What a Labor Nurse Can Handle That You Can’t :(

pain
It’s not really like this for everyone 😉

Women in unexpected pain – It’s labor, so everyone knows it’s going to hurt, right?!? Wrong. Whatever our patients think it’s going to be like, it’s different.  And every time they think it can’t get worse than this, they’re surprised, because it does get worse than this. They think their pain is a scale of 8?  Wait ’til their baby’s head is trying to find it’s way under their pelvic bone. Then the baby’s head has to come out of their vagina. And then they have to deliver the shoulders…  Get the drift? No matter how much they think they know what the pain will be like, there is unexpected pain. And labor nurses have to deal with that and help a woman cope. Some have a pain goal expectation of zero 😞  Well, we’ll keep striving for that, because we want them to be comfortable, but there’s no pain scale of zero in labor and delivery :/ Sometimes they want medication, sometimes they want an epidural, sometimes they just want to move around and do whatever it is their body tells them to do (which we recommend). Often they just want to grab us and stare at us with crazy-eyes, but we are use to this as well.  We just coach them on their breathing and reassure them they aren’t really going to die.

One word: blood – When you think about blood, you may think that this is something an emergency room nurse can handle. But let’s be honest, most people are using the ER like a clinic and although they do see their fair share of blood, in labor and delivery we are guaranteed to see blood at every.single.delivery.  And it’s just different when it’s coming out of a vagina. I’ve never met an ER nurse who could handle vagina blood… Oh, and sometimes, after delivery, we massage a woman’s stomach and clots come out. We’ve all seen some the size of basketballs (seriously!).

Hormones – Surging hormones. Raging hormones. Fluctuating hormones. Think PMS hormones and menopause hormones on crack.  But we deal with those, and we expect those, and to us, these hormones are normal. But a lot of other nurses would have trouble dealing with a woman who is screaming at us one second and crying with gratitude the next.

nurse-jackie-pictureVaginas – And these aren’t perfect “I-just-took-a-bath-because-I-knew-you’d-be-looking” vaginas.  These are “holy-shit-I-can’t-control-what’s-coming-out-of-here” vaginas. But don’t worry, we won’t remember what yours looked like once we walk out of your room.  Again, most other nurses can not deal with vagina-blood.  But for us, this is totally normal. We look at the color, we look at the consistency, we measure the amount, and we even monitor the smell! And vaginas in general are just vaginas to us. We see big ones and small ones and hairy ones and bare ones. Those are seriously a dime a dozen.

Every other “private” part – Besides vaginas, carefully inspecting nipples, breasts, and bottoms is part of our “normal” routine. And we have to chart what we see…You would think vaginas would be kind of original, but nipples come in every size, shape, and color. There are flat ones and big ones, innies and outies, and ones that point this way and that way.  These things may make other nurses squirm, but it doesn’t make us the least bit uncomfortable 😃 Sometimes our patients have these…um, sensitive areas pierced and it’s impossible to get the jewelry off. Imagine what we look like with our faces 5 inches away from their breasts or vagina-region trying to pry off a piece of jewelry…

Charting – Every nurse has a billion things to chart, but it’s standard for labor nurses to have to chart at least every 15 minutes. That’s right, every 15 minutes for our entire shift (if they are on Pitocin or if they are any kind of high risk).  And if they’re not, it’s every 30 minutes :/ After an epidural, when a woman is pushing for delivery, and when we first get to PACU we have to chart every FIVE minutes.  Sigh.

surprised

Hair – hair here,  hair there, hair everywhere.  Except sometimes there.  It’s hard for most women at 9 months to shave their legs. Some just give up shaving anywhere else.  But this doesn’t phase us in the least 😃  I will NEVER forget my first day as a new grad, whispering to my preceptor that I thought only bad girls shaved “down there.” 😃 I was wrong.

Crazy family members – If you’re a nurse and you think you deal with crazy family members, imagine adding a brand new baby to the mix (everyone loves a baby).  They can turn nutso.  Think about how much you like your in-laws :/ And then imagine them in the room, trying to take pictures of your vagina as their grandbaby/niece/nephew makes their grand entrance into this world.  Some times daddies don’t like mommas. Sometimes mommas don’t like daddies. Sometimes mommas don’t like anyone.  You get the picture.

nurse-curse-6
Making “different” look like the new normal – You have to maintain a complete poker face when your patient requests or says something totally out of the ordinary…Some women say they’re going to name their baby “Da’dance” or “Candi” (when their last name is Shoppe).  Sometimes they just make unusual requests.  Once we had a patient who had a cesarean delivery ask us to wipe vagina secretions on her baby’s face :/ Yes, that’s a thing. And we do it without blinking an eye, because that’s just what we do, and it’s their baby 😃

…and honestly, I wouldn’t have it any other way.  I ❤ our patients, I ❤ their families, I even ❤ all those crazy hormones.

Until my next delivery ❤


27 thoughts on “What a Labor Nurse Can Handle That You Can’t :(

  • January 28, 2016 at 3:48 am
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    Glad you mentioned the part about wiping the vaginal secretions on the baby’s face….should be standard practice for cesarean deliveries…the baby benefits from that bacteria so why not? It’s an easy thing to do!

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      • January 28, 2016 at 7:16 pm
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        Check out the documentary “Microbirth” for more info on colonizing cesarean babies with vaginal secretions!!

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      • January 28, 2016 at 10:24 pm
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        A labor and delivery nurse who is ignorant of the role that bacteria plays in the systemic health of the newborn? Typical.

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    • January 29, 2016 at 7:09 pm
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      I was just going to pipe in and say the same thing. There is pretty good evidence on the gut biome and vaginal bacteria. Hopefully this will be a “thing” soon

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      • January 30, 2016 at 1:14 am
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        Puhlease! Unless the baby is a face presentation how has it contacted vaginal secretions? In my20+ years of L&D, I can’t recall even one time that a babe’s face wasn’t wiped off as part of normal drying unless a specific request of mother. This is not a controversy IMHO.

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      • January 30, 2016 at 4:16 am
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        Please do some research on this topic dspreenblog! Babies benefit greatly by being colonized by their mothers vaginal flora during any vaginal birth. Cesarean babies miss out on this very important bacteria colonization. This has been studied and researched and proven!

        Watch Microbirth!

        PS Doesn’t matter how long you’ve been a nurse or been alive, there is always more to learn/discover every day! Be open to learning more in and out of your field every day. “Student for life” is one of my mottos <3

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  • January 28, 2016 at 4:14 am
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    Absolutely!!! And then some! Just wiped my “vaginal swab” over the baby……….of course, after I did PPV and then CPAP. I tried to assure the dad that breathing was just a little bit more important, and the swab could wait. Cough, he didn’t get it. And all the rest! My fave………….vaginas are a dime a dozen. Make that a bakers dozen!

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  • January 28, 2016 at 8:30 am
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    Waaaah! I was imagining my intern days while reading this one, those were the days when I realized if I ever pursue my nursing professio I really want to be a labor and delivery nurse. I laugh when you mention blood and vaginas lol ’cause I rwmeber my classmate fainted during our firat handle of delivery and another classmate who was a guy who bit me in the shoulder as we watched a baby coming out of a swollen vagina. :D Fun days.

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  • January 28, 2016 at 3:26 pm
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    After 35+ yrs of labor and delivery nursing, I just love this ! All SO true! Yeah, get the vag swab on that face during CPR, and can you hurry with the skin to skin?? I truly love them all, want to meet thier needs, but sometimes you just got to shake your head! I remember back in the 80’s thier was a placenta cookbook! Cookies anyone?

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  • January 28, 2016 at 3:50 pm
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    I have worked in OB for 10 yrs and I keep threatening to write a book of some of the comments and events that have happened over time as generations change. Now some of the craze is to keep the placenta for the family to send it to a company to turn it into capsules they can take them orally. My favorite are just some of the comments that are made while the mom is pushing. Every day I am amazed.

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    • January 30, 2016 at 11:46 pm
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      Why send them away—–just use a dehydrator and buy some gel caps. Much cheaper and organic

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  • January 28, 2016 at 10:49 pm
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    The smell. That is something hard to forget. How many times did you encourage a peri cleanse or put a patient on the bed pan to do so. “Oh yes this is completely normal for the baby’s benefit” all the while thinking if I have to spend 12 hours down there I am going to pass out or die

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  • January 29, 2016 at 2:19 am
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    I’ve been a nurse 43 years and 20 of them in L and D. I penned a book DUTY SHOES, A NURSE’S
    MEMOIR, Amazon/Kindle.. 5 chapters contain L and D stories, then and now… Read my account of an abdominal pregnancy that lived that took place in a small hospital in Alabama! Unbelievable!

    All proceeds from the sale of this book go to nursing scholarships.

    Camille Foshee Mason RN

    Reply
  • January 29, 2016 at 4:01 pm
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    and can discuss all of this while eating a meal :)

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  • January 30, 2016 at 5:21 am
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    Have worked in hospital setting since 1970 wearing several titles, seen many trends and requests,
    as long as it safe and possible we can provide and also eat and drink ,watching, discussing and doing it KARN

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  • January 30, 2016 at 1:51 pm
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    23 years in L&D, and have yet to see a basketball – sized bloodclot. Wondering if she meant baseball – -sized?

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  • January 31, 2016 at 12:12 am
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    Agreed Barefoot Cookie.
    18 yrs, and I’ve seen many bleeds that we have a hard time stopping, but no “basketball ” clots!

    Must have meant baseball.

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  • February 18, 2016 at 12:35 am
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    Hi Shelly! I followed your link from this article on the Huffington Post, congratulations on being published there! <3 This is a wonderful read, I wish you'd been my L&D nurse. Mine went and badmouthed me (complete with the f-bomb and all sorts of profanity) to the entire nurses station in front of my family and inlaws. Why? Oh because I chose not to have an epidural and she didn't like that and didn't want me "bitching" when I started being in pain. It all worked out just fine, I never cried or screamed or had any issues without the epidural. It is nice to know that there are nurses like you out there.

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  • February 28, 2017 at 6:11 pm
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    dspreenblog– you state

    <>

    I’m not sure what you’re stating? EVERY SINGLE baby that is born vaginally is covered in vaginal secretions, eyes, nose and mouth. Even though the face is quickly wiped off, these areas have already been colonized by the mother’s helpful bacterial secretions. Later in life these babies that have been colonized do better when compared to the babies that were born by cesarean. The cesarean babies missed being colonized during the pushing stage. So when they are born they are initially colonized by hospital bacteria in the environment leading to a less healthy gut. Some medical practioners and parents believe that if you immediately wipe the baby’s face and hands with the mother’s secretions the baby will have a chance to be colonized with the helpful bacteria first and get the same benefits as the vaginal birth babies. The only problem I see is the vaginal secretions would be best if collected prior to the c-section, as after the surgery there is a large amount of blood in the vagina that may dilute the helpful bacteria. I have been a L&D RN for 28 years and am continually amazed at how smart nature is :-) BTW, there is small but growing evidence to support this practice.

    Reply

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