
The title is a bit dramatic, but sometimes this is how it felt. Let me start from the beginning...
I became a registered nurse in July of 2008. My dream job was to be in labor and delivery (as many new nurses do) and I was determined to get there. I soon learned it was not going to happen any time soon and that I needed to develop my nursing skills and experience before getting into that specialized field. Plus, the joke about a job opening even happening there was either someone had to die or retire. The small community hospital that I started at had a group of lifers in their labor and delivery unit (still do!) and it seemed you had to know someone in order to even be considered.
So, I started my first hospital nursing job in ortho/neuro. That was a ROUGH 3.5 years of my life! I had a heavy patient load, usually 6-7 patients, who were completely dependent on nursing care for everything. I worked with amazing CNAs who worked their butts off and I knew how hard their job was since I worked as an aid for 4 years as well. I unfortunately did not have a supportive team of nurses, especially the charge nurses. There thankfully were a handful of great coworkers and we banded together, but overall I felt like I was drowning every day and no one was there to help. I came home crying most days from work and even questioned if nursing was the right choice for me. I loved caring for people, but I hardly had time to know their name let alone their medical history. It was a constant battle and I feared going to work.
Right around the 3 year mark of being in ortho/neuro, I got the opportunity to interview for a labor and delivery position! I was so excited and nervous, but knew this was my passion. My excitement quickly turned to disappointment, though. The director and manager of the maternity ward did nothing but lecture me on why they don't hire anyone who doesn't have previous L&D experience. They also only talked about the negative side of working there, like the high liability and all the scary situations that can occur. The only questions they asked me were what shifts I was interested in. How am I supposed to get experience if no one gives me the chance? I sat there feeling my dreams get crushed. Once again I wondered if this was what I thought it would be. Maybe it's not...
Well I knew I needed to leave my current unit, so I interviewed for the ER and ICU. Both jobs were offered to me and I chose ICU. I had friends there already and was excited for the new environment. This was the right choice for sure! It was here that I learned there was actual teamwork in nursing. YES! I was so relieved and felt so much more supported in my role there. It was a great team of very intelligent nurses. Many were in the process of getting higher education and were a wonderful resource when I had questions. I learned so much and felt very intimidated when starting. I remember thinking, Okay if there is a code blue, I am supposed to be the expert here. I am the code team? This thought usually brought on a little bit of panic, but I knew that my coworkers would be right there beside me if crap really hit the fan. I learned that I loved the adrenaline rush of codes and high risk situations and actually thrived in them. I also felt like I could actually have the time to take care of my patients instead of running against the clock trying to get all my tasks done. It was exciting and new every day!
A Glimmer of Hope
About 5 months into working in ICU, another old coworker and friend from my ortho/neuro unit told me she interviewed and got the job in L&D. I was so happy for her and so sad at the same time. She said they decided to try out hiring people who had no previous experience from within the hospital to see how it goes. She also said they had two more positions to fill and encouraged me to apply. She also would put in a good word for me, which I knew would help tremendously. As soon as I could get on a computer I applied for the position. I got the interview and this time it was a 180 degree difference. I got the job, but technically had to wait until I had been in ICU for 6 months due to their transfer policy. My manager in ICU asked if I could stay until 8 months due to staffing needs and I agreed to stay as long as L&D held my position, which thankfully they did. I finally made it to L&D on December 10, 2012.
As excited as I was to be there, I was also fighting some personal issues that day. A couple weeks prior I had found out I was pregnant. My husband and I had been trying to get pregnant for several months, but decided to put it on hold once I got my new job. Welp, that didn't go according to plan. I was actually disappointed when my husband yelled to me in the shower that it was positive. Now is really not a great time! But as time went on, I realized it wasn't the end of the world and it would be fine. Unfortunately though, I ended up having a miscarriage on December 8th, two days before starting in L&D. It was the first time this had happened to me and the first I had heard of anyone in my family or friends having one. I felt very alone and guilty. I didn't want to be pregnant, but I didn't want this! I ended up not telling anyone except our parents. I didn't say anything to my new coworkers on my first day, even when I had to leave early to go to my ultrasound to confirm everything had come out. Oddly though, I found the first day in L&D to be healing. Helping another mom bring her new baby into the world seemed so positive to me that it drowned out the sadness I was feeling.
Just as I had hoped, L&D turned out to be exactly what I was looking for. I had a great team of coworkers. I loved most of the doctors, of course there were some bad apples along the way. But I felt like I was living out my purpose and I never planned on changing a thing. That's when God laughed I guess because He had other plans.
Eyes Wide Shut
As the years went by and as my knowledge grew in the obstetric field, I started noticing some things that didn't add up. We talked about using "evidence-based care" yet we weren't implementing it. I also realized that women in labor were losing their autonomy. They were being preyed on in their vulnerable state. Nurses and doctors were doing things out of convenience or ritual rather than medical need. Now I worked with a lot of nurses who felt the same way as me, but I could see that sometimes they felt helpless when trying to advocate for their patients. They didn't want to butt heads with the OBs or make the work environment difficult. So, I did what I could when I was at work. I started making sure to educate my patients on all their options and not just what was being presented to them. I made sure to ask the patient's permission to do interventions instead of just telling them. I tried to keep most of the OBs away from my patients, to be honest, to help buy them time and avoid an unnecessary intervention. I put my hand between a pair of scissors and a perineum to stop an episiotomy without consent. I especially loved when I would give my patient a heads up about what I knew a doctor as going to suggest and encouraged them to ask certain questions about said intervention. The doctors would mostly be irritated or surprised that they were even being questioned. I wanted to put the power back into the patients' hands, but it was a battle.
Then COVID happened. Enough said there, right? I felt like the medical system reared its ugly head during that time. Everything we were taught in school seemed to be thrown out the window and we were expected to follow these new guidelines, which to many medical personnel didn't make sense. But out of fear of the unknown, we followed these rules. We separated babies from their moms who were COVID positive, whether they had symptoms or not. We made moms choose only one support person to be with them and forced everyone else to leave. The staff had to wear so much PPE (mask, shield, gown, double gloves, hair bonnet, goggles) that all you could see was maybe our eyes. Birth had become very scary looking. I would question some of the protocols and ask how they made any sense, like re-using our PPE or being forced to take an experimental vaccine putting our jobs on the line. No one could give me a logical explanation and just said, "Well it's protocol." I couldn't accept that and started questioning everything!
I felt that COVID was an easy tool that could be used to manipulate patients. Fear is a very powerful weapon. Unfortunately, I have learned that this weapon has been used in obstetrics for far too long. I started feeling out of place in the hospital setting. I felt like I had to put on a different face at work. It started feeling like a foreign country instead of the comfortable and familiar place it had been for so many years. I tried pushing the shaky feeling out of me, but I knew God was pushing me into something different...and I didn't like it. After many conversations with my husband and my Bible study ladies, I decided to say good bye to my dream job. I was so nervous to send that resignation email, but I was honest in it and expressed my frustrations with the hospital administration as well as the bullying of the doctors with patients. I wanted it to be known and on record that it was a problem and that they were losing good people over it. I also said how I appreciated my time there, that my coworkers were like my family and that it was not an easy decision to leave. As I half expected, my director sent back a two sentence email. "Sorry to see you go. Best of luck to u in the future." And no, the "u" is not a typo.
As the last two weeks of approached, I started feeling excited instead of sad. I thought for sure I would be a head case my last day on October 26, 2021, but instead it felt like relief! This just confirmed to me that I was making the right decision. Not seeing my awesome team of coworkers was the hardest part, but thankfully we have continued to stay close.
A New Beginning
After leaving the hospital, I worked in home health for about 7 months. It was new and very different from what I was used to in the hospital. I learned new skills and enjoyed the freedom of making my own schedule. But it wasn't my passion and I soon started feeling burnt out from the constant phone calls from patients and trying to balance out my visits and life at home. Thankfully, an email came through from a job search website about an opening at a local OB/GYN office. I applied and got an interview the next day. It was the easiest interview process ever and I was offered the job.
Once again, the office life was very different from what I had done in the past, but I picked it up pretty quickly. I got along with the office staff very well and it started feeling like home. I also learned a lot about gynecology and loved being able to participate in new procedures. I especially loved my pregnant patients. I missed talking to and educating patients about their pregnancy and birth. It was nice to be back in the OB world again.
Unfortunately, I started seeing the same trend in the office as I did in the hospital. Minimal education, no other options being discussed, telling patients they HAD to do things. It was infuriating. I didn't realize that this behavior starts so early in their pregnancy journey. It's like they are programmed and it's no wonder they cave to everything in the hospital. I again started giving patients as much education as I could in the little face to face time I had with them. Their appointment time slots were 15 minutes. This was usually broken down to about 5-7 minutes with the nurse or medical assistant checking them in and then 5-10 minutes with their provider. It's crazy! The patients felt bad asking any questions because they knew the office ran a tight ship and they didn't want to inconvenience anyone. I made sure they didn't feel rushed and that they knew their options and rights as a patient. I would remind them that they are paying us, so they are the boss.
About 6 months into the job, I started really missing being a part of birth. It was nice being with my preggos, but birth has its own special place in my heart. That is when I decided to become a doula and start my own business. I started talking to patients more about doulas and many didn't even know what they were. It was amazing seeing some of their faces light up knowing that option was out there.
To my surprise, my business took off and I started booking a lot of clients. I knew it would be difficult trying to keep both jobs, so my husband and I felt it was okay for me to step away from my nursing job and just focus on my doula work. I was excited and nervous again to send the resignation letter, but my manager and coworkers were so supportive of my business. They were sad to see me go, but they knew it was coming. I am so thankful that I was able to build great relationships with some of the providers, too, who are now handing out my business cards to their patients!
Coming Full Circle
FREEDOM!!! That is what this feels like now. I don't have to be held back by policies or providers. I just freely teach, advocate and support parents in their birth journeys. It's crazy to think how much my past experiences have helped shape my current career. Labor and Delivery gave me the knowledge and experience of birth and pregnancy. Home health taught me how to make my own schedule and get used to in home visits. The OB/GYN office gave me a front row seat behind the scenes of obstetric care outside of the hospital. God doesn't make mistakes and I am so thankful for all the varying detours my life has taken. I feel dangerous in a way. Dangerous to the way of life in the birth world in that I know what they are thinking and how to counter act it. I hope and pray that the system changes, but unfortunately it won't happen overnight. So in the meantime, I will continue to fight for my clients and look to the future with a hopeful gaze.
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