How does the public view nurses?

There is a distorted view of nurses. For the general public, nurses are viewed as self-less caregivers. The media does not provide a view of nurses that gives our profession any justice. For obstetric nurses, the view is even more distorted. Many believe that OB nurses are the puppets of the physicians, and we do what they say–instead we work in a collaborative environment. Some believe we are angelic, empathetic and caring. Some believe that obstetric nurses are secluded in a world of their own-and don’t know how to view them. Many other specialized nurses don’t have a desire to care for laboring women. Why would anyone want to be surrounded by screaming women? This blog was created to give the general public an idea of what we, as OB nurses, may encounter on a daily basis. Our goal as mother baby nurses is to work in a baby friendly hospital where patients and their families come first.

American Society of Registered Nurses wrote a great article describing the role of OB nurses. The presence of OB nurses decreases c-section rates and improves patient satisfaction. The nurse patient ratios in labor and delivery are similar to that of the intensive care unit. This allows nursing to spend the majority of their day at the patient’s bedside. This therapeutic presence improves patient satisfaction.

OB nurses do not know what their patient assignment is going to be. We care for a variety of patients, from those whose pregnancies were planned to those who were surprised. We work with women who have been abused to those in loving relationships. Some families have been through tragic life-changing events. Many women that we care for are anxious about labor, delivery, and the status of their newborn. It takes a nurse who is patient, kind, non-judgemental and is comfortable advocating for a family. OB nursing isn’t for everyone. We are cross trained to care for laboring or post partum families, to circulate or scrub in the operating room during c-sections, tubal ligations and hysterectomies, and to care for these families post operatively in the PACU. We care for the family in a mother baby fashion, usually providing care for the mother and the infant. We provide education about labor, delivery, post partum and newborn care. We provide breastfeeding support through education and hands on assistance.

Not long ago, I was the circulating nurse in the operating room with a near term complete abruption. This mother delivered by emergency c-section under general anesthesia, as she collapsed in the emergency room due to massive blood loss. Her baby did not survive. She she awakened from anesthesia in the PACU, the PACU nurse was astonished that she did not know that her baby had passed. Together, we recovered her as quickly as possible to reunite her and her family. When we transferred her back to her room, the father was cuddling the baby and visabily greiving. The PACU nurse had never been in a situation of this type before and was very disturbed as she had not prepared herself mentally. The PACU nurse stated over and over that she never imagined this would be part of my job. This goes to prove that the rest of the world does not understand what OB nurses face on any given day.

How does the media portray OB nurses?

The nursing profession is often portrayed erroneously by the media, often degrading and comical. A blog was posted on Allnurses.com seeking the public’s views of nursing. How would you feel if you were said to be “strong willed, patient and caring” or “lazy and uncaring?”

Though very comical, the media does not give an accurate portrayal of obstetric nursing.

What is the Reality of OB nursing?

There are many aspects of OB nursing that the general public are not aware of. Being present at the birth of a child is a gift. This time may not always be a happy occasion. We deal with many different social situations, such as adoption, pregnant inmates, maternal drug abuse, and pregnancy as a result of rape. We care for many high risk patients, due to the popularity of many comorbidities. These comorbidities include, but are not limited to, obesity, clotting disorders, heart disease, diabetes, and many other diseases causing a high risk pregnancy. Our patients are at risk for pulmonary embolism, post partum hemorrhage, DIC (massive hemorrhage), social disorders including depression, and anxiety.

When OB nurses have to face grief:

As mentioned before, OB nursing is not limited to good outcomes and happy endings. We face many tragedies, including the loss of an infant. It takes a special person, angel, or nurse to be comfortable providing support to a family who has just lost an infant or beginning this journey. There aren’t many options to assist with our grief, except providing the best care possible to these families. A mother-baby nurse wrote a great blog about losing a baby and the support provided for the family.

Now I Lay Me Down To Sleep is a great program for families who are dealing with losing a baby. Volunteer photographers offer their services to infants and their families in those immediate hours after delivery. They take high quality, high quanitity photographs, touch them up and send the families a CD with the proofs. The photographers are selfless during this process and incorporate all members of the family present in the photographs. Here are two videos portraying some of the images captured by NILMDTS.

What OB Nursing Means to Me

When a woman is in transition and she looks into my eyes, we have a complete conversation without speaking. She is in transition, getting ready to become a mother, scared and anxious about what’s left to come. I am able to instill confidence and decrease fear. This relationship is stronger at this point than at any other. When she looks into my eyes again, just after the delivery, she is thanking me, without saying a word.

The delivery of an infant is a huge emotional event–it’s not just a medical procedure. This isn’t the only time when my eyes fill with tears. When I assist a woman to breast feed for the first time, it’s impossible not to feel a surge of energy. Watching the relationship build between a woman, her baby and her husband, is more amazing than the delivery itself.

Additional Resources:
AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses promotes health of newborns and mothers through nursing education and support.

The National Certification Corporation offers certification exams for obstetric and neonatal nurses, as well as continuing education credits.

Lots of great up to date information
information about pregnancy can be found at medscape.com.

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