Working in the labour room (LR) can be an enriching experience for a LR nurse. It’s incredible to see the birth of a new life and this can be one of the most rewarding experience of being a LR nurse. These nursing professionals play an important role in ensuring safe delivery for the mother and baby.
WHAT DOES A LABOR AND DELIVERY NURSE DO?
The roles and responsibilities of a labour room nurse are strikingly different from the roles and responsibilities of nurses working in other units. A LR nurse not just takes care of the mother in the labour room but also provides emotional support to the anxious partner and other family members.
Some of the responsibilities of a LR nurse includes
- Educating the mother on what to expect through the delivery process
- Monitoring fetal heart rate and contractions
- Preparing the mother for delivery
- Ensuring labor room is ready with all the needed sterile supplies and equipment
- Initiating induction
- Administering pain medication
- Coaching the mother
- Assisting with any complications that may arise
- Prepare for cesarean (c-section) delivery, including emergency c-sections
- Provide supportive care throughout the labor
In the labour room, nurse and patient ratios are typically 1:1 or 1:2 depending on the situation (that means a nurse only takes care for one or two patients at a time, as opposed to four or five), and a day in the life of a labour room nurse looks a lot different than any other part of the hospital.
Post Delivery Responsibilities
The responsibilities of a labor room nurse does not finish with the birth of the baby. She continues to monitor the mother and the baby till they are shifted back to their units. She will teach the first-time mother how to breast feed her baby and taking care of self and the little one. She will continue to monitor and manage for any complications that may occur post-delivery and seek the doctor’s assistance whenever required.
ON A DAY WITHOUT EMERGENCIES …
On a usual day where there is no emergency, the nurses on duty begin their day by taking the hand over from the previous shift nurse. The day nurses would decide among themselves how the patient load would be divided up. The patient load would depend on the acuity of the patient. For instance, if the patient was to have a vaginal delivery, the nurse might have 1-3 patients. If the patient were in active labor, the nurse might have 1-2 patients, depending on staffing. Once the patients are assigned, each nurse would visit her laboring patients and introduce herself. She would provide ice chips if needed. She would then assess the patient, including vital signs and fetal heart monitor strips. The nurse might also turn up induction to assist in the progression of labor if necessary.
In a labour room very little planning can be done as just about everything is unpredictable. This is why that nurses are always on their toes in the labour room as they may never know what to really expect. The nurse is expected to be alert and observant at all the times during her shift especially when there are other variables complicating the pregnancy. For e.g., mothers with diabetes, hypertension, carrying multiples, pre-term labor etc.
CHALLENGES A LABOUR ROOM NURSE FACES
No two mothers or the babies are the same. And so, the plan of care for each is different but very often one may face challenging situations that may throw all planning off the gear. Some of these are
1. Handling difficult babies: Looking at a newborn you are definitely going to fall in love with them. However, there may be times where you may have to deal with continuous crying, managing babies who are unable to latch and therefore unable to take in feeds. This may frustrate you at times as the long list of nursing tasks that you are supposed to complete may be delayed.
2. Handling complicated cases: You never know when things may turn around and a delivery that seemed smooth and easy turns out to be complicated one. This may keep you stressed till it’s over. At times, the obstetrician may have to take a quick call on shifting the mother to the OT for an emergency cesarean and you would be required to do all the needed prep.
3. Shortage of staff: Very often you will be faced with situations where a colleague would have called in sick or another would have taken an emergency leave or there would have been an increase in-flow of patients. While you struggle with difficult babies and complicated deliveries you would wish there were more staff to help you out. The high-stress nature of labor room nursing means that you always feel like you could use one or two extra pair of hands, regardless of how many nurses there are in the department.
4. Getting emotional: After spending hours with the mother supporting and encouraging her in the birthing process, you may get emotional when the mother finally delivers the baby. There may be other not so pleasant moments e.g delivery of a still birth where you may feel as to why the mother had to go through all this pain. In the labour room we tend to participate in the joyful as well as the sorrowful moments.
WHO SHOULD OPT TO BE A LR NURSE?
To become a LR nurse you should have the ability to communicate well not just with your team, but with the parents to be, especially on what to expect during the birthing process. You also need to be a good observer and a quick thinker and should possess a wide variety of skills including expertise in intensive care, knowledge of maternal and child health especially caring for a new born baby. Above all you need to have immense patience in dealing with the mother’s mood swings, her loud screams and crying babies.
There is no shortcut to becoming an LR nurse, but with hard work, determination, and a strong education from a solid nursing program, you can achieve your goals of someday entering this field.
Rarely will the labour room see a dull day. Whether births are normal, short and sweet, complicated and dangerous, the staff will run the full range of emotions before a week is out. Expecting the unexpected is the one constant in a typical day for a labour nurse. The most rewarding part is having a beautiful healthy baby in the mother’s arms and seeing mother and father with their baby for the very first time.