Celebrate Nurses Week

I’ve written about a lot of serious and emotional topics and experiences for me. I think it’s time to get a little lighter for a bit. This will actually be more difficult for me; I am a pessimist by nature. I am a Capricorn. Also, my therapist says because I am an empath, it’s harder for me to not go deep. I don’t do well with small talk. 

So Let’s Celebrate Nurses Week

May 6th thru May 12th

Nurses Week always ends on May 12th to honor Florence Nightingale’s birthday. Each year, there are a few themes for the celebration. 2020 was called “the year of the nurse”, because it was the 200th year celebrating nurses week. We all know how that turned out. This year, I have seen a few different themes from different nursing organizations: The International Council of Nurses announced, Nurses: A Voice to Lead – Invest in nursing and respect rights to secure global health. The American Academy of Critical Care Nurses theme is Rooted in Strength. The American Nurse Association is really spoiling us with Nurses Month all May! How lucky. They kept the theme simple: You Make a Difference. 

We sure do make a difference, that has been VERY apparent this year. What happens when thousands of nurses are leaving the bedside, when nurses start to think loyalty is for losers and they can make double their pay doing travel nursing? Well, costs go up. Hospitals pay double what they were paying for those previous loyal nurses for travel nurses on a rotating schedule, they are paying more for non-productive time to orient new travel nurses every 13 weeks, they are paying sign on bonuses trying to recruit staff for their hundreds of openings. What happens to the patients being taken care of by nurses who have no clue who to call in an emergency, more brand new nurses on specialty floors than ever before, and being taken care of by nurses that may not be as invested in their care and not invested in improving the hospital? We shall see…

Even knowing this, is nurse pay getting an overhaul? Maybe 2% raise here and there, sure, thanks. But our roles and responsibilities have increased much more than 2%. The theme should be being asked to do more and more with less and less. 

Oh… and just so you know, we usually share also this week with teachers, oh, and it’s also Mother’s Day. It was nice that this year teacher appreciation week was before ours, we only overlapped one day. How kind. Do you think some all mighty man at the top thought to lump all the appreciation for female heavy professions and holidays together, or just a happy accident? Hmmm…

Tales From a Labor & Delivery Nurse

The number one response I get when people find out I am a nurse in labor and delivery is, “aw how fun, that’s the happy part of the hospital”. Any other labor nurses out there also find this annoying? I mean, yea sure, I have fun and a lot of patients labor experiences are a happy and joyful experience. Along with that though are high levels of stress, rooms filled with tension, and sometimes really sad outcomes. Sometimes when people make comments like that, it makes me think people don’t value labor and delivery nurses as much in an academic and in a healthcare provider sense, in comparison to an emergency department or ICU nurse for example. 

The second most common comment/questions I am asked when people find out I am a nurse is, what is the craziest thing that’s happened there, or the ever common, what are some of the craziest baby names you have heard. No, it’s not “La-dasha’” Spelled La-A…. I’m quite convinced that is an urban legend that’s been passed around that everyone swears there mother, best friend, sister, whoever, that is a nurse REALLY had…sure Jan. 

I had this whole post written out with some specific patient experiences and stories I have had over the years. Some fun and heartwarming and a few scary and adrenaline filled. They got super long winded. It was cathartic to write them out, but not many people want to read all that. 

I will say, so many times while working with the most amazing and often hilarious nurses, we say, “we really need to write a book”. I’ve also tried to convince many nurses they need to go on a comedy tour (I’m talking to you Sherri Mullinex). Nurse Blake got the jump on that one. Good for you Nurse Blake! So here are a few short and sweets lists with snippets from the nursing world to celebrate Nurses Week 2022! We are all still healthcare heroes in my mind.

The Most “Unique” Names I’ve Seen on Labor and Delivery

(These are both names of moms and babies, ** I’m hopeful I am not breaking any HIPPA laws by just typing names with no other info…sometimes it is essential to the hilarity to include full names…please don’t sue me!**)

I had a patient in labor and her only support person was her much younger daughter. She told me she had no idea what she was going to name her new baby boy. After she delivered, I asked if she had any ideas of made a decision. She spoke really quietly and said a name I couldn’t here. Her daughter spoke up quite clearly, “Mom, no! That is a terrible name.” I was writing it out of her white board in the room, “I’m sure it’s not bad, what do you think its going to be, lets write it down, see how it looks”. She said Blesson. “Blessing?” I asked. She repeated and clarified. Okkkk, how are you going to spell that? (That is always what I ask if I am at a loss for words, or it’s something I have never heard before, or honestly, if I couldn’t hear them. I often wonder if my hearing is really THAT bad or its my ADHD and I stop paying attention randomly) 

She said “b.l.e.s.s. little mark, o.n.” Umm, excuse me what? So I wrote it down and figured she meant an apostrophe because that’s pretty common, Bless’on. She corrected me. No, that could be cute, but not that, a dash. I asked “a hyphen?”. She said again, “No, a dash.” I still wrote it with a hyphen, because what else could it be, Bless-on. Yes, that’s it! I didn’t have the heart to tel her that was a hyphen. 

Nurses Appreciation Week

This year, and honestly, I am pretty sure the previous years too, my hospital is not even calling it Nurses Month, or even National Nurses Week. It is employee or staff appreciation month. All our staff works hard. But guess what? There is a Secretary’s Day, Doctor’s Day, Environmental Service Week, etc etc. And our hospital celebrates those holidays. Can we at least have staff appreciation month, but single nurses and nurse techs out this one week of it?!

Best (read worst) Nurses Week Gifts

1. “Chill pills”– a jar of loose skittles and M&M’s to share (pre-covid life amiright?)
2. “ You ‘da ‘balm’” – very cheap lip balm…felt like wax on top of my lips
3. Baskets of candy brought to the unit to share… Nurses Week is in May… the candy was Christmas themed. Oh and once we got bags of pretzels…they were expired.
4. A tropical themed plastic backdrop posted up in our locker room. “Take a pic! Take yourself on vacation”… No PDO/vacation days needed for that one…lucky me!
5. Clear plastic tumbler that broke after one go round in the dishwasher
6. A rock. Get it? Nurses “rock” 😒
7. Face mask with hospital logo, you know, in case we forgot we were in a pandemic. No hazard pay, but here another mask!
8. Unlimited supply of graham crackers and peanut butter (Actually, I think this is just stealing on our part)
9. NOTHING. But that’s not the worst believe it or not. 
10. Reusable pocket mask for CPR. You know, in case we want to do CPR on strangers in our time off… but do it safe!

For that last one, I really think they must have went into an old supply closet and thought, “hmm what do we have a lot extra of?” 

Let’s Pivot…

Ideas for Actual Gifts for Nurses from our Sweet Patients & Families

1. Donuts! 
2. Baskets of useful tools: gum, quality pens, hair ties, chapstick 
3. Good coffee. In a pinch, hospital coffee will do, but when we get the good stuff, it hits different
4. Edible Arrangements
5. Chick-fil-a Nugget Tray
6. Easy grab and go snacks and soda cans (cheez-it bags, nutrigrain bars, etc) because we most likely won’t get our lunch break
7. Cute badge reels
8. Alcohol
9. Candles. This might be a me thing, I would take a candle as a gift anytime
10. A thoughtful thank you card ☺️

10 Things to Know Before you Decide Labor & Delivery as Your Specialty

Complications and Emergencies

• 1. Amniotic Fluid Embolism: more recently being call Anaphylactoid Syndrome of Pregnancy because an AFE can only be officially diagnosed on autopsy. Some statistics report an almost 90% fatality rate
• 2. Uterine Rupture: the pregnant uterus is very vascular and when a rupture occurs, its possible to have massive blood loss in minutes with a drastic decrease in blood flow to the placenta, and therefore the baby.

Quick story: We had a patient come via EMS to our OBED with complaints textbook of a uterine rupture that started at her home. She went to a hospital without an obstetric unit, so needed to be transferred to us. It took time to get the resident physicians to see what was right in front of them and proceed with an urgent c-section, partly because the symptoms started a few hours before and both mom and baby were still alive. We got back to the OR and her previous c-section scar was fully ruptured, but was completed tamponaded (or plugged up) but the babies head and shoulder. That is the only thing that prevented bleeding. Now THAT baby should have been named Miracle, he truly saved his and his moms life. 

• 3.  OB traumas: you never know what you’re walking into when you go to the ED after you hear an OB trauma called over head. Minor car accident, major high speed T-bone, gun shot wound, ect. The recommendation is if a mother comes in effectively dead (no pulse or breathing), after 4 minutes of CPR and no return of spontaneous circulation you should perform an emergency peri-mortem c-section to try and save the baby. 
• 4.  IUFD: intrauterine fetal demise. You may get a patient come in for decreased fetal movement, bleeding, a regular scheduled induction of labor and discover that there is no fetal heart rate. 
• 5.  Covid-19: hopefully this phase is passing, but you will know Covid-19 is serious when you have to do an emergency c-section in an ICU room on an intubated mom to hope resolving the pregnancy will help her body heal easier from covid. It hurts when you have a mom who never wakes up to meet her new baby. 
• 6.  Eclampsia: a lot of people have heard of pre-eclampsia and now it means high blood pressure, but you need to know how to act fast when the mom has a major seizure and pre-eclampsia turns into eclampsia
• 7.  Shoulder Dystocia: What do you do when a baby head delivers and the rest of the body does not. Usually, you can help the doctors with the maneuvers you are trained to do and its intense, and there can be some long term complications, but in the end its ok. But after 10 minutes of unsuccessful maneuvers and the doctor has to do the dreaded “zavanelli” and push the head back in and proceed with stat c-section and pray. 
• 8.  Sepsis: usually happening after delivery. Maybe a c-section incision that opens back up and get major infection, a kidney infection that goes untreated, and often after a patient attempts to undergo an unsafe abortion. I won’t stay on my soap box long, but if for ONLY the fact that sepsis is the second leading cause of maternal death, access to safe medical abortions needs to be protected. 
• 9.  Postpartum Hemorrhage: often manageable with medications, intrauterine balloons, blood replacement, but sometimes despite your best efforts, knowledge and facilities, this can end in maternal mortality. 
• 10.  A big one: Your life is changed when a patient tells you that you made a difference in their lives, when they thank you for saving them from a c-section, or helped them meet their goal of an unmedicated birth. When you know you did what you were trained and love to do in an emergency and you know you helped save a baby and/or a mothers life. A little corny, I know. 

I knew I wouldn’t be able to get though a post without getting deep and dark. Sorry friends, I can’t help myself sometimes.  

So when people say, oh aww, you’re a labor and delivery nurse, you get to hold babies, I wish I could tell them these stories. A lot L&D nurses will tell you, it seems harder to deal with death in this area of work. I think about it like, in ICU you kinda expect patients to die. Sometimes in the ED, you’re coding a trauma and you’re more surprised when the patient survives. But in labor and delivery, you are not expected to have patients die. It takes a long time before you get used to this; you are never prepared for it. 

So Why do I Stay?

If you’re a nurse reading this, what kind of unit do you work on? Did you know what a shit show labor and delivery can be? Are the rewarding moments what keeps us nurses going? Or is it the adrenaline and flexible schedules? Sometimes I wonder, why do I still do this? There are so many options with nursing, you can do so many things. I can do jobs that don’t deal with the heartbreaks of fetal demise, losing mothers way too young, stressful STAT situations, and more…I could give all that up. But I went to an OB/GYN office once and I hated it, so I would be lying if I didn’t say I am scared to stray again.

I think, even with all the bad, the good is so good that it pulls the weight wayyyyy to the positive side and keeps you there. During the pandemic, nurses realized, you know what? Hospitals aren’t worth being loyal to, I can take my talents and brain elsewhere and make way more money. I don’t blame them. As you can probably already tell, if you have read any of my other posts, I deal with anxiety and change isn’t the best thing for me. So it’s not for me, but shit, I understand why we have lost AMAZING nurses on our unit to travel agencies. 

I am a charge nurse. I orient new nurses to our floor. Deep down, maybe I am a control freak so I like to teach people the “right way” to do things. I tell my new nurses about all my bad experiences: the patient with the amniotic fluid embolism in the middle of the night in my first year as a L&D nurse, the emergency c-section I did in the trauma room where the baby died, the stat c-section I did while I was in charge after a failed vacuum, and the baby died and I blamed myself and cried for a week. I hope they learn from my experiences and they remember those scenarios and it makes them a better nurse. Better nurses than I felt like in that moment. 

There are plenty of deliveries that bring joy that help keep the labor and delivery nurses going, to help counteract all these sad and stressful moments. When a patient wants to delivery all natural and you help her meet that goal and she has a an awesome delivery, or when a patient name their baby after you; that definitely keeps me going. 

We Don’t Really Need Gifts, We Need Respect and Fair Pay

Nurses don’t need gifts. Most of us didn’t go through the grueling years of nursing school with the expectations that hospital administrators would give us anything more than a coffee cup to honor us during nurses week. That said, after all nurses contribute to society and the healthcare system, we deserve appreciation. Real signs and tokens of legit appreciation. 

Any nurses reading? What keeps you going?

Any patients reading? Give a shout out to your labor and delivery nurse! 

ashley, RN

Mental Mommy Nurse