Should a Doula Thank a Nurse?
When I was in college, I worked at a gift and candy shop. It was an easy gig, I got to eat all the homemade chocolates I wanted, and I worked mostly unsupervised and alone. I remember distinctly, an interaction with a customer where I just wasn’t feeling it. I decided I didn’t have any energy to add anything extra to my exchange with her. She brought me her merchandise and attempted to make conversation, and I sat with a sour look on my face, going through the motions of ringing her up. (This is all horrifyingly embarrassing to me now, by the way, but as a teen, I didn’t give it a second thought.) Suddenly the woman said, “It seems like you aren’t in a good mood today.” She said it kindly, without expectation, and it hit me: She noticed I wasn’t being nice!
Wherever doulas gather, there is a question often asked: “Can I thank a nurse?” Not meaning, can I say thank you when she brings us a chair or a drink, but, when I notice a nurse going above and beyond for my client, can I send her a thank you note later? Is this appropriate?
I have heard doulas answer, absolutely not! She is just doing her job. If she hadn’t been your client’s nurse, she would have been someone else’s. She did it yesterday, she did it today, and she’ll do it tomorrow. She is being paid to work as a nurse. She is just doing her job.
As a doula and a childbirth educator, I take clients in the Bakersfield, Visalia, Hanford, and Tulare areas of Central California. I recently attended a birth where I witnessed a nurse just doing her job. It wasn’t that the nursing care she gave was poor – it was just her flat affect showed she simply had nothing else to give. Just like the teenaged-Stacie in the opening story, this nurse was going through the motions with no smiles, no casual conversation, no empathy for the pain my client was dealing with. She was on autopilot, she could have been a robot, and we all noticed it seemed like she was in a bad mood. In that moment, it felt like she hated her job and resented the fact that someone dare be having a baby on her shift in L&D.
As people, don’t we like to hear when someone notices and appreciates the job we are doing? I know I do! Why not, then, send a note to a nurse you felt went above and beyond versus just doing her job? In fact, send it to her boss, and her boss’s boss! Send that praise onward and upward! Let the world know you appreciated this nurse’s attitudes and efforts, her care and concern.
Fortunately, I can say this is a rarity. Most of the nurses I encounter are helpful and kind to the families they serve. We all have bad days, and I bet that lady I served so long ago doesn’t even remember me and my attitude way back when. But the day your baby is born – every person who walks in or out of that room can become a permanent fixture in the recollection of that memory. I still have deep, personal feelings for the nurses who cared for me through all my births, and how grateful I am that they are filled with positivity!
Comfort at Any Stage
Recently for the Bakersfield BirthNetwork, I was presenting on comfort measures for birth. Expectant families, as well as doulas, come to these gatherings, and I love being able to offer information that is not only helpful to parents, but also information other professionals can take to their clients! As a Lamaze-certified Childbirth Educator, I am always putting together ideas in an unusual way to help make learning about birth fun!
The inspiration for this started when I had a few ideas I wanted to squish together into an activity:
1. Update the stages of labor to reflect an additional pre-labor phase at the onset of the first stage
2. Scaffold the stages/phases of labor by choosing and practicing supports meant to intertwine with the key emotional and physical events occurring
3. Provide a handout which not only helps visualize the opening of first stage, but also serves as a cheat sheet to labor happenings, timing, and ways to cope
What I came up with, I call the "Spinning Circles of Womb." Just kidding, I don't. But I think it works, and it's pretty simple, and that's all that counts -- no frilly title needed. Basically, here are the supplies:
I can't remember a time when I sat participants at a table, but for this activity we did, indeed, sit at a table. Surrounded by Mr. Sketch Markers, paper circles, and stickers, I began to share the stages of labor by tacking three sheets of (laminated) paper onto the wall. There is relief when an expectant parent realizes there are only three stages of labor (I did have a dad once who suggested there were 14, but that was his lucky number, and I asked him to take a guess!).
Three. That's not hard to remember, right?
Then I tack up two more papers, which you can see below, right. I share how some genius decided to break the first stage of labor up into phases, which is another word for, let's just insert more stages into this stage and call it good.
On the front of the circles we write things like average length of that phase, approximate cervical dilation achieved, contraction action, and more (note: I don't show all of that in the picture). The pinnacle of this is affixing the face sticker to the appropriate phase, as a handy visual reminder of what a laboring person might be feeling in that moment.
While we are moving through the phases with markers and stickers, we are also brainstorming what comfort measures might be beneficial at what time, and those are added to the back of that circle. We practice these comfort measures as we go. If we expect people to feel comfortable with different physical ways to counter the strong sensations of labor, we can't expect them to get there from a picture alone! Would you step into a ballroom, ready to dance in front of judges, simply from pictures you saw in a book? We need to actually show families what these positions and movements look like, how they feel, and when they help -- or they are of no help at all.
At the close of this activity, families walk away with their concentric circles of information, a piece of pool noodle, and an information sheet which shows about 20 different physical positions of a laboring person and partner working together.
Not a bad way to merge my three goals! A handy takeaway that can be utilized easily during birth.
♥ four young boys and a boy dog (offspring)