A day in the life of a Labour Room Nurse

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.

EMERGENCIES

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.

Nurse making comfortable to patient
Nurse making comfortable to Pregnant Patient
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.

Midwife or nurse and pregnant woman in delivery room of hospital
Nurse checking the Pregnant women.
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.

Career Options Available for a Modern Nurse

As the healthcare industry continues to grow and evolve, Registered Nurses (RNs) no longer have to stick to just one path but have the option to change the direction of their career. In addition to being a noble and virtuous profession, nursing provides opportunities to offer your services in different work environments and in diverse roles. The career path acknowledges individual temperaments, personalities, and the preferred pace of the work environment.Apart from working in hospitals, long-term care facilities, and clinics, RNs can also pursue opportunities in research labs,  physician’s offices, NGOs providing healthcare services,corporates, insurance and law firms and in many other specialty roles. These options have multiplied with specialties and niches for nurses from all education levels. Apart from the bedside care, here is a list of diverse career options for a modern nurse and where they can pursue them:-

Physician Offices

Working as a primary care nurse in a physician’s office can be less stressful and exhausting as you will rarely have to deal with emergencies, and you will have a predictable schedule with fixed “office hours.” However, nurses working in a physician’s office need to be skilled in a variety of daily nursing procedures as they are often the first medical professionals that most patients come in contact with. Primary care nurses typically have to provide care for minor illnesses such as colds and allergic reactions however, they can choose to specialise in certain branches of medicine as the patients that you encounter might vary depending on your expertise. As primary care nurses encounter their patients on a daily basis, many form close personal relationships with them. Primary care nurses are most often employed in physician offices however, hospitals and other healthcare facilities also hire these nurses.

student thinking about her nursing career
A degree in nursing opens up a plethora of fulfilling career options

Research Laboratories

If academics are your calling then you can opt for becoming a nurse researcher. A research nurse works hard to help create, evaluate, and perfect new and old medications and treatments for various medical problems. As a nurse researcher you are at the forefront of new medical discoveries, and help develop breakthrough cures and medical treatments. As this is a highly specific category of nursing, a specialised educational background is required to train you for the profession. Moreover, you must be able to effectively communicate with scientists, physicians, researchers, patients, and corporate executives as you will be working alongside them. Qualified research nurses have the option to work in a number of different settings including research organisations, universities, pharmaceutical companies, teaching hospitals, and government agencies.

Nursing Care Facilities

Transitioning from a bed-side role to a managerial position requires a combination of clinical expertise and leadership skills. The role is instrumental in creating a professional environment and fostering a culture that contributes to optimal patient care along with the opportunity to grow. Apart from supervising nursing staff in a hospital or clinical setting nurse managers oversee patient care, make management and budgetary decisions, set work schedules, coordinate meetings, and make decisions about personnel.

Nurse Ethicist

Ethics influence every facet of a nursing practice. However, despite being challenged with ethical problems on a daily basis, many student nurses never get the opportunity to explore and resolve its complexities. A nurse ethicist works in hospitals, clinics and research facilities to help the staff in combining science with principles and morality. Their duties are three-fold:-

  • Clinical ethics consultation, education, and management
  • Syllabus development and execution for medical student clerkships and residency programs and
  • Research and publication
Nursing Informatics

As effective communication is at the core of nursing, an informatics nurse boosts the management of information and communications in the profession. They take the clinical and the technical languages of the healthcare industry and make it user-friendly and patient-centric while driving improved outcomes for patients and enhanced clinical workflows for healthcare staff. Documentation is the major emphasis in the field of nursing informatics.    

Private and Public Education Institutions

As demand for the nursing profession increases, so does the demand to train qualified nurses. Becoming a nurse educator allows nurses to get the combined satisfaction of providing learners with the technical skills, refined skills, as well as the depth of knowledge that are instrumental for improving the quality of patient care. In order to train future nurses of the world, nurse educators must possess excellent communication skills, critical thinking abilities, and have a solid clinical background along with comprehensive and substantive knowledge in their particular area of instruction. The work setting is diverse ranging from long-term care facilities and hospitals, to universities, community colleges, vocational schools, etc. In addition to working in educational institutions, many nurse educators also work in clinical settings.

Doctor
A medical expert in a private or public educational institute is a rewarding career prospect for a nurse

NGOs 

Although nursing implies care of the vulnerable, the role is often misunderstood and restricted to a traditional hospital setting. However, nurses can also assist by filling the gap in communities without the access to physicians by working in NGOs. While this might be a highly rewarding experience, RNs working in these settings need to acknowledge the lack of resources available for undertaking the care of patients and require strong critical thinking and stress management skills to best serve their patients. Nurses who are interested in pursuing this objective can also work for ‘Doctors Without Borders’ or for the UN in countries such as Africa, Asia or other Middle Eastern countries having refugee crises such as Iraq, Yemen and Syria. They can  undertake leadership positions overlooking care of patients within the most critical zones. Expertise or experience in emergency, pediatrics, infectious diseases, tropical diseases, and/or public health is particularly applicable to the field. Organisations such as these also recruit nurse-midwives, nurse anesthetics, and neonatal nurses. Nurses expecting to work for Doctors Without Borders can expect participating in mass vaccination initiatives for measles or triaging an influx of displaced people fleeing conflict. Working in these challenging settings ensures that you are offering your services to those who are in desperate need of your care and attention thereby confirming a greater social impact. 

Volunteering at NGOs and facilitating mass vaccinations is an in-demand opportunity for a nurse.

Insurance and Law Firms

A career as a legal nurse is in demand with so many lawyers handling medical cases requiring well trained and experienced people with medical knowledge. Legal nurse consultants assist attorneys in the litigation process, and alternatively can also assist in evaluating healthcare and medical insurance claims, conduct medical research, and use their knowledge of both the legal and nursing fields to make recommendations and select medical expert witnesses. To become a legal nurse apart from a degree in nursing and some on-ground experience in the profession, some legal education is also requested by employers. 

Providing medical legal help is a well-paid career option for a nurse

Private Companies

Nurses can choose to offer their services for occupational roles in private companies. Nurses in private companies are expected to provide high-quality care to the employees of the organisation, however they can also choose to work in nursing homes, or provide care to patients in a hospital. Responsibilities include initial patient assessment, monitoring vital signs, and nurturing patients to recovery.  

Conclusion

To conclude, with the constantly evolving medical practices, an education in nursing can open up a diverse range of career options. With rising demand for qualified and trained nurses, the profession offers many worthwhile opportunities that can be pursued suitable to your personality type, especially if you are a little open-minded.  To identify the best option for yourself the only way is to be bold and explore them, be it in a hospital or non-hospital setting.

“Written by Siddhi Latey (Weloquent)”

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