I'm just wondering what the general consensus of nurses is when working with doulas. I'm a doula in private practice and I'm looking forward to starting school this spring to get my RN. I'm currently working as a volunteer doula in part of a hospital program.
If you have had the chance to work with a doula on your foor, what are your feelings? Do you view doulas as an affront to your job? Or an asset making your job a little easier (not having to answer as many call lights).
I'd really love to know the good, bad, and the ugly of anyone who has worked with a doula.
If you don't know what a doula is, visit www.dona.org. This is the website of Doulas of North America, it provides information on the role of the doula and certification.
I've seen awesome duals and terrible dula's. sure there are a few that fall somewhere in-between but most fall in at either end of the extreme.
Good dula's. Support the patient, ask questions, discuss medical issues with patient doctor, nurse. By listening to them I can tell that they are advocating for the patient by making sure the patient receives all the facts to make an informed decision. They don't try to force there own idea's of what birth is on the patient only make sure that the patient is given the options and offer their techniques rather then force them. They never leave the patients side they do as much or as little as the patient requires. They realize that there are good nurse and bad nurses and don't assume that we are the enemy.
Bad dula's, refuse to come to the hospital until the patient is declared officially in labor, they sleep on the couch while the patient labors. OR they fight with staff, accuse us of terrible things, talk over me when I'm talking with the patient, try to make it seem they know more then anyone else. They smother the patient with unwanted activity's or conversations. They scold the patient if they ask for pain medicine and insist that the pateint not ver from the birthplan.
The bad dula's are easy to handle, give them enough rope and they will hang themselves and the patients end up throwing them out.
I see good duals as a great help to patient and my only regret is that I don't get to do much of the support type stuff when they are there.
I personally think that your attitude as a doula is fabulous, especially about the pain meds and birth plans. I have that attitude and hopefully will continue to do so when I finally become a CNM. My midwives with my last two children were just like that and I can only hope to be as great as they were.
Actually, I broke my own rule regarding pain meds the other day. As I said in another post, I have my clients ask for their own meds. But since we were fairly sure that this was headed towards a c-section (80-90% chance), I asked the mom if she was opposed to trying IV Stadol. She was doing a GREAT job with cxns, but labor was really getting rough and baby was starting not to tolerate labor well.
Since I work at this hospital as a volunteer doula and had a great rapport with the nurse, I could go behind the desk and ask her about meds for my client. They wanted to try a half dose of Stadol and that's what I asked for. They ended up giving her a full dose and she got rather loopy. I surely wasn't upset that this happened (she was REALLY getting to the point of needing medication), but this illustrates my reasons for them asking for their own pain meds. For all they know, I went up to the desk and said, "Hey, my lady in there isn't tolerating anything well anymore and hey, could we give her as much Stadol as we can?" - or something to that effect.
In the end, the parents weren't upset with me. But I'm sure that if they weren't so understanding, I could have been in trouble with them.
I think I might post about that birth, because it was so wonderful. I do have their permission to share what went on, but I will not give their names or anything like that.
I love doulas, and am sorry we don't encounter more of them. We only have them occasionally. I wish we had a doula program. I am alwayas happy to ahve a patient who brings a sould with her because usually they are such a wonderful addition top the patient's overall experience.
It's the occasional doula who has her own agenda that makes it difficult for all doulas, if you know what I mean.
Good luck in your RN endeavors. Your doula skills will be such an asset if you become an L&D nurse at some point.
I love doulas, and am sorry we don't encounter more of them. We only have them occasionally. I wish we had a doula program. I am alwayas happy to ahve a patient who brings a sould with her because usually they are such a wonderful addition top the patient's overall experience.
It's the occasional doula who has her own agenda that makes it difficult for all doulas, if you know what I mean.
Good luck in your RN endeavors. Your doula skills will be such an asset if you become an L&D nurse at some point.
Betsy
Betsy,
Thank you for your good wishes. Actually, there are several arenas I am considering for nursing work - L&D, Mother/Baby, and NICU. Although my first love is L&D, I'd love to do NICU work. However, to get to see abnormal processes, I should get to know "well babies" and work in Mother/Baby before doing NICU. We shall see when I get down - it all depends on job openings when I graduate.
Hmm.. as far as a hospital program. I know of a big doula group in CT, I believe they were called the Banbury Doulas. I did a search for them a while ago and couldn't find them. Maybe they changed their name. How about presenting this idea to your volunteer department? I'm sure there are doulas who would love to share their expertise, and the newer ones could get at least get a little experience. That's how we got started, sort of a child abuse prevention network. Our hospital is considered the "Medicaid hospital" for Tulsa county and they were concerned about child abuse in this area. That's how our program got started, and if a Medicaid hospital can do it, probably any hospital that's willing can start one.
We have a general "triage" for who qualifies for a free doula.
1. Primip, no support.
2. Multip, no support
3. Primip, some support
4. Multip, some support
We check in with the charge nurse and she refers the appropriate pts to us, and we go to the room and see if they are willing to accept support. We work in 8 hr shifts, and maybe beyond if we want to.
I love our program, and I hope that it would catch on in our places.
Regarding the patient getting the Stadol....they probably decided to give her a full does (1mg. as opposed to 1/2 mg) because in my opinion, the first dose always works the best and if you don't give that full mg to start, the relief is rarely as effective.
mm.. as far as a hospital program. I know of a big doula group in CT, I believe they were called the Banbury Doulas. I did a search for them a while ago and couldn't find them.
Katherine
Hello!!!!
the Danburry Doula program is poart of the Danburry Hospital in CT. I know one of them if u r interested to know more.
Dayray, RN
700 Posts
I've seen awesome duals and terrible dula's. sure there are a few that fall somewhere in-between but most fall in at either end of the extreme.
Good dula's. Support the patient, ask questions, discuss medical issues with patient doctor, nurse. By listening to them I can tell that they are advocating for the patient by making sure the patient receives all the facts to make an informed decision. They don't try to force there own idea's of what birth is on the patient only make sure that the patient is given the options and offer their techniques rather then force them. They never leave the patients side they do as much or as little as the patient requires. They realize that there are good nurse and bad nurses and don't assume that we are the enemy.
Bad dula's, refuse to come to the hospital until the patient is declared officially in labor, they sleep on the couch while the patient labors. OR they fight with staff, accuse us of terrible things, talk over me when I'm talking with the patient, try to make it seem they know more then anyone else. They smother the patient with unwanted activity's or conversations. They scold the patient if they ask for pain medicine and insist that the pateint not ver from the birthplan.
The bad dula's are easy to handle, give them enough rope and they will hang themselves and the patients end up throwing them out.
I see good duals as a great help to patient and my only regret is that I don't get to do much of the support type stuff when they are there.