Learning to Nurse Patients in Labor

Abstract

Nursing patients during labor and delivery is a demanding and challenging experience. There are many things nurses must learn in order to do this; they learn to make specific observations about the progress of labor, and the well-being of mother and infant, they learn specific activities which provide comfort to the mother, they teach and reinforce earlier knowledge about the birth process, breathing and relaxation techniques, and so on. One kind of nursing skill, needed in many areas in which nurses function, may be developed particularily well in this area. This is the minute-by-minute assessment of the patient's state, and adaptation of nursing care to this. A surgical patient may move from self-sufficient independence, to helplessness, to gradually regained autonomy over a period of days or weeks. The obstetrical patient may pass through these stages in a matter of hours. Thus the nurse must operate on the basis of the patient's behavior, as she sees it, at any point in time; she cannot make a plan of care and follow it for a long period. Rather, she has certain objectives relating to safety, well-being, comfort, physiological stability and so on, but she must continually make adaptations in ways of trying to attain these. Picture a hypothetical patient who arrives in the labor room in early labor. She is full of energy, talkative, happy. She is aware of what is going on in her body, and interested in observing her own progress. She times her own contractions, chats with her husband and the nurses, perhaps knits, walks about, telephones friends. She has