Women Ask Wednesday – A Day on Labor and Delivery

Oh, labor and delivery, you are my absolute favorite place to be. Labor is where my heart is – it’s where I feel my gift is – and it’s how I love to serve women and their families. But sometimes after a 24 hour shift I need to sleep a solid 12 hours to surface back to functioning normally! Here’s what a normal day looks like…

Labor and delivery shifts are either nonstop or there are crickets chirping. The in between is somewhat rare. A shift starts around 6:50 a.m. I like to get to work early and usually prefer to have had two cups of coffee and at least half of breakfast before the shift starts. Sometimes you jump right into patient care and don’t come up for a break, a pee or a snack for a few hours.

Report on the board starts at 7:00 a.m. There’s a review of all patients on the floor – triage patients, laboring patients, postpartum patients, antepartum patients, and planned discharges. Mostly the board check out reviews names, number of pregnancies, number of children, type of delivery, pertinent medical complications in the postpartum period, contraceptive method desired on discharge, and any specific. After sign out and hand off of the deck to the oncoming provider for the next shift, patients are stacked by priority. If I have a patient about to deliver, they get all my attention first because I want to assess if a babe is about to deliver!

Next, I round on all of my labors. Sometimes I’m peeking in on a gal in the tub to see how she is handling early labor, or, talking to a mama being induced about the next steps in her labor and which interventions are on the table as her next step. I like to say hello to every laboring patient on the floor as soon as I can on a shift. Often times, a baby’s heart rate decreases abruptly and the entire team runs in to help turn a mama onto her side and start an IV fluid bolus. Before all of that drama, I like to say: “hello, I’m your nurse midwife today… how are you doing and do you have any questions about your plan of care right now?”

If no one is in labor, the triages and postpartum mamas get the next assessment. Triaged pregnant women can have a simple complaint (“I spent two hours shopping at Target and my round ligament pain is killing me!”) to significant nausea or vomiting that requires prolonged evaluation.

The rest of the day is a fluid mix of patients in triage, labor, delivery, or postpartum. Sometimes I work a 24 hour shift and deliver 6 babies…other days we don’t have a single patient on the unit for a 24 hour period. I’ve worked shifts from 10 hours to 24 hours. Some shifts I get to sleep, but most I don’t. Regardless, labor and delivery has been my love for more than a decade now – and I hope the love never fades. What are your questions about labor and delivery?!

Jamie

3 Comments Add yours

  1. Rachael says:

    How do you stay awake for the long 24 hour shift? What determines if you are there for 10 hours or 24?

    PS – I’m so happy I found this blog. I’m looking into becoming a CNM and this is so helpful!

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    1. Hi Rachael! Coffee and hopefully a nap. Sometimes we get to sleep 4-5hrs and that feels like 8 hours of sleep when you are working 24 hours in a row. If it’s a busy night with lots of babies, that helps the time pass really fast too. And it’s hard to feel sleepy when a baby is being born!

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    2. And the 10 or the 24 hours is determined by our schedulers 🙂 Sometimes we work 7a-7a and sometimes it’s 7a-5p or 5p-7a. Shift work comes in a variety of forms in the world of obstetrics. That’s exciting you want to be a midwife. Let me know what other questions you have on your journey!

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