Diaries of a Labor and Delivery Nurse – This is Going to Kill Us

One of the last days I worked labor and delivery, I distinctly remember leaving thinking that nursing is going to kill us. When I started the day, I thought it was going to be greatest shift ever. My patient was a primip, but she was supposedly advanced dilation, she had an epidural that was working on both sides, and we flipped and flopped her every which way, even though I’m still nursing a torn rotator cuff. She was comfortable and so was I…I took every minute of my break to eat lunch (while watching her strip) and when I finished, I causally walked into her room to check her. By then, it was mid-afternoon and I was expecting to deliver a baby a solid 4 hours before shift change, giving me enough time to recover her and neatly hand her off to the next shift. In my head, I literally planned on getting her up and changing her sheets before 7pm. I would pass her and her baby off like a present with a little bow.

But it didn’t happen like that. When I checked her, she had not made much cervical change, even though my shoulder was throbbing from turning her and using the peanut ball and putting her legs in every kind of position that had gotten her in front of me in the first place. I carefully weighed my words to the physician, telling them my complete SBAR, but putting special emphasis on the fact that she was a primip and I thought she would be able to do it. They were on board with giving her more time, and didn’t even question what the Pit was on. After all these years, I felt semi-okay about telling the physician that the patient wasn’t exactly where I thought she would be. It was the charge nurse and my co-workers I was more reluctant to tell. But I had to ‘fess up. After all…a laboring patient changes staffing, and everyone else had already delivered theirs or was close to. I disclosed that I wasn’t sure if my patient would deliver before shift change. And then, whether in reality or only in my imagination, I felt the weight of everyone’s glances and raised eyebrows. She’s not delivered!?!? What’s taking her so long!? Night shift is going to talk about you. Do you think she needs to be sectioned? And as I defended myself – maybe to myself – I put it all out there: I think she’s going to deliver vaginally. The previous nurse was more generous with her vag exam, I feel like she’s made adequate change. Just give her time. I don’t care if anyone talks about me.

But the truth is, I do. My expectation was to hand off this patient like a present. In our eyes, that means delivered with a healthy baby, with clean sheets and an empty bladder. I pushed that patient before I typically would have, delivered her right at shift change, and stayed over an hour later to finish charting. By the time I left, I didn’t care if there was a bow, I just wanted to go home. I really left thinking that this is going to kill us, we are killing ourselves and each other. It really bothered me that our expectation with laboring women is to deliver them as quickly as we can, because God knows staffing is rarely great on nights. That night, I left feeling defeated and sore. It was an 800mg Motrin kind of day, and it wasn’t even a hard day—and damnit, I did deliver my patient. But the pressure we put on each other, the pressure we put on ourselves is suffocating.

So for any nurse out there that has left feeling the same way, remember to be gentle with yourself. Remember to be gentle with each other.  We only have each other. And our focus can’t be on how fast we deliver each laboring woman, it should be on how we support the labor experience. For now, I’m going to remind myself that tomorrow is a new day and my focus will always be on what’s best for the patient.

Until my next delivery ❤


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Mommasyl
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Mommasyl

I am getting ready to retire next month after 40 years a RN and at least 30 years doing Labor/Delivery or Newborn care. My body is worn out…multiple discs are done in from the physical impact of this job…the turning, lifting, holding, pushing….those not in LDRP have no idea of the physical demands, and you are so right…we must take care and support each other. They also are just waking up to the emotional injuries that we endure…the pregnancy outcomes gone bad…or the shift to shift sniping. Why is there a difference in days and nights regarding staffing? Worked eleven… Read more »

Mommasyl
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Mommasyl

Congrats! You did right by your patient! Awesome job!!!!! Your SBAR report spared her an unnecessary primary C/S. RNs have not fully grasped and embraced their role in reducing primary nulliparous sections…it DOES matter what message we deliver, and our rapid recognition of fetal and/or maternal distress with timely and appropriate interventions which effect placental resuscitation CAN prevent sections…not always, but enough that it makes a difference. Keep up the good work. Invest in a good back support, heating pad, and ice gel packs. :) Take care of yourself, take care of each other, and keep giving the right care… Read more »

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