Re: different hospitals

[Guest guest]

Hi Marna,

Did you read my message concerning what I called coaches. Do you agree or

disagree with how I feel it should be handled?

Cherubjoen@...

[Guest guest]

Hi there:) thanks for all the questions!

>Marna,

>

>I did notknow we had real live doulas on this list. Have you worked at

>various hospitals in your community?

** I have been doing this for a long time now and have worked in several

communitiy hospitals, and yes standards of care differ! I worked in

Wisconsin for awhile, did a few homebirths amongst the Amish community, and

then went and worked at several area hospitals there. Then I moved to New

Mexico and did a lot of reservation births with their DEM's and the moved to

Portland, Oregon, and have done most of my labor support work at St.

Hospital, some at Kaiser Permanente (that is not a fun place to birth), and

some at Emmanuelle (not too many)

I have also flown to a different state, to help a friend give birth at a

free standing birthing center, now that was awesome!

>

>I know in my community standards of care differ markedly from one facility

to

>the next. Do you see that?

*** Yes I have found standards of care markedly different. I found in New

Mexico that the care to be geared toward a more holistic care paridgm. The

most interventions were in Wisconsin. Here in Portland, especially at St.

s, the LD-Nurses rock my world, they are really into labor support,

they always welcome us with open arms. We know our places, and since they

know I am a nursing student, I get more opportunities to learn. I can't tell

you how much easier it is for us, when the charge nurse likes you, and you

are friends with the OB.

>

>I would like to hear your experiences with nurses at the various

facilities.

>Have you ever worked with someone you just clashed with? Is it true that

the

>pt was " right in the middle? "

Ha! You bet I have clashed! It's part of the business I guess. I make it

a point to not place my client in the middle. If I am at a care facility

for the first time, I find out their basic floor policy ahead of time, by

making a phone call or two, I make it really clear that I am working for the

birthing parents, and that I am no way affiliated with the hospital. I make

sure that my scrubs are no where close in resemblance of the LD-Nurses

scrubs, (mine are either Mickey Mouse or Warner Brothers) I have a tag that

has my name and DOULA.

I think the few times I have clashed it's been over a territory issue, or

it's been because I have been in a care facility with archaic and out-dated

rules. I had a mother who was leaking amnio, just a tiny bit, she was at -1

station, hadn't really engaged, OP presentation, and she wanted to walk, not

lay down in bed. The nurse assigned to her told me to get my client back in

bed, as she wasn't to be up if she was leaking fluid. My client said, " I

am not laying bed this entire labor, it hurts to much " So I approached the

nurse and said, " My client has decided she is going to walk, this is where

we will be, if you have an issue with this, let me talk to your CN " So she

did, and I spoke with her CN, and her CN basically told the other nurse to

back off.

I will say all my clients speak up for themselves. I do not speak for them

when staff is present and answer questions the staff is asking them. I have

had clients look at me, and say, " what do you think I should do " and when I

am asked that, I present them with all the information, and remind them that

I can't make a decision of care for them, however if it were me, I might be

inclined to try *A* *B* or *C*.

I always make sure I never wear perfume ( to be courteous to the staff that

has allergies), I bring my own stuff to eat, and drink, so I don't take from

the hospital, and I take detailed notes, so there is not a lot of down time

for me.

Before I leave, I ask the staff to make a Xerox of my notes, in case they

have been crazy busy and didn't catch everything to chart, and I leave my

copy with them.

I thank the staff for their help, and I go on my way. If the staff wants to

debrief about the birth, I am more than welcome to sit down with them, and

talk about it, the good and bad things that may have happened. Then I write

my birth story for the birth parents and the baby.

Sorry didn't mean to be so long winded!

Marna

[Guest guest]

>From: CherubJoen@...

>

>Hi Marna,

>

> Did you read my message concerning what I called coaches. Do you agree or

>disagree with how I feel it should be handled?

>

> Cherubjoen@...

Hi there:)

Heck I don't care what they call me, as long as it's not late for the birth!

Call me a Doula, a Labor Coach, Labor Support Person, it really doesn't

matter.

I have been mistaken for a midwife, and I correct the person who mistakes me

immeadiately. That is why I make the point of wearing clothing that is so

different from the birthing staff at any care facility I may be at.

Now with that being said, I will say that many of my clients get really

ticked off if they hear me referred to as their " Coach " , the often correct

the person, and say, " No, she is a Doula, she is trained in what she does,

Coaches just make us feel better, Doula's can help us understand why we are

feeling the way we feel "

So that's it in a nutshell:)

Marna

[Guest guest]

Hi Marna,

That is not what I meant. I'm not talking about terms. I can see by your

answer that you didn't read my first message, so I'll say it again.

My message was in response to some of the RN's that said that they didn't get

along with the doulas. I said that how I handled it was this way. When they

first arrived in the LDR rooms, I talked to both the mom and the doula. I

found out what their expectations of this labor was. Then I asked the mom and

doula what part they wanted the doula to play in this. After we got our rules

defined, everything went very smoothly. I never had any trouble and each

labor went the way the mom wanted it. (Except, of course, if it turned out to

be a C-Section, but even then, usually the mom had come to grips with the fact

that she was not going to deliver vaginally and was worn out.)

This is what I meant, Marna. I asked you if that is how you have been

treated when you came in with your mom? I don't see why everyone can't get

along and in this day and age, when most hospitals are so short staffed and

the paper work that the RN is required to fill out, because of the lawyers,

it's a nice combination. I usually used to play the part that the doulas play

today and was frustrated, when I didn't have time. Therefore I was grateful

to see the doula arrive, as not all moms can afford one. (By the way, they

get $500. a case out here in souther California.

Hope this clears up my message,k

Cherub

All you can take with you when you die is, what you gave away.

[Guest guest]

In a message dated 3/20/99 8:59:42 PM Eastern Standard Time,

baloo@... writes:

<< Before I leave, I ask the staff to make a Xerox of my notes, in case they

have been crazy busy and didn't catch everything to chart, and I leave my

copy with them.

>>

Our doulas do not do this, but I love the idea. I'm going to share the idea

with a few of our " regulars " if you don't mind!

Jan

[Guest guest]

>From: FreeMexcAF@...

>

>Marna,

>

>It sounds like you perform a wonderful service for laboring parents.

>

>The one time I worked with a doula it was fabulous. However, I do see the

>potential for territory issues in doula-ing as a profesion. Especially if

the

>parents are asking *you* " what do I do? " And, you reply with, here are

some

>choices, but if it were me I would choose X. (Please tell me if I heard

you

>wrong).

I think I may have expressed myself incorrectly, which is my fault. I don't

as a rule contradict a nurse or a doctor's word. However, with that being

said, I am a firm believer that birth is a natural occurence, not a medical

procedure. So, those that hire me from early on, share that like

philosophy, her care providers know how she feels, and when she arrives at

the whatever care facility to birth they all know her philosophy as well.

I don't speak for my clients, that is their job. My job is to educate them

so they walk through those doors as prepared consumers, so they can make

educated choices for themselves and their baby.

>That would be especially hard --I am assuming that the doctor or nurse has

>already suggested something -- say, labor is piddling around at 5 or 6 for

a

>few hours and pit or AROM is suggested, and the parents ask the *doula*

" what

>do I do? " Instead of the nurse? I mean, who has been hired to provide

>clinical care here?

*** Ok let's look at this scenario, a Mom's labor is piddling around at 5 or

6 for a few hours and a pit or AROM is suggested, and a Mom asks me what do

I do. I will present her with all the information. The good points and the

bad points. (there are bad points to AROMing, and pit) I do the same thing

when a mother is very tired from hours of hard labor, and wanting an

epidural, yet afraid to ask for one because she doesn't want to let anyone

done, especially herself. (which is crazy thinking, because no one would

ever put a birthing mother down for asking for pain relief) I have actually

sat with a birthing mother, and been nose to nose to her, while she has

said, " I just can't do this anymore, but if I have the epidural, I won't

have done it right " And I just hold her and comfort her, and tell her that

there is no right or wrong way to give birth, and that if she wants to have

an epidural, she isn't failing, she's just really tired, and needs some

extra help.

Now with that said:) if I have been with a birthing mom who has piddled

around at 5 or 6 for a few hours, and pits and AROM's were suggested, and

the parents didn't know what to do, and when all the options were provided,

Mom rocked on a birthing ball, jacuzzied for awhile, was up walking around,

vocalized a lot, and within 2 hours she was at a 10, and ready to rock n

roll.

>I am not trying to flame anyone. Please know that i have the *utmost*

respect

>for your profession and hope to see more. I think it is wonderful and

>laboring women need physical and emotional support. I wish I had the time

>during a birth to offer more!

I don't think you flamed me at all. And to be honest, I am secure in what I

do. I have been doing this for so long, that I know my role well. I don't

have issues with the birthing staff, I work really well with them, so I must

be doing something right.

>In what ways do you see doulas and nurses working better together. Both

>professionals have the same goal in mind.

Hmmm, well I think if the birthing staff were to realize that Doula's are

not to take their jobs or replace them for one, that might help. No Doula

that I know of is even remotely interested in starting IV's, doing VE's,

etc....

They are there for purely, emotional, physical, and spiritual support,

period of the birthing parents.

Doula's act as a liason between birthing parents and the medical staff when

things can get tense and hairy, and you all I know have had set of birthing

parents who are a pain in the butt, and no matter what you do, nothing

satisfies them. Doula's are that liason, they really help birthing parents,

because they can take the time to explain what's going on, or why something

needs to be done, when on a busy busy labor floor, sometimes your nurse

can't, as she is attending many women at once.

But are Doula's Labor Nurse wanna be's? heck no...

Marna

[Guest guest]

Not at all:)

Marna

[OBnurses] Re: different hospitals

>From: Zukeeper4@...

>

>In a message dated 3/20/99 8:59:42 PM Eastern Standard Time,

>baloo@... writes:

>

><< Before I leave, I ask the staff to make a Xerox of my notes, in case

they

> have been crazy busy and didn't catch everything to chart, and I leave my

> copy with them.

> >>

>

>Our doulas do not do this, but I love the idea. I'm going to share the

idea

>with a few of our " regulars " if you don't mind!

>Jan

>

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[Guest guest]

>From: CherubJoen@...

>

>Hi Marna,

>

> That is not what I meant. I'm not talking about terms. I can see by your

>answer that you didn't read my first message, so I'll say it again.

I must have misunderstood your post and didn't read it correctly, I

apologize.

So in answer to your question, yes, I do meet with the birthing staff, and

the nurse(s) who are assigned to my birthing mom, and we all go over the

birth plan, and talk about our expectations. I also ask the nurse(s) if

they have any special needs, or pet peeves.

One of the most important things I try to encourage my birthing mothers to

embrace, is the idea of not having any expectations. So go into the birth

with an open mind. To be versitale, and open to suggestions, that we are

all there to help her have the best birthing experience possible, not to try

to control it, take it over, or whatever.

Again, I am sorry I didn't read your post correctly the first time. Did

this answer your original question?

I *wish* I made 500.00 a birth - it'll never happen not where I am .

Marna