April 11, 2025 • 39 mins
Angie welcomes doula and nursing student Dani Reed to explore the complementary roles and challenges of nurses and doulas in the birth room, sharing insights from her unique perspective of having worked in both worlds.
• Dani's journey from birth doula of eight years to nursing student pursuing certification as a midwife and women's health nurse practitioner
• The heavy workload nurses carry including documentation, checklists, and physician communication that often remains invisible to patients and doulas
• How patient autonomy requests can disrupt hospital routines and create difficult situations for nurses who must follow doctor's orders
• Nurses act as advocates between patients and physicians but face political challenges when pushing back against hospital systems
• Doulas and nurses view birth from different perspectives – medical safety versus holistic experience
• Creating collaborative relationships by acknowledging each other's humanity and complementary strengths
• Building trust between doulas and nurses through transparency, communication and mutual respect
• The importance of maintaining compassion while developing professional resilience in birth work
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Show Credits
Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:10):
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helpingping thousands
of people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:50):
Welcome to the Ordinary Doula Podcast.
My name is Angie Rozier, I amyour host and I have a very
special guest here with me today.
Her name is Dani Reed and she'sbeen a dear friend for a few
years now, dani, it's been soamazing.
I always tell her I love herjourney and it's true, it's been
amazing to see her come on tothe scene as a doula and she
just thrived quickly.
But she always had a goal inmind.
(01:11):
She knew where she was goingand what she was doing and she's
doing it and I love seeing it.
So I'll let you tell.
I'll let her tell a little moreabout her journey.
But her goal was to become anRN and a CNM and she's doing it.
She's right in the middle ofall that and is gaining so much
cool insight along the way.
I love the pathway she's going.
(01:31):
So I'm gonna let Dani before Iintroduce our topic actually no,
I'll introduce our topic firstand then I'll let Dani talk
about herself a little bit more,kind of extend what I've just
shared.
But Danny and I have discussedthis episode for a while and I
think both of us come tohonestly with a little bit of
(01:51):
trepidation because we want todo it justice.
Danny and I are both in a seatwhere we value people's roles
and want to understand people.
I think we have a pretty goodunderstanding of roles, but we
want to help other peopleunderstand and get a good
comprehension of the differentroles of the birth team.
So, because of Dani's journey,she's in this really unique
(02:15):
position.
She's kind of on a bridgebetween being a doula and being
a nurse and seeing both sides ofthat really clearly, which is a
cool perspective to have.
So what we'll talk about todayis the roles of doulas and
nurses, their perspectives, howthey're different, how they're
the same, the challenges thatmay exist between the roles and
(02:38):
the way they can complementary,enhance each other.
So that's kind of our topic ina nutshell.
We'll get to that.
But, danny, tell us a littlebit about yourself so glad you
could be here.
And, yeah, tell us a little bitmore about yourself.
Speaker 3 (02:50):
All right.
Well, thanks so much for havingme.
I'm so excited to be able tocontribute to your podcast today
.
So, yes, my name is Dani.
I have been a birth doula forabout eight years now and a
childbirth educator for aboutsix.
I've known that I wanted to bea certified nurse midwife ever
since I knew what that was.
I've always been drawn topregnancy, to babies, to birth
(03:14):
especially.
I've always felt a deep respectand reverence for this process
and an eagerness to learn aboutit and to be close to the people
who accomplish these amazingfeats.
And an eagerness to learn aboutit and to be close to the
people who accomplish theseamazing feats.
I went to school for a while butdecided to put school on pause
for 10 years to start my family,and once I was done having kids
(03:40):
, I decided it was time to goback to school to complete my
education.
Having worked as a doula forseveral years, I got my feet wet
in the birth world and it wasreally interesting to me because
I came at this originally witha very, very medical mindset.
Um, and becoming a doula wasactually a huge growing process
for me because there were a lotof things that I uh, had to
change my mentality on Um and Ifelt like it was very valuable
(04:01):
for me to spend that time as adoula to see some of the more
holistic side of things, and nowthat I'm back in school, I am
finishing my nursing degreeright now and hoping to go on to
receive my certification as amidwife and a women's health
nurse practitioner.
Speaker 2 (04:19):
Oh, that's so exciting.
I know like that, what you justsaid sounds easy, but it's not.
I know you're in the middle ofit and it's a lot of work and
has been for a while and willcontinue to be.
So thanks for doing that work.
So, dani, as we talk throughthis, hopefully people
understand I love the positionyou're in right now and I wanted
to catch Dani actually at thistime in her career because she
(04:42):
does have a foot in each world,which is pretty incredible.
So, dani, as you have learnedmore in nursing school and I
know you've worked, you knowsome of your clinicals and
things have been in placesyou're familiar with as a doula.
Tell me a little bit about whatyou have, the insight you have
gained by doing nursing schoolspecifically to childbirth like
(05:06):
as you've worked in that area onboth sides of the doula and
nurse role.
Speaker 3 (05:12):
It's been very interesting to approach nursing
school from a doula perspective.
When I first started nursingschool, I felt a little bit
nervous about my background,knowing that I was surrounded by
very medically minded people.
However, I was pleasantlysurprised to discover that my
nursing school actually has agreat deal of emphasis on
(05:35):
holistic care in a nursingperspective.
They really emphasize takingcare of women in a mind, body,
spirit approach, which I reallyappreciate, have been very
impressed with.
But as I have gone about myclinicals and started working in
hospitals, it's been veryeye-opening for me to understand
(05:56):
the role of nurses, tounderstand all of the
responsibilities, all of thestresses that they have on their
plate and the things that kindof make them tick.
You know, as a doula going intoa birth room, it was easy for me
to oversimplify the role of thenurse because I could only see
what was in front of me.
And becoming a nurse andlearning all that goes into the
(06:20):
job behind the scenes has beenvery, like I said, very eye
opening and understanding howbusy they are.
Very eyeopening, um, andunderstanding how busy they are,
how stressed they are, how muchdemand is placed on them, how
much pressure that they carry Um, it's been very interesting to
discover that and to kind of,like you said, have one foot in
each world.
It's, it's almost like a tug ofwar inside of me, yeah.
Speaker 2 (06:41):
So, um, I guess, what surprised you most about?
It sounds like you've gained alot of empathy for nurses in
learning this role, but what hassurprised you most about, or
helped you gain that empathy orawareness of the heavy load that
they might carry?
Speaker 3 (06:59):
I think, well, there are a lot of things that go into
that.
When I have been working inclinicals, there have been a lot
of logistics that I've had tothink about.
One thing that surprised me wasjust the sheer amount of to-do
lists that nurses carry.
(07:19):
It's not so much a matter ofjust walking in the room and
taking care of the patient.
There's so much that goes onbehind the scenes with
documentation, with followingchecklists, with communicating
with physicians, with othernurses, and to coordinate that
care so that the patient hastheir needs met.
And I guess one thing thatsurprised me a lot was just the
(07:40):
amount of hoops that have to bejumped, I guess.
So you know, for me it would be.
It was easy for me to look at anurse and say, okay, come in the
room, set up your stuff andlet's just have a baby, right.
But.
But on their end they're lookingat the documentation they're
they're charting every you know.
(08:01):
They're charting in intervals oftime where they need to be
accounting for what they've beendoing, what's been happening
inside the room, how the womanis laboring, how they're
responding to that, you know,and accounting for every single
thing that they do.
They have a routine right andtheir checklist of things that
they need to accomplish is huge,and it's really difficult for
(08:25):
them to get that done, even inthe course of their shift, and
so they get into a routine, youknow, to become more efficient.
And in addition to that, theythey work with doctors who have
their own routine, their own waythat they like to have things
done, and anything thatinterrupts that process really
makes their job so much moredifficult.
You know.
So if, if they're going alongin that process, they're in
(08:45):
their groove, they've got theirroutine down, they're moving
along their checklist, they'recharting on time, and then
someone steps in and says, well,wait, how about we do it this
way?
That can really throw thingsoff for them and, additionally,
that can create conflict betweenthem and the doctor.
Speaker 2 (09:02):
Because they have to keep that doctor happy too.
Speaker 3 (09:04):
Right, Like the patient, the doctor, Because
they have to keep that doctorhappy too right.
Speaker 2 (09:07):
Like the patient, the doctor, they're in an
in-between role themselves allthe time.
Speaker 3 (09:24):
They are and they're in it for the long run, you know
for doulas, you know we meetwith this doctor, we see them,
we interact with them once in awhile.
These nurses have to deal withthem, you know, on a daily or
weekly basis.
I didn't mean for that to soundnegative.
They interact with thesedoctors frequently and so you
know some doctors have theirroutines and the way they get
things done, and so when youstep outside of that routine it
can create feelings ofinsecurity about the process.
And so I guess it was veryinsightful for me to understand
the back end of things, thatwhen the routine is going well
(09:46):
and then someone interrupts thatroutine, how it can create
conflict between the staff andit can create difficulty between
the staff and the birthingfamily.
Speaker 2 (09:55):
So that brings up a good, because I think, as a
doula I mean, I've called doulasinterrupters anyway right, we
are interrupters of systems andpolicies, sometimes in a good
way, but that does have somechallenging ramifications for
the systems and that we mightinterrupt, whether it's like one
nurse's routines or thesystematic policies that are
archaic or whatever.
(10:16):
Right, so, as doulas, let's youknow, step on this side of the
fence a little bit.
A lot of times we empower ourclients.
Empower is the word right Toask for things to not be on the
conveyor belt system of patientcare, make your individual like,
individualize your experienceby your requests, by your birth
(10:36):
plan, by whatever, by knowingyour options, by having
knowledge.
But it sounds like sometimes bycreating a lot of patient
autonomy, that can create somechallenges on the systematic
approach of any shift of nurses.
Correct, that's exactly right.
Speaker 3 (10:54):
Okay, yes, I think that that kind of interruption
can be a very positive thing,but it takes a great deal of
adjustment on the part of thestaff, and I think seasoned
nurses who have been supportingwomen for a long time they can
make that adjustment more easily.
But what I've seen is a lot ofthe nurses who are younger, who
are less experienced, have amuch harder time deviating from
(11:17):
the routine, and some of themare less secure about their role
, and so it's easier for them tofeel threatened by someone
coming in and saying, well,let's do it this way instead.
Speaker 2 (11:35):
Or even the patient.
When the patient says, I don'tprefer to do it that way, I want
to do it this way, that canactually disrupt their feelings
of security in their role.
So give us an example ofsomething that a laboring people
might they might ask to dodifferently, like that's off
routine.
Give us an example of that.
Speaker 3 (11:47):
Well, one classic example is declining cervical
exams.
I think that's something thatneeds to be documented
frequently, and so a nurse needsto show that they have been
doing their due diligence, thatthey're that looks like they're
responsible right Exactly.
They're responsible to be ableto identify where this woman is
at in the progression of herlabor, and if she can't account
(12:07):
for that, it appears that she'snot doing her job.
And so it's a very importantthing that a family has the
right to say no.
I don't want this done, but Ithink that can create some
conflict between the staff andthe families when they say but I
need to figure out where youare right now.
I need to understand so that wecan be ready to care for you,
(12:28):
right yeah?
exactly, so we can understandwhat your needs are and we can
respond appropriately to that.
And without that kind ofinformation it's a lot harder
for them to not only documentbut to respond.
Speaker 2 (12:41):
So the perspective of nurses and the perspective of
doulas.
We're looking at the sameobject, which is a laboring
person, right, but fromdifferent vantage points.
So walk us through how a nurseis an advocate for a patient.
Speaker 3 (13:00):
Nurses advocate between patients and physicians
a lot, and physicians a lot.
Nurses are the point of contactfor their patients in
deciphering how the patient istolerating their labor, what
they need.
You know they might have a setof orders for medications but,
you know, because of thepreferences of the family, they
(13:21):
need to contact the doctor andsay, actually this isn't working
for them, you know, and toadvocate for their patients by
saying is there something thatwe can do to change these orders
to accommodate this family,assuming everybody is safe.
Speaking to doctors andchanging plans can be really
intimidating, even for nurses,even for seasoned nurses, and so
that kind of advocacy takessome courage.
Speaker 2 (13:43):
So we could by making simple requests that doulas do
every single day can really putthe nurse in a tough spot that
we might not know about right,like you don't.
It's behind behind the sceneskind of.
Yes, for instance, when I seequite a bit is like okay, we
want to start Pitocin and thefamily's like we don't want to
start Pitocin and so there mightbe an ensuing one, two, three
(14:07):
hours of waiting patientlytrying other things like that
might look different on the backend for the nurse, correct?
Speaker 3 (14:15):
Yes, and I have seen nurses kind of put that off by
saying you know, let's talkabout this and you know we'll
give you some time to thinkabout it and I'll try to kind of
stall this process while youtry to figure out if this is
something that you want or not.
But it is really difficult todisobey an order from a doctor.
(14:35):
When they put in orders tostart Pitocin, I mean it feels
as though you're gambling yourlicense to disobey those orders,
to disobey those orders, and soit's a matter of having those
orders changed.
It's not as simple as saying oh, that's your choice.
As much as I wish that were theway it is, you know to be able
to say, of course, that's whatyou want, like, let's just do
that.
You know it's not that simplefor the nurse.
Speaker 2 (14:58):
Right.
So I've found and probably youin your career as well some we
could get down to individualproviders, but also we can say
places.
Some hospitals and or theculture of their providers seem
like they're much better at thatthan others.
Is that a fair statement?
Speaker 3 (15:16):
Absolutely yes, and I think a lot of the staff are at
the mercy of the hospitalpolicies.
Speaker 2 (15:21):
Right, which are also very different.
Speaker 3 (15:22):
right yes, I've seen many nurses that say I'm
supportive of your preferencesand I am bound by these policies
, so they're in a difficultposition.
Speaker 2 (15:32):
Right, okay, okay, so well, let me, because I think
nurses get a bad rap sometimes,right, and so do doulas, right?
Doulas get a bad rap sometimesfrom nurses and nurses from
doulas.
I was at a birth last night ata hospital I have never been to,
which is kind of rare for myarea I've 20 years, I've never
(15:53):
been to this hospital and sothey introduced me as the doula
and it was shift change andthese two nurses it was kind of
hilarious, they had thisconversation right in front of
me and one of them says theoutgoing nurse says, oh, I love
it when doulas hear, hear.
And the incoming nurse, who Iwas going to be with for the
next 12 hours, said, eh,sometimes it's good, sometimes
it's not.
I'm like, oh gosh, like I hopeit'll be good tonight.
(16:13):
But I heard loud and clear herperspective on some doulas,
right, and so I think, becausewe look at the same subject the
patient we both have what wethink are their best interests
at heart.
We both have what we think aretheir best interests at heart.
We both know them differently,right, we have different focuses
.
Really, as you talked aboutholistic, I love that you
mentioned your nursing schoolfocus on holistic care, which I
(16:35):
love to hear that Because, asdoulas, we absolutely focus on
the holistic, like what are theemotions of this experience
going to be like for this personfor the next decades of their
life?
Right, we're not just lookingat the vitals of their life,
right?
We're not just looking at thevitals of the day, right, the
vital signs of the day, whichare so important, but we're also
looking at the emotional impactof this experience on the mom
and the baby and the family andthings like that.
(16:56):
So I think we look at the samething from different angles.
But in some research I did myown statistics and data that I'd
kept for 20 years.
I asked hundreds of pastclients what was the most
positive things about theirbirth experience and what was
the most negative, and I was soshocked.
(17:18):
I was really pretty surprisedby this.
But other than the length oflabor right, like long labors,
nobody loves that that was thenumber one most negative aspect
of the experience.
Number two was nurses.
Like the whatever you know vibethey got from the nurses or
they didn't get from the nursesand that was I was dismayed to
(17:38):
hear that I wasn't like.
I'd seen that plenty of times.
You know, like the nurse isfrustrating, but, as you've said
, they get put in a tough spot.
Right they are.
They're a liaison between thelabor, the patient, the doctor,
the policies, the safety.
So speak to that a little bitwhy nurses sometimes get a bad
rap.
And this is from patients,right, this is from patients'
(17:59):
mouths.
Speaker 3 (18:00):
Yes, I think it's no secret that nurses have an
extremely difficult andchallenging and demanding job.
Nurses work very long hours.
They aren't paid enough andit's true it's a hard job
they're.
They're very, very busy, youknow.
They're often on their feet forthe entire 12 hours, barely
stopping for lunch, if thatthey're.
(18:22):
They're tired, you know, andthey're stressed.
They're getting pressure fromthe physicians and a lot of them
, unfortunately, tend to act infear.
It only takes a few verytraumatic experiences for a
medical provider or healthcareworker to change their
perspective on anything.
Speaker 2 (18:43):
Moving forward forever more right?
Speaker 3 (18:45):
Yes, and I think I've seen unfortunately, I've seen
this in school as well but Ithink there is a great deal of
fear surrounding birth and Ithink when people approach birth
from any direction with fear,it promotes this kind of
emotional response where you'renot necessarily doing things
(19:05):
because that's what's for thebest, but you're so terrified of
what will happen if you don't.
And so I think a lot of nursesget a bad rap because they,
because they're fearful, theywant to make sure that they are
crossing every T and dottingevery I, that they're being
extremely responsible, so thatthey can prove to themselves and
to the hospital and to thephysician that they have done
everything in their power toprevent bad things from
(19:27):
happening, to take good care oftheir patients.
Yeah, and that's what they want.
I mean, that's what everybodywants.
Right Is for a healthy mom anda healthy baby.
And I think when they have thatmuch pressure coming from
multiple directions and the fearcoming from inside, from
negative past experiences, itcan create a lot of tension and
that tension can lead tofeelings of anxiety, of conflict
(19:48):
.
Speaker 2 (19:49):
Yeah, okay, that's well said.
So I think, as doulas, a lot oftime I can speak, for, I think,
a lot of dozens of new doulasI've seen myself included when I
was a newer doula.
I think we come at childbirthwith this little bit rosy
colored, you know, glasses.
(20:10):
Like birth is amazing, it'sphysiologic, it's perfect.
Just leave it alone, you don'tneed to mess with it.
We come at oftentimes this isgeneralizing, but we have that
belief about birth, right, andnurses come from a little bit
different, like they might be ata different perspective, like
(20:31):
we do need to manage this, weneed to take care of this.
So I think some of the conflictmight just be philosophical,
right, like we're again lookingat the same animal of a
different color, like we're just, um, coming at it from
different philosophicalstandings.
Um, so how do we, as doulas,how do we go into this system
(20:51):
and approach physiologic birth,support, physiologic birth,
patient autonomy, and so thiswill move into the question of
how do these roles complementeach other?
But how can we do that with ourholistic view of birth, which
is ideal?
It's not realistic all the time, but how do we?
Speaker 3 (21:07):
bridge that gap.
That's a really challengingquestion and I feel like this is
one of the great challengesthat doulas have.
I feel like to add someperspective.
In school, nurses are nottaught very much about the
normal, the normal progressionsof things.
They're taught you know verybriefly, this is how things are
supposed to work and the entiresemester is spent on everything
(21:30):
else that can go wrong and allof the reasons why things go
wrong, to the point where peoplecome away feeling like and
saying it never goes rightabsolutely.
Yeah, it's a miracle ifeverything could ever go right.
Speaker 2 (21:40):
Like it's absolutely dumbfounding that things can can
go well so they focus not onthe physiology of it, but more
the pathophysiology of it, likehere's what yes, because that's
what they're addressing Right,and as clinicians, it's their
responsibility to navigate thosepossibilities, you know.
Speaker 3 (21:58):
And so, as doulas, I think it's important that we
acknowledge that we acknowledgethe very real possibilities that
things could go south, thatalthough birth is natural and
normal and beautiful, there arevery real dangers that can be
involved as well, and that werespect that process when we
come to it, that we candemonstrate to the nurses that,
yes, things are going well andI'm happy to support things the
(22:19):
way that they're going now.
But I also recognize that ifthings go this way, I'm in over
my head.
This is not my responsibility.
I'm not going to try to fix it,I'm not going to interfere with
your process.
Speaker 2 (22:30):
Or skills right.
Speaker 3 (22:33):
Yes, and I'm going to support you as you do your job
to help this family navigatethis challenge okay, okay, um.
Speaker 2 (22:39):
So because you have, I know that your time as a doula
is going to have an incrediblepositive effect on your time as
a nurse and your time as amidwife.
So let's speak to both sides ofthat.
How can, like, how is being adoula going to impact you being
a nurse and how can being nowthat you have are in nursing
(23:03):
school and have done somenursing work, how is that going
to shift your role as a doula?
Like, how would you, how doesit make you doula differently
that you've gotten into thenursing role, and vice versa.
Speaker 3 (23:13):
That's a great question.
I feel like this, this addedperspective.
It's been a very interestingmeshing of worlds and sometimes
I have a hard time joining themtogether.
Sometimes I feel likecompartmentalizing.
Yes, right now I'm a doula andI see everything is wonderful
and natural, and now I'm a nurseand I'm very clinical.
But being able to merge thoseworlds has been actually a
(23:34):
greater challenge than Ianticipated.
But I feel like having greatercompassion for each role and the
unique responsibilities thatthey carry has been key to this.
So, as a doula, when I'mworking, I can appreciate with
greater depth what the nursesare doing.
I can look at them and say wow,you're really busy and you're
still taking the time to dothese things that aren't really
(23:55):
part of your job, you know,thank you for getting that for
her, thank you for helping megive counter pressure, thank you
for providing those encouragingwords.
You didn't have to do that, youknow.
But but you're here, you'redoing that and showing up for
her, and I can have anappreciation for that.
And when I'm working as a nurse,I can see people who are trying
to support the patient and Ican appreciate them too and say
I'm so busy I don't have time todo that right now.
(24:16):
I'm tired.
I don't have the strength tocarry on doing counterpressure
because I'm taking care of fourother people right now.
So thank you for what you'redoing.
I think overall it's justgiving me a greater amount of
compassion for each role and theway that they complement each
other, because ultimately, anurse can be phenomenal, an
absolute asset to the birthingfamily, and so can a doula, but
(24:38):
they have very different rolesand they come at it from
different ways.
Speaker 2 (24:41):
So when they have both, when the patient has both.
That's, that's your goal, right?
Yeah, that's where the money?
Yes, that's the ideal.
Yeah, very cool.
Okay, I want to ask maybe atricky question about politics
like the politics of a place andpolicy Like does and we kind of
(25:01):
touched on that already butdoes that come into play
sometimes, like the behind thescenes, some politics going on
for nurses?
Speaker 3 (25:10):
Absolutely.
If there's a nurse who pushesback too much people around them
can make their job absolutelyhorrible.
Those kinds of nurses that wantto fight the good fight and
stand up for their patients andadvocate for change are often
the nurses that get trampled onand unfortunately, those nurses
end up having to redirect andreroute and go elsewhere.
(25:31):
It's.
It's very difficult to.
Unfortunately, the politics aresuch that that physicians, the
doctors and midwives are incharge, that they're, because
their scope of practice is somuch larger and because they're
the ones writing the orders andcreating the plans.
It's kind of what they say goesand even though they're often
(25:54):
not the ones in the room,they're calling the shots.
And if there's a nurse thatcomes in and says actually I've
spent all this time with thepatient, I understand them and
their needs a lot better, itchallenges their authority.
It creates an imbalance ofpower and this imaginary
sensation that you'rethreatening my authority, and so
(26:14):
I feel like it's very difficultit's a very delicate balance
for nurses to walk to show theirrespect and the support for
their patients and to show thedeference that the physicians
deserve as well and to say Iunderstand, this is what's
clinically best and this is alsowhat they need for their mental
, their emotional, spiritualneeds.
How can we combine that, howcan we pull this together and to
(26:37):
find the very very tactful,very creative and careful ways
(26:59):
to advocate for their patients.
Speaker 2 (27:01):
It's a can exist when people get the support of a
doula and the support of a nurse, and when those complement each
other, I think you can.
That's your best situation,right?
Your absolute best situationfor the patient, which is
incredible.
So for some parting thoughts,if you're cool with it, and I
think you and I could talk aboutthis online actually but what
(27:24):
are some some best ways or sometop ways that, as doulas or
patients as they understandgoing in, because, honestly,
dani, like I work in a hospitaland I think a strength that
doulas have is to take thepatients one at a time, right.
Like doulas have a lot of touchpoints with their patients,
(27:47):
literal touch points, time spentin their home, like they get to
know these people incrediblywell, on a very intimate level,
and then the nurse doesn't right.
The nurse knows their urine,she knows their, you know their
blood pressure, she knows a lotof their vitals, she knows a lot
about the medical but not thepersonal part of the person.
And so what I see as I work inhospitals, when I work in all
(28:11):
the time as a lactationconsultant, and then as I've
worked in other hospitals.
I'm always shocked at the quicktouch points which are not that
intimate, right, they're notvery connecting, whereas a doula
we have.
Very like, one of our toppriorities is the emotional
concern and care of the people,whereas the nurses, like I mean,
(28:33):
they can sit out at the deskand say some pretty disparaging
things.
As you in a professional world,you say like, oh, room six, blah
, blah, blah.
And if you really dig into roomsix, if they're complaining
about it, wow, maybe this istheir third loss.
Or you know, they had threelosses before this pregnancy.
That's why they're so nervousor whatever.
Like if you dig into the person, which is what doulas, do you
(28:53):
understand more.
So I guess my question is howcan we bring those two roles
together in a less, with lessconflict and more collaboration?
What are ways that those tworoles can appreciate each other?
So, as people, as people whohire doulas, they have a doula.
How can they best set up thatideal situation for themselves
(29:15):
where they have the bestcooperation among the different
roles?
Speaker 3 (29:21):
I think in a perfect world nurses would have the time
to do this and I think if theycan take even just a few moments
in the patient's room to have aconversation that's not
clinical, I think if doulas andnurses can talk together in a
conversation with the birthingfamily and just get to know each
other a little bit, you know,tell me a little bit about it On
(29:42):
a human level right, just humanlevel, yep.
Yeah, how long have you workedhere?
You know what do you like aboutthis hospital.
You know, do you have kids?
And connect with them on a morehuman level?
I think when you can accesstheir humanity beyond the scrubs
, you know, I feel like that'swhen they become invested in you
.
It's so easy for them andhonestly it's a I think it's a
(30:05):
coping mechanism for them tokind of keep their patients at a
distance because you just don'tknow what's going to happen and
it's so much more exhausting toinvest yourself emotionally.
But if people can invite eachother in, if nurses can invite
doulas into the dialogue anddoulas can invite nurses into
the dialogue, and they canconnect on a human level, I feel
like that's where that supportcan really take place and
(30:27):
develop.
But I feel like when theopposite happens, that's usually
when the alienation occurs andwhen it becomes a me versus them
kind of mentality.
It's all about the approach.
I think so and I think it'sjust about connecting with the
other people and finding youknow what's important to you,
why you work here.
I mean, obviously they didn'tgo to nursing school so they can
pick on people and controlpeople Right, they don't hate
(30:49):
people.
No, because they'recompassionate, they're caring,
they want to help, they want todo some good in the world, you
know.
So access that.
You know, dig and find that alittle bit, and I think when you
find that then it shines.
Speaker 2 (31:08):
Yeah, that's cool, the humanity of accessing
humanity there's.
As I've worked in hospitals andthe hospital that I work in
every week, when the tough stuffhappens on labor and delivery,
like the hard things, right Likeout at the nurse's desk, you
feel it Like it can ruin a wholeshift for dozens of people,
right Like I've seen days whereall the nurses are crying, right
, because something tough,because they do care, something
very difficult has happened andthen they have to walk into that
(31:28):
next patient's room as ifthey're fine, right Like that
they're 110%.
So, also, seeing the humanityof that side of the nurses and
what they're dealing with,because they're not going to let
you know how they feel, right,about whatever's going on in
their day, if it's the 11th hourof their 12 hour shift and
they're exhausted or, you know,maybe down the hall they just
had a patient there was a hugeloss or a terrible, you know a
(31:51):
terrible situation.
They don patient.
There's a huge loss or aterrible, you know a terrible
situation.
They don't let their otherpatients know that.
So, um, I think, just like yousaid, accessing humanity of each
other, um, and appreciation,finding ways to appreciate each
other's roles, and I think thatcan lie.
That can be a doula role, rightlike the.
The doulas um can bring peopletogether, um, not just the, you
(32:12):
know, for the patient, but forthe patient's benefit.
But it's not just the patientthey're bringing together, it's
the whole team.
So, oh, wow, dani, that's somegood stuff.
Anything else you want to addas we kind of get towards the
end of our conversation?
Speaker 3 (32:25):
I guess one other thing that I wanted to point out
is that nurses are not usuallytaught the importance of things
like maternal positioning, evenfetal positioning other than,
you know, cephalic right.
Um, they don't often know whatdoulas are or even what their
rules are, um, and they might,they might have this idea that
(32:45):
if anything that's not strictlymedical is weird or interfering
or possibly even dangerous, youknow, and so, because of there's
so much unknown to them, theyapproach doulas with a very with
a large feeling of suspicion,and it's really easy for them to
look at them and say what is ityou're going to do?
Speaker 1 (33:00):
And they're on edge, you know, yeah.
Speaker 3 (33:02):
And they want to protect their patient Right, and
they look at this doula goinglike what, what is it that
you're planning on doing when Iturn my back, when I'm not in
the room?
Like can I trust you?
Are you on my team too?
So true, you know, and it'sit's scary for them to leave
their patients in the hands ofsomeone that they don't trust.
Yeah, you know, and so I I feellike being transparent as a
doula and and tying explainingto your nurse you know, I'm just
(33:23):
going to give some counterpressure here.
This is going to help give hersome relief or just verbalizing
that to your client with thenurse in the room, you know,
helping them understand, likethis is what I'm here to do.
Or even just saying it, justcoming out right and saying to
the nurse this is what I havefound that has really helped a
lot of laboring women.
Like do you want to learn howto do it too?
Like do you want to come helpme do it and invite them to be
(33:44):
part of that process?
I think can be really valuable.
Speaker 2 (33:46):
That's true.
You bring up some great pointsthere.
I think collaboration again ishuge between doulas and nurses
and really, like I love that,the distrust thing.
I think doulas and nurses comeat each other with a fair amount
of distrust for the good of thepatient, right, same person,
like we're talking about thesame person here, but just like
looking at again from differentperspectives.
So I think a lot of times Ilove that collaboration piece
(34:09):
and a lot of times I will ask anurse like, okay, here's what
I'm thinking, what are youthinking?
Like draw them in and discusswith them?
Say, all right, you know she'skind of nervous about this, or
how can you, what are some ideasyou have that we can address
with this fear or this whatever,or I think, the baby's ROP,
what you know, I was thinking ofdoing some opening chest, or
(34:31):
you know doing some.
You know the fire hydrant.
What do you think?
Are you comfortable if we, youknow, get the stool out, or do
you have a ball we could use?
So and I think that's againcollaboration, right, like we're
on the same team here, we'rehelping the same person and if
we can use both sets ofstrengths to do that, that is
just all the more benefit reallyfor the patient.
Speaker 3 (34:51):
Yes, I absolutely love that approach.
I think when you approach anurse like they're a fellow
teammate, they can feel that,and when you come at them like
you're scared of them or you'renervous or suspicious about them
.
They feel that too.
So I think it's really importantto acknowledge their strengths,
acknowledge all of the goodthat they can do, and then show
(35:15):
what you have to bring to thetable and say how can we work
together to accomplish this?
You want what I want.
Let's work together to helpthis woman to have a positive
experience.
Speaker 2 (35:23):
I love it when doulas can make the nurse's job easier
as far as tidying up the roomor letting her know like, oh,
she's feeling pretty pushy, oryou know, this alarm's going off
, Can you?
You know this IV bag's almostdone, or whatever it might be.
You know, hopefully we can.
I think part of a doula's roleis to make the jobs nurse or,
excuse me, make the nurse's jobjust a little bit easier, just
(35:45):
to lighten their load a littlebit so that they can go about
all their many duties that theyhave on shift for sure.
So I absolutely agree with that.
Cool.
So as you go into what do youwant to keep Like firmly keep,
as you go into nursing and orCNM care from the doula world?
Speaker 3 (36:09):
I want to keep my deep sense of compassion and awe
of humanity and the incrediblemiracle that is pregnancy and
birth.
I never want to becomecalloused to the experiences
that people have.
I never want to become so toughand so strong that I can't feel
for my patients anymore.
I don't want to be so afraid offeeling those things that I
(36:29):
build a wall between myself andthem.
I want to be accessible to mypatients.
I want to be able to sit withthem in their victories and in
their miseries and in their painand everything in between, and
to say that I see you, ratherthan being very sterile about
things and I think that it'svery, very common for medical
providers to build up thosedefenses to protect themselves
(36:51):
Because, honestly, burnout isvery, very high in healthcare
and for me they see some hardstuff yes, incredibly hard
things, impossible things, and Ithink one of the greatest
challenges for all healthcareworkers is to find that very
delicate balance betweenresilience and compassion, and
so that's one of my greatestgoals.
I want to maintain thatcompassion and that deep
(37:15):
intimacy and that love that Iexperienced toward my clients.
I want to carry that with methroughout the rest of my career
.
Speaker 2 (37:22):
Very cool.
I think you're well on your way.
That's amazing, very cool.
Well, dani, thank you so muchfor spending time with us here
today.
It has been eye-opening for meto hear both sides of these two
roles the nurse and the doulaand how patients you know
benefit vastly Like there's ahuge benefit from both roles and
(37:42):
how we can work together toimprove the patient experience
and outcomes right Like outcomesare important emotional,
physical, mental, spiritual,like all the outcomes that come
after a labor and birthexperience for not just the
patient but the whole family,the baby as well.
Thank you, dani, so much forbeing here.
Appreciate your time and goodluck to you on your journey.
(38:05):
I'm so excited as you could justmarch through your journey.
I know it's a lot of waitingthrough things and I appreciate
the work that you're doing, sothank you for that.
I can't wait to work with youas a CNM somewhere.
Hopefully I get the opportunitydown the road.
I would love it.
Yeah, just give me a few moreyears.
I'm there.
I'm there for it, so we'll wrapit up today, but thank you so
much for being with us on theOrdinary Dealer podcast and, as
(38:27):
always, please make a humanconnection today.
Reach out to someone, someoneyou know, someone you don't, but
reach out and make someone'slife a little bit better by
human connection today.
Thanks for being with us andwe'll see you next time.
Speaker 1 (38:49):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth.
Thank you.
Welcome to the Ordinary Doula Podcast with
Angie Rozier, hosted by BirthLearning, where we help prepare
folks for labor and birth withexpertise coming from 20 years
of experience in a busy doulapractice, helpingping thousands
of people prepare for labor,providing essential knowledge
and tools for positive andempowering birth experiences.
Speaker 2 (00:50):
Welcome to the Ordinary Doula Podcast.
My name is Angie Rozier, I amyour host and I have a very
special guest here with me today.
Her name is Dani Reed and she'sbeen a dear friend for a few
years now, dani, it's been soamazing.
I always tell her I love herjourney and it's true, it's been
amazing to see her come on tothe scene as a doula and she
just thrived quickly.
But she always had a goal inmind.
(01:11):
She knew where she was goingand what she was doing and she's
doing it and I love seeing it.
So I'll let you tell.
I'll let her tell a little moreabout her journey.
But her goal was to become anRN and a CNM and she's doing it.
She's right in the middle ofall that and is gaining so much
cool insight along the way.
I love the pathway she's going.
(01:31):
So I'm gonna let Dani before Iintroduce our topic actually no,
I'll introduce our topic firstand then I'll let Dani talk
about herself a little bit more,kind of extend what I've just
shared.
But Danny and I have discussedthis episode for a while and I
think both of us come tohonestly with a little bit of
(01:51):
trepidation because we want todo it justice.
Danny and I are both in a seatwhere we value people's roles
and want to understand people.
I think we have a pretty goodunderstanding of roles, but we
want to help other peopleunderstand and get a good
comprehension of the differentroles of the birth team.
So, because of Dani's journey,she's in this really unique
(02:15):
position.
She's kind of on a bridgebetween being a doula and being
a nurse and seeing both sides ofthat really clearly, which is a
cool perspective to have.
So what we'll talk about todayis the roles of doulas and
nurses, their perspectives, howthey're different, how they're
the same, the challenges thatmay exist between the roles and
(02:38):
the way they can complementary,enhance each other.
So that's kind of our topic ina nutshell.
We'll get to that.
But, danny, tell us a littlebit about yourself so glad you
could be here.
And, yeah, tell us a little bitmore about yourself.
Speaker 3 (02:50):
All right.
Well, thanks so much for havingme.
I'm so excited to be able tocontribute to your podcast today
.
So, yes, my name is Dani.
I have been a birth doula forabout eight years now and a
childbirth educator for aboutsix.
I've known that I wanted to bea certified nurse midwife ever
since I knew what that was.
I've always been drawn topregnancy, to babies, to birth
(03:14):
especially.
I've always felt a deep respectand reverence for this process
and an eagerness to learn aboutit and to be close to the people
who accomplish these amazingfeats.
And an eagerness to learn aboutit and to be close to the
people who accomplish theseamazing feats.
I went to school for a while butdecided to put school on pause
for 10 years to start my family,and once I was done having kids
(03:40):
, I decided it was time to goback to school to complete my
education.
Having worked as a doula forseveral years, I got my feet wet
in the birth world and it wasreally interesting to me because
I came at this originally witha very, very medical mindset.
Um, and becoming a doula wasactually a huge growing process
for me because there were a lotof things that I uh, had to
change my mentality on Um and Ifelt like it was very valuable
(04:01):
for me to spend that time as adoula to see some of the more
holistic side of things, and nowthat I'm back in school, I am
finishing my nursing degreeright now and hoping to go on to
receive my certification as amidwife and a women's health
nurse practitioner.
Speaker 2 (04:19):
Oh, that's so exciting.
I know like that, what you justsaid sounds easy, but it's not.
I know you're in the middle ofit and it's a lot of work and
has been for a while and willcontinue to be.
So thanks for doing that work.
So, dani, as we talk throughthis, hopefully people
understand I love the positionyou're in right now and I wanted
to catch Dani actually at thistime in her career because she
(04:42):
does have a foot in each world,which is pretty incredible.
So, dani, as you have learnedmore in nursing school and I
know you've worked, you knowsome of your clinicals and
things have been in placesyou're familiar with as a doula.
Tell me a little bit about whatyou have, the insight you have
gained by doing nursing schoolspecifically to childbirth like
(05:06):
as you've worked in that area onboth sides of the doula and
nurse role.
Speaker 3 (05:12):
It's been very interesting to approach nursing
school from a doula perspective.
When I first started nursingschool, I felt a little bit
nervous about my background,knowing that I was surrounded by
very medically minded people.
However, I was pleasantlysurprised to discover that my
nursing school actually has agreat deal of emphasis on
(05:35):
holistic care in a nursingperspective.
They really emphasize takingcare of women in a mind, body,
spirit approach, which I reallyappreciate, have been very
impressed with.
But as I have gone about myclinicals and started working in
hospitals, it's been veryeye-opening for me to understand
(05:56):
the role of nurses, tounderstand all of the
responsibilities, all of thestresses that they have on their
plate and the things that kindof make them tick.
You know, as a doula going intoa birth room, it was easy for me
to oversimplify the role of thenurse because I could only see
what was in front of me.
And becoming a nurse andlearning all that goes into the
(06:20):
job behind the scenes has beenvery, like I said, very eye
opening and understanding howbusy they are.
Very eyeopening, um, andunderstanding how busy they are,
how stressed they are, how muchdemand is placed on them, how
much pressure that they carry Um, it's been very interesting to
discover that and to kind of,like you said, have one foot in
each world.
It's, it's almost like a tug ofwar inside of me, yeah.
Speaker 2 (06:41):
So, um, I guess, what surprised you most about?
It sounds like you've gained alot of empathy for nurses in
learning this role, but what hassurprised you most about, or
helped you gain that empathy orawareness of the heavy load that
they might carry?
Speaker 3 (06:59):
I think, well, there are a lot of things that go into
that.
When I have been working inclinicals, there have been a lot
of logistics that I've had tothink about.
One thing that surprised me wasjust the sheer amount of to-do
lists that nurses carry.
(07:19):
It's not so much a matter ofjust walking in the room and
taking care of the patient.
There's so much that goes onbehind the scenes with
documentation, with followingchecklists, with communicating
with physicians, with othernurses, and to coordinate that
care so that the patient hastheir needs met.
And I guess one thing thatsurprised me a lot was just the
(07:40):
amount of hoops that have to bejumped, I guess.
So you know, for me it would be.
It was easy for me to look at anurse and say, okay, come in the
room, set up your stuff andlet's just have a baby, right.
But.
But on their end they're lookingat the documentation they're
they're charting every you know.
(08:01):
They're charting in intervals oftime where they need to be
accounting for what they've beendoing, what's been happening
inside the room, how the womanis laboring, how they're
responding to that, you know,and accounting for every single
thing that they do.
They have a routine right andtheir checklist of things that
they need to accomplish is huge,and it's really difficult for
(08:25):
them to get that done, even inthe course of their shift, and
so they get into a routine, youknow, to become more efficient.
And in addition to that, theythey work with doctors who have
their own routine, their own waythat they like to have things
done, and anything thatinterrupts that process really
makes their job so much moredifficult.
You know.
So if, if they're going alongin that process, they're in
(08:45):
their groove, they've got theirroutine down, they're moving
along their checklist, they'recharting on time, and then
someone steps in and says, well,wait, how about we do it this
way?
That can really throw thingsoff for them and, additionally,
that can create conflict betweenthem and the doctor.
Speaker 2 (09:02):
Because they have to keep that doctor happy too.
Speaker 3 (09:04):
Right, Like the patient, the doctor, Because
they have to keep that doctorhappy too right.
Speaker 2 (09:07):
Like the patient, the doctor, they're in an
in-between role themselves allthe time.
Speaker 3 (09:24):
They are and they're in it for the long run, you know
for doulas, you know we meetwith this doctor, we see them,
we interact with them once in awhile.
These nurses have to deal withthem, you know, on a daily or
weekly basis.
I didn't mean for that to soundnegative.
They interact with thesedoctors frequently and so you
know some doctors have theirroutines and the way they get
things done, and so when youstep outside of that routine it
can create feelings ofinsecurity about the process.
And so I guess it was veryinsightful for me to understand
the back end of things, thatwhen the routine is going well
(09:46):
and then someone interrupts thatroutine, how it can create
conflict between the staff andit can create difficulty between
the staff and the birthingfamily.
Speaker 2 (09:55):
So that brings up a good, because I think, as a
doula I mean, I've called doulasinterrupters anyway right, we
are interrupters of systems andpolicies, sometimes in a good
way, but that does have somechallenging ramifications for
the systems and that we mightinterrupt, whether it's like one
nurse's routines or thesystematic policies that are
archaic or whatever.
(10:16):
Right, so, as doulas, let's youknow, step on this side of the
fence a little bit.
A lot of times we empower ourclients.
Empower is the word right Toask for things to not be on the
conveyor belt system of patientcare, make your individual like,
individualize your experienceby your requests, by your birth
(10:36):
plan, by whatever, by knowingyour options, by having
knowledge.
But it sounds like sometimes bycreating a lot of patient
autonomy, that can create somechallenges on the systematic
approach of any shift of nurses.
Correct, that's exactly right.
Speaker 3 (10:54):
Okay, yes, I think that that kind of interruption
can be a very positive thing,but it takes a great deal of
adjustment on the part of thestaff, and I think seasoned
nurses who have been supportingwomen for a long time they can
make that adjustment more easily.
But what I've seen is a lot ofthe nurses who are younger, who
are less experienced, have amuch harder time deviating from
(11:17):
the routine, and some of themare less secure about their role
, and so it's easier for them tofeel threatened by someone
coming in and saying, well,let's do it this way instead.
Speaker 2 (11:35):
Or even the patient.
When the patient says, I don'tprefer to do it that way, I want
to do it this way, that canactually disrupt their feelings
of security in their role.
So give us an example ofsomething that a laboring people
might they might ask to dodifferently, like that's off
routine.
Give us an example of that.
Speaker 3 (11:47):
Well, one classic example is declining cervical
exams.
I think that's something thatneeds to be documented
frequently, and so a nurse needsto show that they have been
doing their due diligence, thatthey're that looks like they're
responsible right Exactly.
They're responsible to be ableto identify where this woman is
at in the progression of herlabor, and if she can't account
(12:07):
for that, it appears that she'snot doing her job.
And so it's a very importantthing that a family has the
right to say no.
I don't want this done, but Ithink that can create some
conflict between the staff andthe families when they say but I
need to figure out where youare right now.
I need to understand so that wecan be ready to care for you,
(12:28):
right yeah?
exactly, so we can understandwhat your needs are and we can
respond appropriately to that.
And without that kind ofinformation it's a lot harder
for them to not only documentbut to respond.
Speaker 2 (12:41):
So the perspective of nurses and the perspective of
doulas.
We're looking at the sameobject, which is a laboring
person, right, but fromdifferent vantage points.
So walk us through how a nurseis an advocate for a patient.
Speaker 3 (13:00):
Nurses advocate between patients and physicians
a lot, and physicians a lot.
Nurses are the point of contactfor their patients in
deciphering how the patient istolerating their labor, what
they need.
You know they might have a setof orders for medications but,
you know, because of thepreferences of the family, they
(13:21):
need to contact the doctor andsay, actually this isn't working
for them, you know, and toadvocate for their patients by
saying is there something thatwe can do to change these orders
to accommodate this family,assuming everybody is safe.
Speaking to doctors andchanging plans can be really
intimidating, even for nurses,even for seasoned nurses, and so
that kind of advocacy takessome courage.
Speaker 2 (13:43):
So we could by making simple requests that doulas do
every single day can really putthe nurse in a tough spot that
we might not know about right,like you don't.
It's behind behind the sceneskind of.
Yes, for instance, when I seequite a bit is like okay, we
want to start Pitocin and thefamily's like we don't want to
start Pitocin and so there mightbe an ensuing one, two, three
(14:07):
hours of waiting patientlytrying other things like that
might look different on the backend for the nurse, correct?
Speaker 3 (14:15):
Yes, and I have seen nurses kind of put that off by
saying you know, let's talkabout this and you know we'll
give you some time to thinkabout it and I'll try to kind of
stall this process while youtry to figure out if this is
something that you want or not.
But it is really difficult todisobey an order from a doctor.
(14:35):
When they put in orders tostart Pitocin, I mean it feels
as though you're gambling yourlicense to disobey those orders,
to disobey those orders, and soit's a matter of having those
orders changed.
It's not as simple as saying oh, that's your choice.
As much as I wish that were theway it is, you know to be able
to say, of course, that's whatyou want, like, let's just do
that.
You know it's not that simplefor the nurse.
Speaker 2 (14:58):
Right.
So I've found and probably youin your career as well some we
could get down to individualproviders, but also we can say
places.
Some hospitals and or theculture of their providers seem
like they're much better at thatthan others.
Is that a fair statement?
Speaker 3 (15:16):
Absolutely yes, and I think a lot of the staff are at
the mercy of the hospitalpolicies.
Speaker 2 (15:21):
Right, which are also very different.
Speaker 3 (15:22):
right yes, I've seen many nurses that say I'm
supportive of your preferencesand I am bound by these policies
, so they're in a difficultposition.
Speaker 2 (15:32):
Right, okay, okay, so well, let me, because I think
nurses get a bad rap sometimes,right, and so do doulas, right?
Doulas get a bad rap sometimesfrom nurses and nurses from
doulas.
I was at a birth last night ata hospital I have never been to,
which is kind of rare for myarea I've 20 years, I've never
(15:53):
been to this hospital and sothey introduced me as the doula
and it was shift change andthese two nurses it was kind of
hilarious, they had thisconversation right in front of
me and one of them says theoutgoing nurse says, oh, I love
it when doulas hear, hear.
And the incoming nurse, who Iwas going to be with for the
next 12 hours, said, eh,sometimes it's good, sometimes
it's not.
I'm like, oh gosh, like I hopeit'll be good tonight.
(16:13):
But I heard loud and clear herperspective on some doulas,
right, and so I think, becausewe look at the same subject the
patient we both have what wethink are their best interests
at heart.
We both have what we think aretheir best interests at heart.
We both know them differently,right, we have different focuses
.
Really, as you talked aboutholistic, I love that you
mentioned your nursing schoolfocus on holistic care, which I
(16:35):
love to hear that Because, asdoulas, we absolutely focus on
the holistic, like what are theemotions of this experience
going to be like for this personfor the next decades of their
life?
Right, we're not just lookingat the vitals of their life,
right?
We're not just looking at thevitals of the day, right, the
vital signs of the day, whichare so important, but we're also
looking at the emotional impactof this experience on the mom
and the baby and the family andthings like that.
(16:56):
So I think we look at the samething from different angles.
But in some research I did myown statistics and data that I'd
kept for 20 years.
I asked hundreds of pastclients what was the most
positive things about theirbirth experience and what was
the most negative, and I was soshocked.
(17:18):
I was really pretty surprisedby this.
But other than the length oflabor right, like long labors,
nobody loves that that was thenumber one most negative aspect
of the experience.
Number two was nurses.
Like the whatever you know vibethey got from the nurses or
they didn't get from the nursesand that was I was dismayed to
(17:38):
hear that I wasn't like.
I'd seen that plenty of times.
You know, like the nurse isfrustrating, but, as you've said
, they get put in a tough spot.
Right they are.
They're a liaison between thelabor, the patient, the doctor,
the policies, the safety.
So speak to that a little bitwhy nurses sometimes get a bad
rap.
And this is from patients,right, this is from patients'
(17:59):
mouths.
Speaker 3 (18:00):
Yes, I think it's no secret that nurses have an
extremely difficult andchallenging and demanding job.
Nurses work very long hours.
They aren't paid enough andit's true it's a hard job
they're.
They're very, very busy, youknow.
They're often on their feet forthe entire 12 hours, barely
stopping for lunch, if thatthey're.
(18:22):
They're tired, you know, andthey're stressed.
They're getting pressure fromthe physicians and a lot of them
, unfortunately, tend to act infear.
It only takes a few verytraumatic experiences for a
medical provider or healthcareworker to change their
perspective on anything.
Speaker 2 (18:43):
Moving forward forever more right?
Speaker 3 (18:45):
Yes, and I think I've seen unfortunately, I've seen
this in school as well but Ithink there is a great deal of
fear surrounding birth and Ithink when people approach birth
from any direction with fear,it promotes this kind of
emotional response where you'renot necessarily doing things
(19:05):
because that's what's for thebest, but you're so terrified of
what will happen if you don't.
And so I think a lot of nursesget a bad rap because they,
because they're fearful, theywant to make sure that they are
crossing every T and dottingevery I, that they're being
extremely responsible, so thatthey can prove to themselves and
to the hospital and to thephysician that they have done
everything in their power toprevent bad things from
(19:27):
happening, to take good care oftheir patients.
Yeah, and that's what they want.
I mean, that's what everybodywants.
Right Is for a healthy mom anda healthy baby.
And I think when they have thatmuch pressure coming from
multiple directions and the fearcoming from inside, from
negative past experiences, itcan create a lot of tension and
that tension can lead tofeelings of anxiety, of conflict
(19:48):
.
Speaker 2 (19:49):
Yeah, okay, that's well said.
So I think, as doulas, a lot oftime I can speak, for, I think,
a lot of dozens of new doulasI've seen myself included when I
was a newer doula.
I think we come at childbirthwith this little bit rosy
colored, you know, glasses.
(20:10):
Like birth is amazing, it'sphysiologic, it's perfect.
Just leave it alone, you don'tneed to mess with it.
We come at oftentimes this isgeneralizing, but we have that
belief about birth, right, andnurses come from a little bit
different, like they might be ata different perspective, like
(20:31):
we do need to manage this, weneed to take care of this.
So I think some of the conflictmight just be philosophical,
right, like we're again lookingat the same animal of a
different color, like we're just, um, coming at it from
different philosophicalstandings.
Um, so how do we, as doulas,how do we go into this system
(20:51):
and approach physiologic birth,support, physiologic birth,
patient autonomy, and so thiswill move into the question of
how do these roles complementeach other?
But how can we do that with ourholistic view of birth, which
is ideal?
It's not realistic all the time, but how do we?
Speaker 3 (21:07):
bridge that gap.
That's a really challengingquestion and I feel like this is
one of the great challengesthat doulas have.
I feel like to add someperspective.
In school, nurses are nottaught very much about the
normal, the normal progressionsof things.
They're taught you know verybriefly, this is how things are
supposed to work and the entiresemester is spent on everything
(21:30):
else that can go wrong and allof the reasons why things go
wrong, to the point where peoplecome away feeling like and
saying it never goes rightabsolutely.
Yeah, it's a miracle ifeverything could ever go right.
Speaker 2 (21:40):
Like it's absolutely dumbfounding that things can can
go well so they focus not onthe physiology of it, but more
the pathophysiology of it, likehere's what yes, because that's
what they're addressing Right,and as clinicians, it's their
responsibility to navigate thosepossibilities, you know.
Speaker 3 (21:58):
And so, as doulas, I think it's important that we
acknowledge that we acknowledgethe very real possibilities that
things could go south, thatalthough birth is natural and
normal and beautiful, there arevery real dangers that can be
involved as well, and that werespect that process when we
come to it, that we candemonstrate to the nurses that,
yes, things are going well andI'm happy to support things the
(22:19):
way that they're going now.
But I also recognize that ifthings go this way, I'm in over
my head.
This is not my responsibility.
I'm not going to try to fix it,I'm not going to interfere with
your process.
Speaker 2 (22:30):
Or skills right.
Speaker 3 (22:33):
Yes, and I'm going to support you as you do your job
to help this family navigatethis challenge okay, okay, um.
Speaker 2 (22:39):
So because you have, I know that your time as a doula
is going to have an incrediblepositive effect on your time as
a nurse and your time as amidwife.
So let's speak to both sides ofthat.
How can, like, how is being adoula going to impact you being
a nurse and how can being nowthat you have are in nursing
(23:03):
school and have done somenursing work, how is that going
to shift your role as a doula?
Like, how would you, how doesit make you doula differently
that you've gotten into thenursing role, and vice versa.
Speaker 3 (23:13):
That's a great question.
I feel like this, this addedperspective.
It's been a very interestingmeshing of worlds and sometimes
I have a hard time joining themtogether.
Sometimes I feel likecompartmentalizing.
Yes, right now I'm a doula andI see everything is wonderful
and natural, and now I'm a nurseand I'm very clinical.
But being able to merge thoseworlds has been actually a
(23:34):
greater challenge than Ianticipated.
But I feel like having greatercompassion for each role and the
unique responsibilities thatthey carry has been key to this.
So, as a doula, when I'mworking, I can appreciate with
greater depth what the nursesare doing.
I can look at them and say wow,you're really busy and you're
still taking the time to dothese things that aren't really
(23:55):
part of your job, you know,thank you for getting that for
her, thank you for helping megive counter pressure, thank you
for providing those encouragingwords.
You didn't have to do that, youknow.
But but you're here, you'redoing that and showing up for
her, and I can have anappreciation for that.
And when I'm working as a nurse,I can see people who are trying
to support the patient and Ican appreciate them too and say
I'm so busy I don't have time todo that right now.
(24:16):
I'm tired.
I don't have the strength tocarry on doing counterpressure
because I'm taking care of fourother people right now.
So thank you for what you'redoing.
I think overall it's justgiving me a greater amount of
compassion for each role and theway that they complement each
other, because ultimately, anurse can be phenomenal, an
absolute asset to the birthingfamily, and so can a doula, but
(24:38):
they have very different rolesand they come at it from
different ways.
Speaker 2 (24:41):
So when they have both, when the patient has both.
That's, that's your goal, right?
Yeah, that's where the money?
Yes, that's the ideal.
Yeah, very cool.
Okay, I want to ask maybe atricky question about politics
like the politics of a place andpolicy Like does and we kind of
(25:01):
touched on that already butdoes that come into play
sometimes, like the behind thescenes, some politics going on
for nurses?
Speaker 3 (25:10):
Absolutely.
If there's a nurse who pushesback too much people around them
can make their job absolutelyhorrible.
Those kinds of nurses that wantto fight the good fight and
stand up for their patients andadvocate for change are often
the nurses that get trampled onand unfortunately, those nurses
end up having to redirect andreroute and go elsewhere.
(25:31):
It's.
It's very difficult to.
Unfortunately, the politics aresuch that that physicians, the
doctors and midwives are incharge, that they're, because
their scope of practice is somuch larger and because they're
the ones writing the orders andcreating the plans.
It's kind of what they say goesand even though they're often
(25:54):
not the ones in the room,they're calling the shots.
And if there's a nurse thatcomes in and says actually I've
spent all this time with thepatient, I understand them and
their needs a lot better, itchallenges their authority.
It creates an imbalance ofpower and this imaginary
sensation that you'rethreatening my authority, and so
(26:14):
I feel like it's very difficultit's a very delicate balance
for nurses to walk to show theirrespect and the support for
their patients and to show thedeference that the physicians
deserve as well and to say Iunderstand, this is what's
clinically best and this is alsowhat they need for their mental
, their emotional, spiritualneeds.
How can we combine that, howcan we pull this together and to
(26:37):
find the very very tactful,very creative and careful ways
(26:59):
to advocate for their patients.
Speaker 2 (27:01):
It's a can exist when people get the support of a
doula and the support of a nurse, and when those complement each
other, I think you can.
That's your best situation,right?
Your absolute best situationfor the patient, which is
incredible.
So for some parting thoughts,if you're cool with it, and I
think you and I could talk aboutthis online actually but what
(27:24):
are some some best ways or sometop ways that, as doulas or
patients as they understandgoing in, because, honestly,
dani, like I work in a hospitaland I think a strength that
doulas have is to take thepatients one at a time, right.
Like doulas have a lot of touchpoints with their patients,
(27:47):
literal touch points, time spentin their home, like they get to
know these people incrediblywell, on a very intimate level,
and then the nurse doesn't right.
The nurse knows their urine,she knows their, you know their
blood pressure, she knows a lotof their vitals, she knows a lot
about the medical but not thepersonal part of the person.
And so what I see as I work inhospitals, when I work in all
(28:11):
the time as a lactationconsultant, and then as I've
worked in other hospitals.
I'm always shocked at the quicktouch points which are not that
intimate, right, they're notvery connecting, whereas a doula
we have.
Very like, one of our toppriorities is the emotional
concern and care of the people,whereas the nurses, like I mean,
(28:33):
they can sit out at the deskand say some pretty disparaging
things.
As you in a professional world,you say like, oh, room six, blah
, blah, blah.
And if you really dig into roomsix, if they're complaining
about it, wow, maybe this istheir third loss.
Or you know, they had threelosses before this pregnancy.
That's why they're so nervousor whatever.
Like if you dig into the person, which is what doulas, do you
(28:53):
understand more.
So I guess my question is howcan we bring those two roles
together in a less, with lessconflict and more collaboration?
What are ways that those tworoles can appreciate each other?
So, as people, as people whohire doulas, they have a doula.
How can they best set up thatideal situation for themselves
(29:15):
where they have the bestcooperation among the different
roles?
Speaker 3 (29:21):
I think in a perfect world nurses would have the time
to do this and I think if theycan take even just a few moments
in the patient's room to have aconversation that's not
clinical, I think if doulas andnurses can talk together in a
conversation with the birthingfamily and just get to know each
other a little bit, you know,tell me a little bit about it On
(29:42):
a human level right, just humanlevel, yep.
Yeah, how long have you workedhere?
You know what do you like aboutthis hospital.
You know, do you have kids?
And connect with them on a morehuman level?
I think when you can accesstheir humanity beyond the scrubs
, you know, I feel like that'swhen they become invested in you
.
It's so easy for them andhonestly it's a I think it's a
(30:05):
coping mechanism for them tokind of keep their patients at a
distance because you just don'tknow what's going to happen and
it's so much more exhausting toinvest yourself emotionally.
But if people can invite eachother in, if nurses can invite
doulas into the dialogue anddoulas can invite nurses into
the dialogue, and they canconnect on a human level, I feel
like that's where that supportcan really take place and
(30:27):
develop.
But I feel like when theopposite happens, that's usually
when the alienation occurs andwhen it becomes a me versus them
kind of mentality.
It's all about the approach.
I think so and I think it'sjust about connecting with the
other people and finding youknow what's important to you,
why you work here.
I mean, obviously they didn'tgo to nursing school so they can
pick on people and controlpeople Right, they don't hate
(30:49):
people.
No, because they'recompassionate, they're caring,
they want to help, they want todo some good in the world, you
know.
So access that.
You know, dig and find that alittle bit, and I think when you
find that then it shines.
Speaker 2 (31:08):
Yeah, that's cool, the humanity of accessing
humanity there's.
As I've worked in hospitals andthe hospital that I work in
every week, when the tough stuffhappens on labor and delivery,
like the hard things, right Likeout at the nurse's desk, you
feel it Like it can ruin a wholeshift for dozens of people,
right Like I've seen days whereall the nurses are crying, right
, because something tough,because they do care, something
very difficult has happened andthen they have to walk into that
(31:28):
next patient's room as ifthey're fine, right Like that
they're 110%.
So, also, seeing the humanityof that side of the nurses and
what they're dealing with,because they're not going to let
you know how they feel, right,about whatever's going on in
their day, if it's the 11th hourof their 12 hour shift and
they're exhausted or, you know,maybe down the hall they just
had a patient there was a hugeloss or a terrible, you know a
(31:51):
terrible situation.
They don patient.
There's a huge loss or aterrible, you know a terrible
situation.
They don't let their otherpatients know that.
So, um, I think, just like yousaid, accessing humanity of each
other, um, and appreciation,finding ways to appreciate each
other's roles, and I think thatcan lie.
That can be a doula role, rightlike the.
The doulas um can bring peopletogether, um, not just the, you
(32:12):
know, for the patient, but forthe patient's benefit.
But it's not just the patientthey're bringing together, it's
the whole team.
So, oh, wow, dani, that's somegood stuff.
Anything else you want to addas we kind of get towards the
end of our conversation?
Speaker 3 (32:25):
I guess one other thing that I wanted to point out
is that nurses are not usuallytaught the importance of things
like maternal positioning, evenfetal positioning other than,
you know, cephalic right.
Um, they don't often know whatdoulas are or even what their
rules are, um, and they might,they might have this idea that
(32:45):
if anything that's not strictlymedical is weird or interfering
or possibly even dangerous, youknow, and so, because of there's
so much unknown to them, theyapproach doulas with a very with
a large feeling of suspicion,and it's really easy for them to
look at them and say what is ityou're going to do?
Speaker 1 (33:00):
And they're on edge, you know, yeah.
Speaker 3 (33:02):
And they want to protect their patient Right, and
they look at this doula goinglike what, what is it that
you're planning on doing when Iturn my back, when I'm not in
the room?
Like can I trust you?
Are you on my team too?
So true, you know, and it'sit's scary for them to leave
their patients in the hands ofsomeone that they don't trust.
Yeah, you know, and so I I feellike being transparent as a
doula and and tying explainingto your nurse you know, I'm just
(33:23):
going to give some counterpressure here.
This is going to help give hersome relief or just verbalizing
that to your client with thenurse in the room, you know,
helping them understand, likethis is what I'm here to do.
Or even just saying it, justcoming out right and saying to
the nurse this is what I havefound that has really helped a
lot of laboring women.
Like do you want to learn howto do it too?
Like do you want to come helpme do it and invite them to be
(33:44):
part of that process?
I think can be really valuable.
Speaker 2 (33:46):
That's true.
You bring up some great pointsthere.
I think collaboration again ishuge between doulas and nurses
and really, like I love that,the distrust thing.
I think doulas and nurses comeat each other with a fair amount
of distrust for the good of thepatient, right, same person,
like we're talking about thesame person here, but just like
looking at again from differentperspectives.
So I think a lot of times Ilove that collaboration piece
(34:09):
and a lot of times I will ask anurse like, okay, here's what
I'm thinking, what are youthinking?
Like draw them in and discusswith them?
Say, all right, you know she'skind of nervous about this, or
how can you, what are some ideasyou have that we can address
with this fear or this whatever,or I think, the baby's ROP,
what you know, I was thinking ofdoing some opening chest, or
(34:31):
you know doing some.
You know the fire hydrant.
What do you think?
Are you comfortable if we, youknow, get the stool out, or do
you have a ball we could use?
So and I think that's againcollaboration, right, like we're
on the same team here, we'rehelping the same person and if
we can use both sets ofstrengths to do that, that is
just all the more benefit reallyfor the patient.
Speaker 3 (34:51):
Yes, I absolutely love that approach.
I think when you approach anurse like they're a fellow
teammate, they can feel that,and when you come at them like
you're scared of them or you'renervous or suspicious about them
.
They feel that too.
So I think it's really importantto acknowledge their strengths,
acknowledge all of the goodthat they can do, and then show
(35:15):
what you have to bring to thetable and say how can we work
together to accomplish this?
You want what I want.
Let's work together to helpthis woman to have a positive
experience.
Speaker 2 (35:23):
I love it when doulas can make the nurse's job easier
as far as tidying up the roomor letting her know like, oh,
she's feeling pretty pushy, oryou know, this alarm's going off
, Can you?
You know this IV bag's almostdone, or whatever it might be.
You know, hopefully we can.
I think part of a doula's roleis to make the jobs nurse or,
excuse me, make the nurse's jobjust a little bit easier, just
(35:45):
to lighten their load a littlebit so that they can go about
all their many duties that theyhave on shift for sure.
So I absolutely agree with that.
Cool.
So as you go into what do youwant to keep Like firmly keep,
as you go into nursing and orCNM care from the doula world?
Speaker 3 (36:09):
I want to keep my deep sense of compassion and awe
of humanity and the incrediblemiracle that is pregnancy and
birth.
I never want to becomecalloused to the experiences
that people have.
I never want to become so toughand so strong that I can't feel
for my patients anymore.
I don't want to be so afraid offeeling those things that I
(36:29):
build a wall between myself andthem.
I want to be accessible to mypatients.
I want to be able to sit withthem in their victories and in
their miseries and in their painand everything in between, and
to say that I see you, ratherthan being very sterile about
things and I think that it'svery, very common for medical
providers to build up thosedefenses to protect themselves
(36:51):
Because, honestly, burnout isvery, very high in healthcare
and for me they see some hardstuff yes, incredibly hard
things, impossible things, and Ithink one of the greatest
challenges for all healthcareworkers is to find that very
delicate balance betweenresilience and compassion, and
so that's one of my greatestgoals.
I want to maintain thatcompassion and that deep
(37:15):
intimacy and that love that Iexperienced toward my clients.
I want to carry that with methroughout the rest of my career
.
Speaker 2 (37:22):
Very cool.
I think you're well on your way.
That's amazing, very cool.
Well, dani, thank you so muchfor spending time with us here
today.
It has been eye-opening for meto hear both sides of these two
roles the nurse and the doulaand how patients you know
benefit vastly Like there's ahuge benefit from both roles and
(37:42):
how we can work together toimprove the patient experience
and outcomes right Like outcomesare important emotional,
physical, mental, spiritual,like all the outcomes that come
after a labor and birthexperience for not just the
patient but the whole family,the baby as well.
Thank you, dani, so much forbeing here.
Appreciate your time and goodluck to you on your journey.
(38:05):
I'm so excited as you could justmarch through your journey.
I know it's a lot of waitingthrough things and I appreciate
the work that you're doing, sothank you for that.
I can't wait to work with youas a CNM somewhere.
Hopefully I get the opportunitydown the road.
I would love it.
Yeah, just give me a few moreyears.
I'm there.
I'm there for it, so we'll wrapit up today, but thank you so
much for being with us on theOrdinary Dealer podcast and, as
(38:27):
always, please make a humanconnection today.
Reach out to someone, someoneyou know, someone you don't, but
reach out and make someone'slife a little bit better by
human connection today.
Thanks for being with us andwe'll see you next time.
Speaker 1 (38:49):
Thank you for listening to the Ordinary Doula
podcast with Angie Rozier,hosted by Birth Learning.
Episode credits will be in theshow notes Tune in next time as
we continue to explore the manyaspects of giving birth.
Thank you.
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