Tuesday, March 24, 2009

A L&D nurse's fantasy land

A L&D nurse's blog that I follow, 10 centimeters and beyond, has an excellent post called Nurse Fantasy Land. I'm taking the liberty of reposting it here (and I hope you don't mind--please let me if you do!).
In a perfect world, we would never be short-staffed. There would always be enough nurses so that you could do one-on-one labor support for each mom, and you had plenty of time for teaching. Gone are the days of juggling 3 labor patients. Charting would be minimal, as each nurse is equipped with a device that electronically (magically) charts every intervention that is done/heart tones/etc as it is being done, automatically. No more staying after your shift for an hour, looking at strips and charting - it's already done as you go! (Man, wouldn't that be wonderful!). Decisions about how patient care would be carried out would be made by people who actually are at the bedside...not people who haven't done patient care for decades, or ever. There would always be working equipment that was easy to use. Patient scanning devices for medications/labs/etc., would be user friendly. Call lights would become unnecessary because you would have plenty of time to care for your patient and so you are able to anticipate her needs. All members of the healthcare team: Nurses, Techs, Doctors, etc., would all treat each other with respect that everyone deserves. Communication would be exceptional. No one would ever feel left out of the loop or show up at work and find that something has changed without warning. Leadership would actually listen to the staff, value their opinions and run the unit/hospital/etc well. In OB, there would not be elective inductions - those patients would go into labor on their own and progress as nature intended. No continuous monitoring for healthy mama's, and in those who need continuous monitoring, there is an abdominal girdle that picks up baby constantly, regardless of movement and position. So, no need for internal fetal monitors. There would always be an OB and anesthesiologist in house for those emergencies (I know some hospitals have this, but mine does not). C-sections would only be done if there really was a need and VBAC's would be the norm instead of repeat c-sections. Medical inductions would be successful and episiotomies would be a thing of the past. Every breastfed baby would come out of the womb and latch right on. Aaaahhh, a nurse can dream, can't she!?
Interestingly, implementing the Baby-Friendly and Mother-Friendly childbirth initiatives, along with Lamaze's recommendations for six practices that promote normal birth, would bring hospitals close to many of these ideals.


  1. Having an acceptable amount of nurses on staff to take care of all the patients would be priority one in L&D Nurse fantasy land. You can implement all kinds of stuff but if you only have one nurse watching 3 laboring women, you are not going to get the extras. And on nights like that anything that does not help keep mom and baby alive is extra....Food is extra. Bathroom break for the nurse is extra...food for the nurse is extra....

  2. Thanks for sharing. This is beautiful. Someday!!!

  3. If only....I'll just keep dreaming about it, talking about it in the meantime. Maybe one day it will be true.

    Oh, wait. It is. At home. Or in a birth center.

    Silly women, hospitals are for sick people and high risk mothers.


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