to try? She was interested ans receptive. I walked the halls with her and told her how to squat a little bit with contractions. Then she got tired and wanted to sit, so I showed her how she could sit and rock on the ball or the rocking chair instead of sitting in bed when she was hooked up. In that hour she made good enough progress to get admitted. :) She also started getting fllushed, sweaty, and vomiting a little bit, all signs of labor picking up. I encouraged her to keep sitting in the rocking chair next to the monitor if that was more comfortable than the bed, and to walk if she felt up to it in the time it took to get her fluids in before the epidural. She and her family thanked me so much for my support, and I patted her, said good luck and left.
However, my instructor said later that I might have crossed a line and annoyed the nurses. When the pt was transferred to L&D she asked that I stay with her until her friend arrived and the nurse in L&D was insistent that I leave (in a polite but firm way) and not follow her. I had already understood that I was not going to follow the patient past getting her and her things to the room, so that's all I did.
I don't get it-- maybe I'm just naive. I did not contradict the nurses in any way. I just spent more one on one time with the pt than they might have able to. And I feel that the pt benefited from it, which was the most important thing.
And I also don't understand in general why doulas have a bad reputation in this department. There is research showing that doulas decrease the need for interventions and they even decrease pain perception in some patients. Which leaves the nurse free to carry out the nursing side of things with caring for the pt's safety and health.
I think it also depends on the hospital and the particular staff. I acted as labor support for a friend of mine and the staff was so nice to me. They showed me where I could store my friends food in a fridge and various other amenities on the floor. At one point my friend said something about me and the nurse looked confused and said, "You aren't a doula?" :)
It just so happens that I went for an L&D interview at a different hospital. When asked why I was interested in nursing and L&D, I explained that my first birth went terribly. I had a nurse who treated me horribly - never introduced herself, snapped at me when I rated my pain a 7 (telling me that 10 was gunshot wound and "what was my pain, really?), and the sticking an emesis basin next to my head and running out the door when I said I had nausea. I mentioned in the interview how scared and vulnerable I felt and how I never wanted any woman to feel that way. I went on about how i looked forward to learning what a mom wants for her birth and supporting her as best I can. I also tried to emphasize my involvement with LLL since the hospital doesn't have LCs on staff (thought that would be a bonus!). The manager asked if I had other kids. I know that's not an appropriate question but I answered it. She asked how my kids were born. When I mentioned 1st was a c-section and the 2nd one was a lady partsl birth, she gave me this look of horror as if to say, "Oh no! You are one of those...." Needless to say, I didn't get the job....
It sounds like everything you did was incredibly appropriate, and well within the scope of NURSING...so why it's even being brought up that doulas are so terrible sounds like just a somewhat toxic work environment.
I can see in an environment like that where that animosity would get fueled. However it got started...at this point, the nurses are pushy and rude with the doulas, the doulas are pushing back against interventions because they don't trust the nurses, and where does that leave mom? caught in a sucky power struggle when she just wants to have a baby.
In my area, as a doula I have had great experiences with nurses. One of our hospitals has a doula program which I worked for, so that facilitated a much greater partnership. But I do remember at one birth, the CNM was over the top happy with me because I didn't discourage a mom from accepting Pitocin during a long 2nd stage labor. It was a completely reasonable intervention, and I don't ever really encourage or discourage anything more than informed consent on my clients. I do think some doulas out there have a very different interpretation of their role, however, and I can see how that would build animosity in the hospital environment. I have stood by and watched things unfold in ways I have found unfortunate, and supported women making decisions exactly the opposite of what I would do...but I just don't think it's my job to force them to think like me.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I think it also depends on the hospital and the particular staff. I acted as labor support for a friend of mine and the staff was so nice to me. They showed me where I could store my friends food in a fridge and various other amenities on the floor. At one point my friend said something about me and the nurse looked confused and said, "You aren't a doula?" :)
It just so happens that I went for an L&D interview at a different hospital. When asked why I was interested in nursing and L&D, I explained that my first birth went terribly. I had a nurse who treated me horribly - never introduced herself, snapped at me when I rated my pain a 7 (telling me that 10 was gunshot wound and "what was my pain, really?), and the sticking an emesis basin next to my head and running out the door when I said I had nausea. I mentioned in the interview how scared and vulnerable I felt and how I never wanted any woman to feel that way. I went on about how i looked forward to learning what a mom wants for her birth and supporting her as best I can. I also tried to emphasize my involvement with LLL since the hospital doesn't have LCs on staff (thought that would be a bonus!). The manager asked if I had other kids. I know that's not an appropriate question but I answered it. She asked how my kids were born. When I mentioned 1st was a c-section and the 2nd one was a lady partsl birth, she gave me this look of horror as if to say, "Oh no! You are one of those...." Needless to say, I didn't get the job....
THIS may be needless to say, but it is clear you would not want to work there anyhow!!!
And I feel that the pt benefited from it, which was the most important thing.
rbytsdy
350 Posts
I think it also depends on the hospital and the particular staff. I acted as labor support for a friend of mine and the staff was so nice to me. They showed me where I could store my friends food in a fridge and various other amenities on the floor. At one point my friend said something about me and the nurse looked confused and said, "You aren't a doula?" :)
It just so happens that I went for an L&D interview at a different hospital. When asked why I was interested in nursing and L&D, I explained that my first birth went terribly. I had a nurse who treated me horribly - never introduced herself, snapped at me when I rated my pain a 7 (telling me that 10 was gunshot wound and "what was my pain, really?), and the sticking an emesis basin next to my head and running out the door when I said I had nausea. I mentioned in the interview how scared and vulnerable I felt and how I never wanted any woman to feel that way. I went on about how i looked forward to learning what a mom wants for her birth and supporting her as best I can. I also tried to emphasize my involvement with LLL since the hospital doesn't have LCs on staff (thought that would be a bonus!). The manager asked if I had other kids. I know that's not an appropriate question but I answered it. She asked how my kids were born. When I mentioned 1st was a c-section and the 2nd one was a lady partsl birth, she gave me this look of horror as if to say, "Oh no! You are one of those...." Needless to say, I didn't get the job....