Interview

1.Couldyoudescribeoneofyourtypicalworkdaysforme?
Iwork12hourshiftsandIarriveatworkabout15minutesbeforemyshiftstartsbecause
Ihavetochangeintoscrubsthatthehospitalprovides.Wewearclothesthatthehospital
providesbecauseofkeepingourhomegermsawayfrompatientsandalso,sowedon'ttake
hospitalgermstoourfamilies.
Wegatheratthenursingstationandlookatthebig'greaseboard'(lookslikeawhitedryerase
board)forourassignments.BecauseIworkinLaborandDelivery,thebiggestassignmentI
wouldreceiveis2patients.(Ourpregnantmomsarereallyconsidered2patients:themomand
herbabyinsideher!).Dependingonhowfarthemotherisinherlaboristhefactoronhowmany
mothersIamassignedtocareforatonetime.
TheLaborandDeliverynursecaresforapregnantmotherfromthetimesheentersthe
hospitaluntil23hoursaftergivingbirth.Whensheisadmitted,wehavetoaskabout80
questionstogetadetailedhistoryofherpregnancy,herhealthandherdesiresforherbirth.We
currentlyhaveanelectronicmedicalrecordthatcomesfromtheMDofficebywayofInternetso
manyofthequestionsarealreadyinthecomputerfromherentirepregnancy.Thefirstpriorityof
whenthemotherarrivesistotakehervitalsigns(bloodpressure,pulse,respiration,and
temperature).Theverynextactionthatwetakeistoplaceherontheelectronicfetalmonitor.
Wewanttodeterminetheconditionofthebabyandmotherwhentheyfirstarriveonthe
unit.Thisisveryimportantinourjobtodeterminewhatconditioneveryoneisinaswe
startcaringforthem.Wealsoneedtoknowifthebabyishavinganyheartratedistress
whenthemotherfirstarrives.
Oncewehavegottenourbaselineinformation,wewillperform
acervicalexam(doingavaginalexamwithasterileglovetomeasurehowopenthemother's
cervixis).Manytimes,wefindthatthemotherisalmostreadytodeliverbecauseofher
advanceddilatation.Onceweknowhercervicaldilatation,weareabletoformourplanofcare:
willshegetinthejacuzziforrelaxation?,willshegowalkinginthehospitalhallstospeedup
labor?,willshereceivemedication(painmedsorepidural),willsheneedtohaveanemergency
C/sectionbecauseofpositionofthebabyorseverevaginalbleedingorfetalheartratedistress?
LaborandDeliverynursesaregivenmuchautonomytomakedecisionsonthecareofour
patients.OurMDsandnurseMidwivesareusuallyinthehospitalsothatwehaveimmediate
contactwiththem.Wehavestandingordersforallthecareweneedtogiveourmothers.Ifthe
motherarrivesandisindistress(eitherherbaby'sheartrateisdangerouslyloworhervitalsigns
areindangerouslevels)weimmediatelycalltheMDtothebedsidetoseethemotherandmake
emergencydecisions.Ifthemotherarrivesandisdeliveringherbabyonthestretcher,orinthe
wheelchair,orinhercarthenursesusuallydeliverthebaby!!!WeattempttogetanMDin
theroombutbabiesdon'tusuallywaitforanyone!
Oncewehaveorderstoimplementforthemother,westartmakingsuretheyandtheir
familiesarecomfortable.WealwaysdrawlabworkwhenshearrivesandusuallystartanIVsite(

foremergencyveinaccess).90%ofthemothersinCharlottedeliverwiththeuseofanepidural
sowehavetohaveIVfluidsinbeforewecangivetheepidural.LaborandDeliverynursesare
consideredtheIVexpertsofthehospitalbecausewemustgetinaveinquickly(evenifthe
motheriswrigglingaroundwiththebabycoming!).Weareconstantlykeepingoneeyeonthe
electronicfetalmonitortomakesurethebabyisdoingwellwiththelaborcontractionswhile
alsohelpingthemotherbreathethroughhercontractions,helpinghertochangepositionsoften
forcomfort,gettingherclearliquidsforcomfort,tryingtokeepeveryonecalmintheroom,and
answering2000questionsfromthedadtobeandthegrandparents!!Manymothersare
nauseatedduringlaborsowemustbeonthelookoutforthrowupandofferingmedicationsto
helpherwiththesesymptoms.Weperformvaginalexamsabout12hoursunlessthemotherhas
signsthatthebabyiscomingquicker.
Oncethemotherisreadytopushherbabyout,wearethepeoplestandingbyherto
coachherintheproperpushingtechniques.Itcantake12hoursforafirsttimemothertopush
herbabyout.Wearecoachingherwithcontractionsevery23minutes.Ourfeetandbackstake
abeatingduringthistime.Wearethebiggestcheerleadersduringthistimealsobecausethe
motherisverytiredandlosesconfidenceinherabilitytopushherbabyout.Wehavetogetvery
creativeinwaystoreassureourmomsthattheyaresafeandthattheycanDOTHIS!!!!Oncewe
canseeabout78centimetersofthetopofthebaby'shead,wecalltheMDintodeliverthe
baby.TheMDdeliversthebabyandwewrapthebabyinablanketandimmediatelyhandthe
babytothemotherandfather.Theidealsituationisforthenakedbabytobeplacedimmediately
onthemother'sbarechestforwarmthandcomfort.Ifthebabyisnotbreathingwellorhasalow
heartrateatdelivery,weimmediatelystartaprotocolcalledNeonatalResuscitation(NRP).Itis
likegrownupCPRbuthascertainstepstomakesurethebabystartstobreatherapidly.(Wetake
an8hourclasstolearntodothisandhavetobecheckedoffonitevery2years).Whilethe
babyiswiththemother,wearetakingthebaby'stemperature,puttingonidentificationbracelets,
andmakingsurethebabyisdoingwell.Wearealsocheckingthemother'svitalsignsandgiving
suppliestotheMD(ifheneedstodoanystitchingafterdeliveryofthemother'svagina.).Once
theMDisfinishedwiththemother'svaginalassessment,theRNcleansthemotherup(givehera
newgownandputthebedbacktogether).Duringthistime,weareassessingthemotherthatshe
isnotbleedingtooheavily,thatherBloodpressureisstableandthatshefeelsgood.Wearealso
askedtotakepicturesofthenewfamily(myfavoritethingtodo!)andtohelpthemotherstart
breastfeeding.Wearealsoawarethattheotherfamilymembersareanxiouslywaitingtoseethis
newfamilymember.Thenewparentswanttohavesomeprivatetimewiththeirnewbornbaby
butalsowanttosharetheirnewbabywithfamily.Asthenurse,wetrytohelpthemgetsome
balanceduringthistimesothatthemotherdoesn'tgettoooverwhelmed.
Wemonitorthemotherandthebabyforabout2hoursafterdeliverywegivethenew
babyit'sfirstbath,wehelpthemotheroutofthebedforthefirsttimeandtothebathroom,we
makesureshehasameal(she'sstarving!!)andwehelpthenewdaddygetusedtoholdinghis

baby.Wemovethemothertoanotherwing(theMotherBabywing)whenherbabyisabout2
hoursold.
Whenwereceiveourassignments,ourmothersmaybeatanystageoflabor.Weeither
getabrandnewadmissionsowedoalloftheabove.Sometimes,ournewpatientisaboutto
deliverorwearestartingtogivehermedicinetomakeherlaborstart.
AnotheraspectofdeliveryistakingcareofmotherswithaC/Section.Ifitisdecidedthe
patientneedsaC/Section:weshaveherabdomen,putacatheterinherbladder,andtakeherto
theOperatingRoom.Wearethepersonintheroomthatmakessurethesurgicalcasegoes
smoothly.Wecountalltheinstrumentswiththescrubtech,wecounttheneedlesandspongesto
makesurenothingisleftinthemotherandwemakesuretheoperatingteamhasallthesupplies
theyneedforthecase.Theoperatingteammustkeeptheirhandssterilesowearethepeoplethat
opensuppliesandhandthemtothemwhilekeepingthesuppliessterile.Oncethesurgeryisover,
wetakecareofthemotherandbabyintherecoveryroomforabout2hours(untilthemothercan
moveherlegsandhervitalsignsarestable).Westillhelpherbreastfeedandmakesurethebaby
isbreathingwell.

2.Whatpartsofyourjobdoyoufindmostchallenging?
Themostchallengingpartsofmyjobaredealingwithfamilymembersofmypatients.
Manytimes,theyarenotpayingattentiontotheirlovedonesandareonlyconcernedabout
themselves.Manyofthemaren'ttunedintothefactthatthenewmotherisscaredanddoesn't
reallywanttohearalltheirscary'labor'stories.Manytimestheywanttoonlyhavetheirhusband
inthedeliveryroomwiththemandnot"abunchofsightseers"!AsCharlottehasgrown,we
haveseenanincreaseinamixtureofnationalities.Itisverydifficulttoworkwithsomecultures
becauseofthelanguagebarrier.WeusuallyhavenotroublefindingSpanishorFrench
interpretersbutitisverydifficulttofindaTagaloointerpreterat
3:00
inthemorning!!!Ihavea
lotoffrustrationincaringforthesewomenbecauseIcan'tcalmtheirfearsduringdelivery
withoutexplainingwhatishappeningtothem.Wearenotallowedtousefamilymembersas
interpretersbecausetheymaynotknowtheaccuratemedicalterminology.Manyofourpatients
onlyhaveoneortwopeoplethatcomewiththemtothehospitalbutnoneofthemwillspeak
English.Iamalwaysveryconcernedwhenwehaveemergencieswiththesepatientsbecausethe
mothercan'treceiveproperexplanationsofwhatishappeningtoherorherbaby.Weutilizean
interpretertelephone(ithas2handsetssothatIcanholdoneandthemotherholdstheother
whileaninterpreterisonthephone)butweloosemuchwithouthavingfacetoface
conversations.

3.Whatdofindmostenjoyable?
Icouldgoonforaboutaweekaboutthis!Thereisnothinglikebeingwithawomanfor
manyhoursbeforeherdelivery,seeingherviewherbaby'sfacefortheveryfirsttime,crying
withherhusbandastheyheartheirbabycryforthefirsttime,andwatchingthembecomea

family!ItistheveryreasonIkeepdoingthisfor36years!!!!Theotherbestfeelingisbeing
absolutelyterrifiedbecauseababy'sheartrateisdangerouslylow,werunintotheC/Section
roomlikewearerunninginatrackmeet,andwhenthatbabycomesoutandcries:wefeelthe
absolutebiggestwaveofrelief!Weusuallyarehigh5ingintheroomandfeelahugerushof
adrenaline.Itisaveryhardfeelingtodescribetoothersbutitreallybondsustogetherasastaff.
Thisiswhymanynursesareunbelievablyclosebecausewefeellikewehavebeenthroughmany
battlesdaily.

4.Aretoomanyortoofewpeopleenteringthisprofession?
TheagegroupthatIamin(4060)isoneofthelargestgroupofRNsintheUS.Because
wearethelargestgroup,wewillalsobethelargestgroupretiringatthesametime.Becauseof
thisfact,thereneedstobeahugegroupenteringtheprofessiontoreplaceus.Becauseofthe
levelofexpertisethatwillbeleavingatthesametime,therecouldbealargegapinquality
nursingcare.Therearemanystudiesbeingreleasedonthisissue.TheInstituteofMedicinehas
releasedastudyonthestateofhealthcareforthenext10yearsthatstateswewillneedmany
morepeopletoenterthenursingfield.Thisissueisalsoimpactingnursingprogramsin
universities:theprofessorsandeducatorsarealsogettingclosetoretirementage.

5.WhatwouldbeareasonablesalaryrangetoexpectifIenteredthisfield?Whatisthelong
termpotential?
StartingsalaryfornewgraduatenursesinhospitalsinCharlotteisabout$40,000/year
withoutanyshiftdifferential.ShiftDifferentialisthehourlyratepaidfornightshiftsoursis
about$4.00/hour.So,ifanewRNworksnightshift(wheremostnewgradsstart)theywillreally
bemakingabout$46,000/year.Thepotentialcurrentlyforveryexperiencednursesinthe
hospital(atthebedsideandnotinadministration)isaround$75,000$80,000/year.ARNthatis
innursingmanagementcanmakeupto$125,000/year.NursesinNursingAdministration(Vice
presidentsinhospitals)canmakeupto$180,000/year.

6.Whateducationalpreparationwouldyourecommendforsomeonewhowantstoadvancein
thisfield?
Iwouldrecommendacourseofstudyheavyinsciences(chemistryandbiology),Physics
isnotnecessaryfornursing.Mathisimportantbuthigherlevelsofmatharen'tutilizedin
medicine.ItookCreativeWritingmysenioryearofhighschoolmyadviserstatedthatthe
'feeling'partofthiscoursewouldhelpmewithnursing.Anymedicalexplorercoursesare
alwaysgoodbutnotarequirementforstudy.Besuretoalsohavesomeclassesyouenjoy
becauseyouneedabalancewiththesereallytoughclasses.

7.Whatqualificationsdoyouseekinanewhire?
Newhire:enthusiasmforlearningnewskills,previousexperienceasanursingassistant(
summerjob)reallyisabonus!becausethesenewnurseshavealreadylearnedhowtomanagea
patientassignmentandbeorganized,professionalattirefortheinterview,professionalresume
beveryawarethatemployerswillcheckFacebook/Instagramforhistoryoftheapplicantpay
attentiontoscreennamesandemailaddresses.Ihadanapplicantonetimethatusedascreen
namethatsuggestedshewasachampionalcoholdrinker!IdidNOTinterviewher!!!Pictures
shouldnotbepostedwithalcoholicbeverages,revealingclothesorinappropriatelanguage.

8.CanyourecommendanycoursesIshouldtakeinhighschool/college/graduateschool?
IthinkIpreviouslyansweredthis:math,sciences,SPANISH,anexcellentstudycourse
tohelpwithorganizationalskillsforcollege.Extracurricularactivitiesshouldbein
helping/charityareas.MedicalExplorersisagreatactivitytocheckoutmanyaspectsofmedical
careers.

9.Whatskillsarerequiredinyourpositiononadaytodaybasis?
Daytodayskills:stamina(goodphysicalhealth)tohandle12hourshiftswhilestanding
excellentpeopleskillstodealwithfamiliesthatareatahighstresslevelflexibilityinpersonal
lifetoaccommodateschedulechangesthatmayberequired,dedicationtoyourjobtoinclude
spendingthenightatthehospitalwhenthereisiceorsnow(noexcusesformissingworkduring
badweather),agoodsenseofhumortodealwithbusyassignments,stressedpeople,etc.

10.Ifyoucouldstartalloveragain,wouldyouchangeyourcareerpathinanyway?Why?
Iwouldneverchangemycareerpath.Ihavemetthemostamazingpeopleduringmy
career,gottenthechancetochangemanylivesbybeinganadvocateduringverystressful
deliveries,beenaleaderduringmanyyearsthathelpedopenanewunit,hadtheopportunityto
experienceadrenalinerushesofemergenciesandtheunbelievablerushofemotionswhena
motherholdshernewbornforthefirsttime.IwilltrulymissthiscareerwhenIretire!!!!!