A story of hope: From Burned-Out to Refreshed in One Delivery
Oh Yeah! THIS is why I love my job!
As a nurse for over 25 years, I have seen and experienced many instances of extreme joy, sadness leading to bouts of both physical and emotional exhaustion. I have tried it all from clinical nursing, leadership and management, teaching, and working in an office setting. Ultimately, I always seem to come back to my core passion, nursing at the bedside. My clinical focus since the very onset of my career has been in Women’s and Infant’s health and I have endeavored to explore each and every nook of the specialty with excitement and a strong sense of life-long learning. I have learned so much and personally feel a great deal of pride surrounding my knowledge, skills and abilities related to caring for moms and babies.
Recently, I have become a bit restless and find myself struggling with a fair amount of helplessness, detachment, self-doubt, cynicism, and general decreased career satisfaction. Feeling over-worked, under paid and quite literally spent from shift to shift is not uncommon at all in the profession of nursing and certainly not an emotion held only by myself. In fact, the feelings described above represent a common state of emotion for healthcare workers today called “Burn-Out”. The prevalence of this state of mind is so enormous that The International Statistical Classification of Diseases and Related Health Problems (commonly known as the ICD) has assigned a code for billing purposes to cover heavily reported symptoms and complaints that have recently increased dramatically and have caused health workers injury and/or disease. Thankfully, what has been one of the dirty, little secrets of the healthcare work setting, and consequently the demise of far too many dedicated and gifted medical professionals seems to now be validated as a real and pressing concern for healthcare in the near future.
"Feeling helpless, detached and burned out a short time ago, I began my stretch of three, twelve-hour shifts in three days."
Feeling helpless, detached and burned out a short time ago, I began my stretch of three, twelve-hour shifts in three days. I was less than excited to learn I would be assigned a very young mom who was having her first baby. It was further shared with me in report that this patient was insistent upon having no pain medication at all and would be laboring with a Doula, or birth assistant in the room. My stress level rose as I assumed the worst. Generally speaking, a Doula can be hired to assist a mom in labor by way of presence, emotional support, message, and education, as well offering general labor coaching and positive feedback. Most Doulas are private pay employees offering a service to moms who are seeking a bit of extra support and generally well received in the hospital setting as a whole. My experience with birth attendants up to this point had been favorable, however there are some Doulas who have difficulty with their role as support person and the role of the trained nursing and medical staff leading to a fair amount of conflict as labor progresses and interventions are needed. My generally negative emotions led me to assume I was about to have a long shift wrought with conflict, pain and challenge. With this on my mind, and a good amount of burn out in my soul, I begrudgingly entered the room to meet my patient and begin my morning assessment.
With introductions and my initial assessment complete, professionalism reigned supreme and I set out to make a plan of care for the next twelve hours. I had concerns about my patient’s age, her tolerance for the pain associated with labor, her understanding of the enormity of the labor process and the fact that neither her family nor the father of the baby were here or involved in her life or the life of her baby. She seemed to be completely alone. My patient, her Doula, the MD and I discussed the next steps of the labor process, and as we spoke I found myself surprised to hear agreement and even a bit of excitement from the Doula who I had wrongly assumed would be aggressive and possibly there to challenge each and every move I made this shift. I felt myself begin to shed a bit of the cynicism and dread I was feeling and began to feel enthusiastic about the day supporting this lovely young lady in labor.
"At one point, I came into the room after I had suggested the patient get out of bed and move some with her contractions to find my patient and her Doula “twerking” together at the side of the bed to rap music pouring out of her cell phone during a contraction."
As the day and my patient’s labor progressed, the Doula shared with me that she was in fact a family member of the patient and was being compensated for her support of her cousin by the state in a brand new, evidence based, pilot program designed to incentivize women to become educated in birth assistance and Doula care of laboring women. The doula attended all the prenatal visits with her cousin, committed to help her eat well and rest often during her pregnancy as well as support her throughout the entire labor process! I had no idea this was even a “thing” and happily wanted to know more as I began to see how connected and supported she was with my patient. It was quickly becoming very clear that I was terribly wrong in my initial assumptions and that what had started out to be a negative experience was now becoming exciting and quite positive. I was feeling energized by the Doula’s enthusiasm and motivated by the strength of my patient as she moved through labor with literally no pain medication like a warrior princess; this extreme control and focus courtesy of complete support and devotion of her Doula. At one point, I came into the room after I had suggested the patient get out of bed and move some with her contractions to find my patient and her Doula “twerking” together at the side of the bed to rap music pouring out of her cell phone during a contraction. I smiled to myself as I realized what I just witnessed. The doula, perhaps without knowing it, had just hit on the very crux of nursing care; meeting the patient on their level, without judgment or reservation intended solely to support and enhance her experience in a safe and effective manner. I was in awe at what I had just seen.
The experience described above left me overwhelmed with a sense of positivity and a renewed confidence in Doula services.
The experience described above left me overwhelmed with a sense of positivity and a renewed confidence in Doula services. I was quite literally touched deeply on a human level to witness sheer kindness and the amazing ability of the Doula to “nurse” her cousin beyond any care I could possibly provide as a trained nurse assisting patients for more than two decades. The burn-out I was dealing with before this shift began to melt away as I realized I had been given a gift by this patient and her doula. I was given the opportunity to go back in time to a place when I was a brand new a nurse where I was excited, optimistic, humble and eager to help pour out my soul to those in need. I left that day feeling amazing. I will never forget that delivery and commit to thinking of it each time I feel exhausted, helpless or cynical about a profession I sincerely love.