Obstetrical Nursing: The Good, the Bad and the Crazy
The Crazy: Leaving Corporate America to Pursue a Dream
For as long as I can remember, I wanted to be a nurse, but because I was not the most confident gal on the planet back in high school in 1985, I followed the path of least resistance, which meant local community college, a daily commute sans the dorm and campus life that I really wanted.
I earned an Associate's degree in Business Administration in 1987, left my small hometown for the "big city, and an entry-level office job that paid peanuts. It also happened to be the same company my father worked for, which made him proud. At that time in my life, that was what I thought life was all about...making your parents proud; basically living for others. I was a people-pleaser extraordinaire.
For four years I worked in this typical office environment, full of drama and politics. I had gotten married in 1988 and became pregnant with my first child six months later. I kept thinking that something had to give. I didn't want my baby to be in a daycare setting, but neither of us made enough money to survive on one income.
Fast forward to my Labor and Delivery room in 1989, giving birth to my sweet baby boy. I was in awe of the experience and was asking a hundred questions to my nurses, most likely being annoying. It was then, I decided this was what I wanted to do for a career. It was a heat-of-the-moment decision, and because I was caught up in the emotions, my family did not take me serious.
During my maternity leave, I applied to the closest college of nursing I could commute to from the office and home, and was accepted in a pre-nursing curriculum. I began chipping away at the prerequisites needed to apply for the actual program. I had no science classes to speak of, having come from a business background. It was hard starting with basic chemistry, algebra, and biology, but I was determined to make a better life for my family and live the life I wanted, not what others wanted for me. I set my sights on being a labor nurse and never looked back.
I continued taking classes in the evenings and weekends. 20 months later, in 1991, I gave birth to my daughter. With a newborn and a toddler keeping me busy, I left the business world during my maternity leave, took on three part-time nursing-related jobs, and was finally accepted into the nursing program.
For the next two years, I would work for my kid's pediatrician 8-12 hours a week, a busy cancer unit at a local hospital every other weekend,16 hours, and a mother-baby unit at a different hospital, whenever I could fit hours in—all while attending nursing classes and clinical rotations for 20 hours per week.
I felt like I was dying a slow death and was more overwhelmed than one could imagine. I kept my eye on the prize. Never again, would my children spend 40 hours a week with a babysitter, because nursing would allow me the flexible schedule to raise my own children.
The only way to be truly satisfied is to do what you believe is great work, and the only way to do great work is to love what you do. If you haven’t found it yet, keep looking, and don’t settle. As with all matters of the heart, you’ll know when you find it.— Steve Jobs
The Good and the Crazy: Nursing School and Night Shift
In 1993, I graduated and was oddly excited to don a nursing cap for my pinning ceremony—even though I'd never actually ever wear one. All I could think of was how much I wanted to work in Labor and Delivery. I didn't get hired there initially and was devastated (new graduates rarely got hired in Labor and Delivery back then). I was instead, offered a position working 12-hour night shifts on the postpartum unit where I was already a nursing assistant, and that was close enough to pacify me...temporarily.
For most of my career, I would sacrifice sleep following many dreadful night shifts, to stay up with my kids during the day, and that was where things really got rough. I’d come home and nap for just a few hours while they slept or watched Disney movies with me in my bed, and then I'd stay up until it was either time to go to work again, or time to go to bed. My days and nights were always mixed up, but it's what worked best for the kids to not go to a babysitter.
Many days I was difficult to live with, but my family never seemed to never hold it against me. They knew not to push my buttons and that if I was grumpy, it was from being flat-out exhausted. I give them credit for putting up with a tired, run-down mamma. They knew how important it was to me and that I did it to give them a better life, not to be shuffled to a sitter.
The Bad: Trial by Fire
Moving right along to 1995 and having child #3, a son, I went into labor just as I was getting up to go to work, as I was on a temporary day-shift rotation. I managed to make it nine hours before finally succumbing to a labor bed myself, where I would proceed to endure my longest labor. At this time, I'm still working on the Postpartum unit and getting more anxious by the day to make my move to Labor and Delivery.
Little did I know that six weeks into that maternity leave, I would finally get the phone call on Friday: “We have an immediate position in Labor and Delivery and we need a nurse who can start now. The catch is, you must start on Monday, or we will move on to other candidates.”
What the hell! This was not happening now!? With six weeks to go in my 12-week leave, I was left with a very hard decision. I was not mentally or physically ready to go back yet, but it was clear I was being tested to see how bad I wanted this position. If I passed it up, I may have blown my chance. After a weekend of tears and mental anguish, I decided to go for it. I bargained with the "powers that be", that if I cut my leave short per their request, I would be granted my remaining six weeks later that year. I was shocked when they agreed to my terms, but they were also very desperate for help. Little did I know what was about to happen.
I showed up to work that following Monday morning as requested, totally pumped and ready to learn...and was thrown straight to the wolves; left to make it on my own, without any bit of orientation, and here is why:
Labor and Delivery nurses almost always have, at a minimum,12-weeks of orientation before working independently. As luck would have it, staffing was very short from a recent turnover, and the nurses were angry hey had hired someone without experience. In fact, the staff was so upset, they refused to help me acclimate to my new position. I had to teach myself the ins and outs of labor and birth, where supplies were located, the doctor's preferences, and the general flow of the unit. I wanted to crawl in a hole and never come out, but at the same time, I was not about to admit defeat. I'd waited too long for this opportunity, so it was "game-on".
I cried on my way home after every shift, and felt so alone. I spent hours reading my obstetrical college textbook, trying to learn and understand what had happened that day—Google simply wasn't a thing back then, and I was not about to be broken.
I eventually learned the ropes and this made me stronger and helped immensely with my confidence, despite it being the hardest thing I've ever done. It was unconventional, and to this day, I’ve never seen another nurse put through this type of situation. I wanted to quit so many times, but I made it my mission to learn and to be the best nurse I could be. This experience made me more attentive and helpful to future new nurses that I would eventually help educate. It took nearly two decades for me to embrace this experience in a positive light. I rarely spoke about it, because it was embarrassing, and I wanted to forget, but I didn't and couldn't. Now I know and understand it's place in my life and try to look at the experience as a positive contribution to my growth as a nurse, a co-worker, and a friend.
Being a Pregnant Labor Nurse
In 1997, I gave birth my 4th and final child at the age of 30. It's amazing how long you can be on your feet running up and down the hallways of a busy delivery unit until the last second of pregnancy. There are no special treatments for making sure the pregnant nurse gets to eat, drink, pee, or even use the breast pump after returning from maternity leave. Your back hurts from lifting heavy patients with epidurals and pushing patient's in their beds to the operating room.
The Good and the Crazy: Cutting the Cord
In 2006, I decided it was time to move on and look for more opportunity and growth in my career. I felt like I needed a fresh start, where no one knew me or my crazy story. I wanted to feel accepted and part of the team and I felt as if I'd hit a dead-end of sorts.
I called the manager at my current hospital, bypassing Human Resources and the usual application process, and asked if she would consider meeting with me to discuss a contingent position to get my foot in the door. She agreed to meet me and after a brief tour and some favorable responses from some of the physicians I knew, she hired me on the spot.
I kept both jobs until 2008, when I felt confident to "cut the cord" after 17 years. It’s tough to be the new person and here I was, many years later, doing it all over again. However this time, it was different. I got my second chance to make a great first impression, to be accepted, respected, and to fit in.
As a bonus to having made the move to another hospital system, I was able to finish my degree and advance to BSN with a BA minor, fully paid for by the hospital.
The Good: Opportunities For Growth and Change
I have spent all but 1.5 years of my nursing career in Labor and Delivery. I have also worked in Maternal-Fetal Medicine and Antepartum, caring for high-risk and medically challenged pregnant patients.
I have also had the exciting opportunity to be part of a national television reality series called One Born Every Minute for two seasons. The series was filmed at our hospital and aired on Lifetime Television. Two of my episodes are: S1E1: "To Medicate or Not to Medicate"; and S1E5: "Mission Impossible". Working with a major television production crew was an amazing experience. The show is narrated by Jamie Lee Curtis and is still showing reruns today and is also available on iTunes. What you will see is the real deal. These are not actors and nothing was rehearsed.
I have helped with the opening of a brand new hospital within our system and the biggest and most exciting stepping stone is being part of a new branch of OB nursing in the telemedicine field called “Electronic Labor and Delivery” (EL&D). Today, I get to enjoy this new and innovative method of patient care, by closely observing fetal monitor tracings and watching for heart rate and contraction pattern changes that can lead to an unfavorable outcome for the baby. This change came at the perfect time, as I had begun to get burned out. It’s sad to say, but changes in healthcare, insurance requirements, malpractice, and overall patient health conditions have been the cause.
The Good: The Best Part Being an OB Nurse
Someone once asked me, “What is the best part of your job?” For me, it’s been being able to help my friends labor and deliver their babies. I have been fortunate to have assisted in the birth of over 40 of my friend’s babies! I’ve come in special for every one of these beautiful births. I love the special bond I have with these women, who were already some of my closest friends or coworkers. It gives us something to share and reminisce about that most people will never understand or experience. I love giving them that extra bit of TLC and expertise. For many nurses, taking care of friends is frightening or uncomfortable, but for me, it’s special, unique, and loads of fun!
Another favorite part of my job is when babies are coming fast and the doctors don't quite make it in time. I love getting to deliver the baby. When they are coming that fast and easy, there are rarely complications. It is such an adrenaline rush getting to catch the baby and hand him or her to mom and dad for the first time!
I also love natural, unmedicated labors and births. Women today do not know how strong and fierce they and their bodies are and 90% of women don't even want to try a natural birth. We live in a world of instant gratification and pain medicine, so only about 10% of women today will experience an unmedicated birth. These women are prepared from the get-go, or the ones that come too fast. I love coaching and encouraging women who opt for natural labor. Being a runner, I often compare it to running a marathon. The first 20 miles are fun and somewhat easy, you're talking and moving along with ease. The next six, you hit the wall, and the last 0.2 miles you wish you were dead!
I have also made lifelong friendships with some of my patients. Most women forget all about their delivery nurse and can't even remember their name. But every once in awhile, you instantly click and know you will always be a special part of their life.
The Bad and the Crazy
Not all aspects of being a delivery nurse are smiles and roses. There are times of intense sorrow and times when you go home and swear you can't do this another day. We care for women with current medical conditions, women who develop serious conditions while pregnant, and women who will either never take their baby home, or who will endure a lifetime of special needs for their child. We see traumas and we save lives; both mothers and babies. We see family dysfunction at it’s worst and frustrating language barriers and cultural differences we will never understand.
We do not eat a normal meal most shifts and rarely get to take even a ten-minute break. If we get a chance to go to the bathroom, it's only after we've been holding it for what feels like forever. Our meals consist of grabbing whatever we can between cervical exams, because our patient's needs always come before our own, no exceptions.
All that said, I loved working in the busiest labor and delivery units in the country. The options and versatility of nursing are endless, the rewards are plentiful, and it will toughen up the weakest of hearts and minds. You will learn conflict resolution, time management, how to deal with bullies, and how to bite your tongue. You will work holidays, weekends, and miss countless family events; you will hate that part the most. You will travel in level III snow emergencies to get to work and be crazy jealous that everyone else is cozied up at home safe and sound. You’ll get speeding tickets because it's better than dealing with the attitude you get when you’re late to relieve your coworkers. You will get out of some of them, because cops seriously respect nurses. You will work for other nurses so they can do things with their families and when you need help in return, those same people will not help you. You will get annoyed with your coworkers for 1000 reasons, yelled at by doctors, and will feel unappreciated by your patients and managers. Yet somehow through it all, there’s still nothing you’d rather be doing, but being a OB nurse.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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© 2018 Debra Roberts