April 21, 2008

I feel like a real labor nurse

This weekend I actually felt like the labor nurse I always try to be. I took care of a mom, laboring with her second baby and wanted to go natural. She had a reasonable birthplan that she talked to her doctor about beforehand. With her first, she was induced and ended up with a very dense epidural. She did say that she may change her mind and decide on an epidural, and we talked about when it would be too late. She was my only patient, so I was able to really help her with each contraction. Dad wanted to be involved so I showed him how to do counterpressure and really got him involved in the labor as much as a dad can be. And she was doing quite well. Until she got to 8 cm. That's when people usually start to say "I can't do this". She wanted an epidural, but at that point it was too late. The baby was sitting really low and her cervix was incredibly stretchy. Her doc was already there, and after a couple minutes, her water broke, and the baby was crowning. She pushed twice and had her baby. Then it came time for the stitching of the small tear. Since she was numb last time, she didn't remember the burning from the lidocaine, or feeling the pulling of being stitched up. She nearly came undone, and her doc thought she was actually having a meltdown. Most moms don't pay too much attention to that part when they go no epidural because they just pushed their baby out. She even said afterwards that she wishes she had gotten the epidural and that next time she won't be doing it that way. That was a bit disappointing, because other than the whole stitching, she did really well. After I got her moved out to postpartum, I got another labor patient, a firsttimer who also wanted to deliver without pain meds/epidural. She really wasn't in control and wanted to stay in bed, evn though I encouraged her to reposition, move around, use the ball, etc. She just thought she'd be more uncomfortable if she got up. Pat of me was thinking, "Yeah, you're right, what do I know? I'm only a labor nurse". Finally she decided to try the rocking chair, and she said "You were right, this is so much better than sitting in bed". I don't know if I needed to somehow prove to her I knew what I was doing because after that, she was open to any suggestion I made. Her husband was really supportive, I was able to be there to help her with contractions, and after awhile, her husband was doing all the supporting and she was much more in control with each contraction. She did deliver like she wanted a few hours after I left. All in all, I felt like I was actually able to help encourage my patients to keep going, to believe in themselves, and I even had dads who were really involved. It's nice to see.


AwkwardMoments said...

I think i need you to be my nurse!

grats on 18 lbs down !

Jennifer (Niffer) said...

Doesn't it make it all worth while! I love when I really make a difference for my moms! I to recently had a mom who wished she would have done it different. She was a G5P4 and when she got to the hospital she was 8cm! UCS only like every 5-6 minutes, and not palpating very strong. she rated them @ 7/10. at out hospital we have 24hr anesthesia on our floor, so she got her epidural. Any way, finally she goes to complete after AROM by the doc and isn't pushing for crap! she's had huge babies like almost 10 pounders, so I'm thinking this kid's huge. I asked the CRNA to turn her epidural down, as she was numb to the gills and finally we start making some headway! literally! LOL! Anyway, now she's hurting, but that kiddo's really coming down and I encouraged her to just "push through it"! she agreed, she just wanted to be done! Great delivery, and then she says to me " I wish I would have had my epidural redosed! ARE YOU KIDDING ME? UGH!

Jennifer (Niffer) said...

oh by the way, the babe was only a 7 puunder!