'I Want to Be a Labor Nurse'

When people from the outside look at labor and delivery, they see birth and babies and happiness. And that's true... it's like the icing on the cake after a lot of really hard work. But sometimes, the birth isn't what we thought it would be.
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I frequently hear people say "I want to be a labor nurse." Sometimes when I sit in on interviews, I hear fresh-faced new grads say this, and when I ask them what makes them want to be a labor nurse, I usually get an explanation of their own great birthing experience or a proclamation of their love for babies. That's not what makes me want to be a labor nurse. When people from the outside look at labor and delivery, they see birth and babies and happiness. And that's true... it's like the icing on the cake after a lot of really hard work. But sometimes, the birth isn't what we thought it would be, sometimes the baby doesn't present the way we want it to, sometimes there's heartache and sometimes it's just gross.

One of my first memories as an L&D nurse was of a patient coming into triage around 21 weeks 8 cm dilated with a bulging bag of water. The provider broke her bag of water right there in triage, with what seemed like no notice or warning. I watched as her family (and some of her nurses) became hysterical. All around me there was so much commotion. And the patient just sat there in bed, staring at the ceiling and silently crying. I had been thrown into triage by my preceptor, who wanted me to get exposure to preterm labor, artificial rupture of membranes, and ultimately, a fetal demise. This preterm labor looked just like regular labor and the AROM happened so fast not a single nurse knew it was coming. But I did get an experience. The experience I got was of the patient. As a flurry of people hustled and bustled around her, the patient just sat there, alone in a sea of people. We made eye contact for a moment and for a second it felt as if time stood still. We just stood there staring at each other as people screamed and cried all around us. I walked out of triage and saw a nurse sitting on the floor, her head in her hands, sobbing that this was it. Crying that she could no longer do this this way. I'll never forget that. She did not quit (not that day, anyway) but it taught me a very valuable lesson about how people -- patients, families and nurses alike -- handle death and the unexpected.

We frequently get splashed with amniotic fluid, with blood, with urine and with poop. If we wrote everything up as an incident, we would never get any work done. And do you know what they would tell you if you did (I know, because as a new nurse I tried to do it the right way)... they would tell you to wear protective gear. (Seriously!? I'm supposed to wear a mask and goggles and a suit to every single delivery?!?) And we all have back problems from lifting legs and rolling patients and bending over to pick up babies from open cribs and from helping moms breastfeed. Sometimes we massage a fundus and the patient bleeds and bleeds and bleeds while a thousand family members are in the room, oblivious to the fact that their daughter/wife/sister is asking for a bucket to vomit in and hemorrhaging to death. And sometimes the providers don't make it and we deliver the baby. Although, I can't really complain about that one because in most precipitous deliveries, the baby comes out red and screaming, or there may be facial bruising from hitting the cervix so hard. But I don't care, I'll take it (as long as it's screaming!). What's worse is when the baby comes out limp like a doll and blue. Then you have to pray that everyone around you knows what they're doing... because God knows, I'm only so-so with the babies.

And then, lets face it--we stare at vaginas all day long. We see hairy ones and bare ones and stinky ones and normal ones. The only constant is that you never remember what they looked like when you step out of the room.

So every time I hear someone say that they want to be a labor nurse, that's what flashes through my mind, like segments from a movie... occasional bad behavior on the part of providers, a fetal demise, nurses at the end of their rope, amniotic fluid splashing into my mouth, limping for a year thanks to plantar fasciitis, straining my back to ensure the patient doesn't roll off the bed, catching a baby from a precipitous delivery with my bare hands, holding a patient as she sobs that her baby is dead, or worse, telling a mom her baby has died after delivery, watching a mom's eyes roll into the back of her head and she hemorrhages, getting to work before the sun has come up and getting home after the sun has gone down. And that's just the start of it. So I leave you with this: the next time you hear someone say they want to be a labor nurse, smile and think of every crazy/bad thing that has ever happened to you or that you've ever seen. And even thinking of the laundry list of weirdly wacky things that you've been witness to, I bet you'd still answer the same way... yes, you want to be a labor nurse. Could you seriously imagine working anywhere else?!? But I bet it's not your own magical delivery or your love of a baby that keeps you coming back for more.

Until my next delivery.

Originally published in Adventures of a Labor Nurse

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