1. Simpson, Kathleen Rice PhD, RNC, FAAN

Article Content

In my opinion, supporting a woman during labor and attending her birth are the best parts of being a labor nurse. Sure, paperwork, electronic information systems, maternal-fetal monitoring, "upping the pit," challenging interactions with members of other disciplines, and unit operations can hinder us throughout the day. These things are likely here to stay. But the real fun is directly connecting with our patients and sharing the joy of birth with women and their families. Because this special issue of MCN is devoted to intrapartum care, there are articles to help you be your best while doing the things that many of us love most.


Keeping mothers and babies safe during the labor and birth process is the highest priority. Therefore, it's appropriate that several of the articles have patient safety as the central theme. Are you ready to safely and sensitively care for the woman who is extremely obese? If you read the article on this topic, you will have important information to plan and guide your care. Do you know all that you should about oxytocin and the clinical implications of its new status as a high alert medication? The article on oxytocin provides valuable information regarding its safe and effective use during labor. The article on labor induction summarizes medications and methods commonly used. How do other labor nurses handle common clinical disagreements with physician colleagues during labor and birth? You may be surprised to find that results of this study could be more consistent with real-life clinical practice than what you have read in journals and textbooks. Perhaps you can relate to how nurse participants in this study responded in conflict scenarios. Are you a "reasonably prudent nurse"?


How do you feel about caring for women in labor? Compare your feelings with those of the nurses described in the article on this topic. Just how well does your perinatal team handle emergent care when the fetal heart rate pattern is suggestive of fetal compromise? The results of the study regarding failure to rescue in obstetrics shed light on care processes and medical record documentation in these situations. If you would like to use the tool described in the study to assess care processes on your unit, send me an e-mail and I will provide a copy.


How do women perceive our care and their birth experiences when things don't go as well as planned? Sometimes things that we might not see as being a big deal (such as an operative vaginal birth or cesarean) have significantly negative personal implications for the mother. Although we all know that anything other than a spontaneous vaginal birth is always a possibility and we have become accustomed because we see it everyday, not all women have positive perceptions of these interventions, even when the interventions are done in their best interest. The stories and words in the article are powerful and should make us all stop and take stock of how we interact with women during these unplanned situations. Women offered suggestions for what we could do better, and we should learn from them.


I hope you find this series of articles reflective of contemporary clinical care useful to your practice. Perhaps you also have something to share. Please take the opportunity to think about aspects of intrapartum care that are not well covered in the literature but could be helpful to your colleagues. The genesis of the article about extreme obesity, written by Dotti James and Mary Ann Maher, was lack of useful clinical information in the literature to guide care for this population. I'm sure you've had challenging patients and developed plans of care that you could communicate with others in an article format. Intrapartum nursing care is rich with opportunities for research, yet few nurse researchers study labor and birth. No doubt you have encountered clinical situations and wondered if care could be provided in a better or different way but haven't had the time or resources to take the next step to find out. A doctoral degree isn't necessary to conduct meaningful rigorous research. You just need a good clinical question and partnership with a research mentor. Think about an aspect of intrapartum care that you could study and find someone to help you make it happen. Contact me if you want to talk about potential ideas. I'd love to hear from future nurse researchers.


Best wishes, and enjoy the articles.