40 Ways to Know You are a L&D Nurse

by Birth Without Fear on May 22, 2013

We recently read a ‘note’ by a nurse and shared by many other nurses and even midwives. It was not just a ‘sense of humor, deal with our hard job’ list of how you know you are a nurse. It was rude, disrespectful and a perfect example of what many women find wrong with their traumatic hospital births.

After this was shared and discussed, a wonderful group of nurses sent me this list. I am so appreciative of them taking the time to write this for the BWF Blog and our followers. It more accurately (and gracefully) shows what the job of a supportive, caring nurse looks like.

40 ways to know you’re a L&D nurse …

Fredericksburg VA Birth Photographer 2

1. You can eat your lunch next to that placenta you’re waiting to send to path for chorio without batting an eyelash.

 2. You’ve calmly said “I’m a little concerned about your baby” while you’re heart is sinking in your chest.

 3. You’ve started all of your intrauterine resuscitation measures, called for more nurses, and drawn up your pre-ops… All while hearing the clunk – - clunk – - clunk of heart tones… And keeping the laboring woman and every family member in the room calm.

 4. Asking your patient if her high school has a daycare and if they’ll call her when her baby is ready to nurse is normal chit chat.

 5. You really, really hope that the patient that took castor oil earlier to jump-start her labor doesn’t want an epidural.

 6. You get your almost comically soft voice on while family members are trying to frantically “soothe” the laboring woman hoping they’ll take it down a notch…  “That’s it… Perfect… In through the nose… Out through the mouth… Just like that… You’re doing great…”

 7. You know that whomever designed those “informed consents” and made nurses have laboring women sign them a) wasn’t a nurse and b) was never an actively laboring woman asked to “sign here… And here…And here… Initial here…”

8. You just state “oh, it happens, don’t worry, I’m used to it” while cleaning up a multitude of bodily fluids because you know the patient is totally embarrassed about it anyway.

 9. You have a hate-hate relationship with tangled cords and IV lines.

 10. You enthusiastically have said, “You’re hurting more, that’s great, we’re going the right direction.”

 11. And also, “you’ve got great bloody show!”

 12. You know preventing the primary cesarean helps prevent future cesareans and all of the associated risks for each future pregnancy, plus, most pelvises are adequate for the baby to get through if the baby’s in a good position – you’ve just got to buy that prime some time and maybe get that baby to turn.

 13. You know to ask about the father of the baby, history, and domestic violence when the patient is completely alone because the most unexpected people can have big secrets.

14. You would love your job even more if you didn’t have to chart it.

 15. You daydream about inventing a telepathic chart-bot so you could magically chart while holding sacral pressure.

 16. You get report, hang D5, clear her ketones, get her out of “left tilt” to way super lateral, and have a baby.

 17. “Is she on her side? Like, all the way over to her side?” Is the go-to first-step solution to all problems.

 18. You’ve held a woman’s hand and said, “I’m so, so sorry” and felt the emptiness surround you in the room.

 19. You know the patient will look to you while the doctor’s talking, and the family won’t absorb what the doctor has said until s/he’s left the room and you’ve sat at eye level with the patient and explained everything again.

 20. You want to get the low-risk no-pit laboring woman on intermittent monitoring before you see that little blip of a variable because we’re better off not knowing if all else is well.

21. You tell the doctor what you’ve already done and what orders you wrote for them.

 22. You have a list of tricks for women with and without epidurals to get the baby positioned well, “open the pelvis up” and get the laboring woman to push the baby out effectively- and you’re not afraid to consult with your peers if you’ve exhausted your list and nothing has worked.

 23. You get genuinely excited when the new issue of JOGNN comes in the mail and you get to read all of the new research articles.

 24. You know the differences in evidence-based practices and tradition/policy-based practices, and know that change is a frustratingly slow-moving train, but keep on fighting the good fight.

 25. It’s better to tell the laboring woman and family (and OB) she’s “almost there” than 10/100/0 and labor down a bit.

 26. When another nurse calls out for “more hands!” you run straight to the room to help.

 27. Same if she says “terb!”, “shoulders!” or “hemabate!”

 28. You suggest methergine when the doctor says hemabate, because you know nobody, including the patient, wants to deal with hemabate poo.

 29. When another nurse calls for the ultrasound machine and no heart tones are on the monitor yet, you bring it in without any questions.

 30. You can talk yourself down from a crappy strip…”ok, we’ve got variability here, scalp stim, palpable fetal movement… This baby’s not acidotic… Still Category II…” … And you can chart it defensively.

 31. You realize crappy strip and a crash c/s and you’ll have 9/9 Apgars most of the time, and a beautiful looking strip can just as easily have a crumpy baby.

 32.  You don’t let the IUPC fool you because you know adequate MVUs means cervical change, not a hard number.

 33. You walk the fine line between knowing when to bite your tongue and when to speak up in front of the patient be the best advocate for her. You have the resources and research to discuss things you didn’tagree with at an appropriate time. 

34. You know the chain of command and hope to goodness you don’t have to use it.

35. You advocate for immediate skin to skin contact- better for mamas, better for babies, and easier for nurses (and can’t we just wait a moment with the baby on mama before fussing with clamping and cutting the cord already?).

36. You can manage a an insulin drip, mag, labatelol and pit on a very sick mama, and know when it’s time to throw in the towel and get the baby out.

37. You have thought, “I really need to poop before she starts pushing” but decided against it because you had too much charting to catch up on. 

38. When you see a woman come up sitting tilted sideways in a wheelchair and huffing and puffing, you get gloves on. She’s either complete and about to have a baby or she’s 1/thick/high – but better to error on the prepared side.

39. You can check a woman’s cervix within minutes of meeting her. 

40. You’ve gotten a thank-you note from a patient and practically burst into tears because you remember why you endured through nursing school just to work yourself to the bone, have a crazy schedule, pull your muscles, get UTIs from not peeing, stay hours late charting, miss Christmas and birthdays and BE A NURSE!

Rebecca Colefax Photo

 Top Photo Credit: www.littlefredericksburgphotography.com
Bottom Photo Credit:  www.rebeccacolefax.com

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{ 123 comments… read them below or add one }

Katlin Stewardson May 22, 2013 at 11:19 am

A much better list!

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Babymoon Birth Services May 22, 2013 at 11:22 am

Oh My Gosh! I LOVE this!! #3, #6, #8, #10, #12, #24, #30… And lmao at #37…What is up with that?! It’s so true.
Great list.

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Stefani Vechery May 22, 2013 at 11:42 am

Coming from an L&D nurse, this is spot on. Some of them are funny-#37…haven’t we all wished for a second to run to the bathroom while you’re on hour 2 of pushing?? And those are always the nights when it’s crazy and there’s no one to step in for you…lol. Thanks Birth without Fear! You do good work!

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Melissa May 22, 2013 at 12:09 pm

I love this! Nurses are amazing! And I pray I get the same nurses I had with my first. They are angles! I absolutely loved me nurses! When my epidural stopped working on one side of my body they did everything they could with out a secound thought as I cried through contractions. She made me comfortable by being there. My nurse had to leave before I gave birth. But early the next morning I woke up to her hold my baby and telling me she was beautiful. I couldn’t thank God enough for sending her to me and making my experience a good one.

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Bad Wolf May 22, 2013 at 12:15 pm

I read the first list and I cried, but this made me want to cry for a different reason. I really do remember every single nurse from all 5 of my births. I don’t remember all of their names, but I remember each face and the way she treated me. It really makes the difference between a good birth experience and a traumatic one. I have had a couple births that didn’t turn out the way I wanted, but I was perfectly happy and at peace with the experience because I was treated with compassion and respect. L&D nurses set the tone for birth in the hospital. It really is all them. I am so grateful for all the wonderful nurses out there. They deserve so much more credit than they get.

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RR May 22, 2013 at 12:31 pm

Now those are nurses I would want to meet! Can they spread the word?

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Rachel May 22, 2013 at 12:52 pm

I was an L&D Nurse for 18 years but have not worked as a Nurse for the last 2 years and number 18 made me cry. Some days I really miss Nursing and being a part of sometimes the happiest and sometimes the saddest moments in peoples lives. Great work putting this together. I do not miss the Hemabate poo at all!

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Dayna May 22, 2013 at 1:13 pm

im curious about number 5, just wondering why hoping they dont want an epidural?

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Denee May 22, 2013 at 2:19 pm

Dayna,
Probably because of the fact that the effects of castor oil can be…messy. A woman with an epi can’t get up to use the bathroom ;)

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Shary May 22, 2013 at 8:03 pm

My castor oil induction failed. I did however have a serious relationship with my toilet and I can imagine how not being bale to walk to the bathroom would be the most undesirable situation for mamas and l&d nurse.

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Chantel May 23, 2013 at 5:34 pm

And why do women think taking castor oil at night is a good thing. Take it in the morning so if you have to be up and awake to poop every 3 minutes you are not missing any sleep!

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Liz May 22, 2013 at 4:58 pm

This is GREAT!!
The only thing I would add to this is that you wish you had 4 arms and hands to manage all the stuff you need to do while “it” gets exciting in your labor room. And that is not counting keeping track of all of it at the same time.
Though I could add a few more possibles…………
Your child calls their private anatomy by the correct anatomical terms and will most likely be the source of their friends sex ed.
And your child wants to know the sex of the child in the photo at the end of the list.

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Jill Shivers May 22, 2013 at 6:16 pm

Oh my gosh this was so awesome and right on!

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Carrie Young May 22, 2013 at 6:38 pm

This is a great list. Other nurses think that we just hold the mother’s hand and rock babies.

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Meghan May 23, 2013 at 9:31 pm

As a former ICU/current PACU nurse, I gotta say, I’ve taken care of patients who have had their lives saved by L&D nurses – nothing but respect for how hard you all work!

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Cristen May 22, 2013 at 7:47 pm

So refreshing to read this! That other list was disturbing. This one renews hope :) Your nurses really can make or break your birth. Much love to the good ones.

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Jenn May 22, 2013 at 7:52 pm

Love! Great list.

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Jessica Becker May 22, 2013 at 8:05 pm

I can’t for the life of me remember my nurses name when I was in labor. (i went through quite a few nurses, doctors, PLUS med students.) I think her name was Karen!(maybe!) She was so helpful, gentle, and she saved me from a CS! I wish I could remember because I really want to thank her!

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Tannis W May 22, 2013 at 8:15 pm

I very much remember the nurse who was with my husband and I for # 18.

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Robin May 22, 2013 at 10:30 pm

This is a beautiful list and all so true. I was a unit clerk for 5 years in a LDRP (labor, delivery, recovery and post-partum) it was so beautiful no matter how hard things got the whole process of the mother, father and family being support or the staff stepping in when the family can’t be there (military moms). I have had placenta’s thrown on my desk while eating and just ate. LOL that comes with the territory. Kuddos to all the moms out there and to the NNP, Midwives, Staff and Nurses. You all Rock

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Emma Rose May 22, 2013 at 10:40 pm

I am an aspiring birth worker, and this list has really warmed my heart! I hope to eventually get my nursing license, and while I don’t think it will be the permanent destination of my career, I often think of how I may someday have the opportunity to work as a L&D nurse, and how I might be able to be one of those amazing nurses that makes all the difference in a Mama’s labor. We’ve all heard it (or experienced it) before—your nurses can make or break your birth experience. I’m so thrilled to hear this list from a stellar nurse’s perspective, and I hope to one day have the honor of serving women in the same way.

I also greatly appreciate the way Birth Without Fear and the author of this list responded to the original list. Instead of responding negatively, you acknowledged the disrespect of that list, and responded with a beautiful, empowering, positive list. Responding to the negative with love, light, and optimism. So lovely.
<3

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Julie May 22, 2013 at 10:55 pm

Could someone explain #32? I’ve had 5 babies, but all with midwives. The first at the hospital, the second two at a birth center, and the last two at home. I understood most of this list, but #32 had me stumped.

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Sharmaine May 23, 2013 at 4:01 am

An IUPC means “intrauterine pressure catheter” and it calculated the actual pressure inside the uterus from each contraction. Some doctor called ” Montevideo” said if the cumulative pressure of the uterus over a 10 minute period was high enough, then the cervix should open…. That’s all good in theory, but sometimes moms with very low MVU’s (Montevideo units) still open the cervix, and others with “adequate forces” don’t. I guess you could say the proof is in the open cervix.
Those tubes are only used in hospitals!

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Julie May 26, 2013 at 1:15 am

Thank you so much for explaining that!

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Beth Gish May 22, 2013 at 11:10 pm

After having 3 children, now age 32, 31, and 16, I still can remember the faces of my wonderful nurses. My first child was a very hard labor ending in a c-section. My nurse let me squeeze her hand for hours with no complaints. Ahn was there for me with the birth of my daughter a year later and with the miracle birth of my youngest 15 years later to my large, breech baby daughter. Needless to say, my best friend has been a labor and delivery nurse for many years and has been a godsend to countless many mommas and babies!

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Erin May 22, 2013 at 11:14 pm

thank you for posting this. I am and L&D nurse and I am glad you know we aren’t all bad. Some of us really are fighting the good fight for women.

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TessaW May 22, 2013 at 11:31 pm

Thank you.
And thank you to the wonderful people who put this list together.

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Krista May 22, 2013 at 11:35 pm

I’m a labor nurse and I shared this! Thank you! A much better list! #28 “And Lomotil?????” I also like “Like WAY on her side?”

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June Clark retired midwive May 23, 2013 at 12:18 am

Forgetting to get out of the way, actually not caring when you get bathed in lovely liquor at 2nd stage, and also remembering how good liquor is for the skin.
The feel of lanolin/vernix on your fingers, best cream ever.

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Ronda May 23, 2013 at 1:21 am

Absolutely loved this. We do make a difference. My first L&D nurse made me into one. 29 years ago I didn’t like the choices she made for me , but now I understand. I have to laugh when I commit those same heinous acts out of love for my patient.

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Lovetta Culver May 23, 2013 at 1:45 am

That truly shows the real story of a L/D nurse.

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Sharmaine May 23, 2013 at 4:03 am

I am a labor nurse and I LOVE the list! Thank you so much for it!

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Mary May 23, 2013 at 6:01 am

This list is true of all the laboring team. We obstetricians want a happy healthy mom and baby each time too.

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Bridget May 23, 2013 at 7:08 am

Absolutely, 1000% TRUE. Nicely done :-)

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Tina May 23, 2013 at 7:47 am

Never saw the first list but Love the this list!! I have been a L&D nurse for 33 years and have done, said or thought every item on this list a multitude of times. The hardest part of my job was # 18. The favorite part of my job was when that family returned for the birth of the next healthy beautiful baby!!

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Kathie May 24, 2013 at 3:06 am

Dito to Tina above. Every baby is beautiful and brings joy but there is something so precious about that good outcome for patients who know it doesn’t always end that way.

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Joy G May 23, 2013 at 9:06 am

I am so glad to see this list in support of nurses/hospitals! Sometimes, as a Mom who had a pretty traditional, non-traumatic hospital birth, I find on birth advocacy sites that I feel like people want me to feel guilty about the way I chose to bring my LO into the world or that I’m just uninformed and wouldn’t have made the decisions I did if I knew better. The fact is that I had some of these wonderful nurses described in the list above that made my delivery exactly what I wanted. Thanks for posting, and this site isn’t one that makes me feel that way! ;)

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Debbie May 23, 2013 at 10:28 am

Been doing this job over thirty years and still wonder how I got such a great job. Seeing a baby come into the world and having the mother hug you cuz you helped her sooo much is the greatest reward!
The whole list is spot on …..LOA on # 20 and 28!

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Lisa May 23, 2013 at 11:47 am

I’m an L&D nurse as well. This list is SPOT. ON. It’s so great to get some recognition and validation from others for what we do :) Hospitals aren’t evil, & neither are all nurses. I wish every woman could have a flawless, peaceful, beautiful, event free delivery but unfortunately it’s not always the case :/ But every time I go into a room I silently pray that whatever the outcome, I am able to serve that woman to the best of my abilities and provide her with the best experience possible.

I need to add one more to the list though before I go: “if you’ve ever ridden the bed to the OR with the patient…and you know why…you might be an L&D nurse!”

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Sarah L May 23, 2013 at 6:30 pm

Awesomeness! I’ve never ridden the bed but I’ve had to give a “vag hand” in c/s before!! I’ve been an L/D RN for 8 years and i still think I have the greatest job in the world!!

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Rosa-Maria May 24, 2013 at 1:22 am

The first c/s I did as a brand new RN on orientation was a stat for prolapse. Talk about initiation!

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Charlotte May 24, 2013 at 8:25 am

I totally understand your addition try the ride 7 months pregnant yourself and still get 8/9 apgars is a moment one never forgets! (Even 10 years later)

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Rosa-Maria May 24, 2013 at 12:12 pm

I swear its always the pregnant nurses that end up riding to the back on the bed! Or trying to speed-push that unweildly thing to the OR.

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Cin May 23, 2013 at 11:48 am

May I add one? You know you’re an excellent L&D nurse when a labouring woman with hyperemesis comes in to deliver, and you immediately call the doc to make sure she gets her Zofran on time — and you also encourage her during pushing by saying “The puking is almost done! You can do it!”

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Nicole Brandenburg May 23, 2013 at 12:11 pm

Love this! There are a lot of great nurses out there not getting the kudos they deserve. I’m glad to see some positivity here!

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Anna Van Loon, RNC-OB May 23, 2013 at 12:43 pm

CAN I GET A WITNESS?!? Going to re-post this on the unit, such an honor and a blessing!

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Beth May 23, 2013 at 1:41 pm

Love the list. Definitely was written by an experienced labor and delivery nurse. I love my job, although it’s hard. You will go without eating, breaks, potty trips, etc. But it’s OK because we don’t mind doing whatever we have to do to help our patients in any way. I’ve been a L&D RN for nearly 20 years. It is a wonderful honor to have a patient beg you not to give report to the next shift, or thank you from the bottom of their heart. Although at our hospital they will get another great nurse because we are experienced, all help one another, and truly care for our patients at Hillcrest L & D, Tulsa, OK.

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Jenny May 23, 2013 at 2:53 pm

I’m curious about that first list… where can I go to read it?

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Lisa May 24, 2013 at 8:49 am

Don’t bother, it had a disturbing volume of sarcasm…made me wonder why they even went into nursing…much less a field where mothers and babies deserve compassionate care. I used to tell OB nurses who had become cynical to go work in orthopedics if they couldn’t hack it..
I believe it was Maya Angelou who said you may not remember what someone said, but you will always remember how they made you feel….as evidenced by these testimonials here.

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Sherry May 23, 2013 at 3:27 pm

I was an L&D nurse for 22 years, it is very hard physically but most rewarding spiritually, I tell people God is at every delivery, at the vaginal deliveries, at the stat c/s deliveries when everyone is praying please let mom and baby be okay when this is over, and especially at the silent deliveries when mom, dad, families and nurses need him most. That is one of the reasons I love that job, I believe it is a calling, and not everyone is up for it but it is worth every second!

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Tanya A May 23, 2013 at 4:12 pm

My L&D nurses were the positive part of my hospital birth with my 1st son. They supported my choices, advocated for me, and made me feel like even though my birth didn’t go as planned, it was still wonderful and that I did a great job.

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Vicki Duncan, MD May 24, 2013 at 12:33 am

I LOVE this list, and I LOVE my L&D crew! They are the reason I continue what I do. This list is great, as well as accurate. One more item -they don’t hesitate to strike when the issue is patient care…even though it means no paycheck for days…

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Rosa-Maria May 24, 2013 at 12:14 pm

Love working with supportive MDs. They truly understand how much time the RN is with the patient and take their recommendations, concerns seriously. It makes the team function so well.

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BettyN May 24, 2013 at 1:13 am

Two others:
* You have a 3nd grader who gives unsolicited pregnancy advice to her pregnant teacher because she knows a great deal more about the birthing process than her peers with No-OB RN parents.
* You use your first two fingers to ‘measure’ stuff other than a cervix…..you never need to hunt up a ruler.
I love my L&D life.

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Kathie May 24, 2013 at 3:13 am

Awesome list! I’ve been an L&D nurse for over 20 years and have said or thought most everything on this list. It’s an amazing career, where you laugh cry and laugh again. Still brings me joy.

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Liz May 24, 2013 at 8:09 am

Loved loved loved my L&D nurses during my recent (first!) delivery. I’m a physician, but not an OB, so for the most part I was like any other patient and they were so so wonderful to me and my family.

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Ann Hopkins May 24, 2013 at 8:25 am

This was sent to me by my former babysitter(a college student at the time) that helped me care for my 3 small children(she was there through the 3rd’s pregnancy and was the first to care for him when my husband and I worked weekends) while I worked as a L&D nurse. She just had her first baby after we had several discussions about birth…the power and beauty of the mom and baby working together; how birth can be an empowering experience when trust, respect, and support are the “medicine.” Love this list…hope these nurses become the majority…keep writing and sharing. As a Lamaze educator I encouraged my moms and their families to look for mutual respect and decision making birth stories because we all need to have a voice-doctors, midwives, nurses, families and I am glad you are out here sharing.

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val lyke May 24, 2013 at 2:01 pm

That was a beautiful piece of art.. and labor is still the same and so are the Nurses and Midwives who love their job and continue to devote their life and love to it,who ,continue in the spirit it was meant to be…

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Leah R May 24, 2013 at 5:16 pm

This is so great, makes me love the job I do even more! My fav was #39, what odd interactions we have sometimes! The other one I would add is:
You can smile and calmly say, “The doctor is on his way, but you do what your body is telling you to do”, while knowing you are about to deliver a baby.

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Dori May 24, 2013 at 6:18 pm

Thanks for posting this. I am not an L&D nurse but am a post partum/nursery and NICU nurse. My twin sister is an L&D nurse and posted that first list on her facebook. I was appalled and saddened. I am happy to read this one and will pass it on to her!

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catherine May 25, 2013 at 7:38 am

I still remember that it was a L&D nurse who had the courage to say to me in the hospital the day before I got my son circumcised that “there is no medical reason to do it”. I remember thinking at the time that I had received other information from other sources. I dismissed her, in my mind despite the fact that I thought it was kind of her to care enough to say something. Now when a nurse talks, I frickin’ listen and seriously consider what she’s saying…even if it flies in the face of other “trusted” medical sources of information. If I had known the kinds of things she very likely knew, I personally wouldn’t have opted for my son to be circumcised.

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Jo Ann Evans May 25, 2013 at 1:47 pm

Jo Ann I am a retired l/D of 32 years. This right on the spot, been there done that. Babies are so precious and bring so much joy to the world. I had an amazing career.

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Chris May 25, 2013 at 5:20 pm

And there’s the definition of the “old OB nurse”, I think it was from Carol Harvey many years ago—you see the big deceleration at the desk, run into your patient’s room and do the vag exam, and find the prolapsed cord. You reach for the call button and say, “I have a prolapsed cord, open the OR, and can someone relieve me? I was about to go to lunch?”

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