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 …
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!