Running head: THINK LIKE A NURSE

Thinking Like A Nurse

Deirdre E. Dressie
Auburn University at Montgomery

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Thinking Like a Nurse

I became a nurse so that I could one day work in the labor and delivery department and
help families bring new life into world. I previously had a career as a Social Worker exclusively
working with abused children. These children were mistreated by parents that did not know how
to love them or for whatever reasons could not love them. I longed to help people and be in the
midst of joy when working with the public, and I thought the miracle of birth would satisfy that
longing. I naively believed this until my first night of my labor and delivery clinical. This is
when I discovered that even with the experience of labor, happiness is not always guarantee. It is
a lesson that I will not forget. As I write this paper, I will identify why this is an unforgettable
situation, and why I believe that my thinking about the situation needs critical reflection as it
relates to nursing care provided. I will outline assumptions, explain how this one encounter with
this patient has helped me to view things differently, and change my perspective as a nurse.
It was my fourth semester of nursing school, and the semester that I had been awaiting so
patiently to arrive. I had already successfully completed medical-surg., geriatrics, and pediatrics.
Now, I was finally going to embark upon my dream clinical of labor and delivery. I had done so
well in my maternity nursing class that I assumed that I was ready for any and everything. I had
previously completed care plans on how I would make the mother comfortable through
distraction, relaxation techniques, positioning, and even administering medication if ordered. I
would encourage the mothers and fathers to bond with their children, try to keep their babies in
their rooms often, and encourage breastfeeding if they had already planned to breastfeed.
I had been shadowing 2 nurses all day and all was going just as I had imagined, and I was
learning a lot. A new patient had been admitted and was coming to the floor soon. One of the
nurses that I was shadowing was assigned to her. I went ahead and looked the patient up in her
EMR so that I could get an idea of her background, and I asked my mentor for a report on what

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her situation and status was. The young lady was a twenty-five-year old, Caucasian female. She
was a professional who was married, and this was their first child. They were expecting to a boy.
She was 42 weeks gestation, and earlier in the day she reported that the unborn child had not
moved at all in several hours. She felt this was abnormal because the child had been very active
the previous day and throughout much of her pregnancy; therefore, she was accustom to feeling a
lot of movement. She was seen right away by her obstetrician who could no longer detect a
heartbeat, and a sonogram confirmed the unimaginable fact that the baby was deceased;
therefore, the woman and her husband were there to have labor induced just as if it was a normal
induction to birth a living baby. I went into the patients room before she arrived to try and make
sure that the environment for her and her husband was as pleasant as it could be. I made sure
that the temperature was neither too hot nor too cold, that there was light coming into the room,
and nothing was obstructing the view at the window. A healthy environment is good for a
patient and comforting and caring is at the center of all good health care (Malam, 2001, p. 43).
I observed that the room was set up just like the previous rooms that I had been in earlier
witnessing the birth of life and the joy that was present; however, I knew that what was about to
occur in this room would bring pain and sorrow. My mentor explained to me that this was
something that the nurses normally took turns in regards to who would be the laboring nurse.
It would not be fair for one nurse to always have to endure this sort of loss, she stated.
The patient and her husband arrived to the unit. Their faces were visibly red and their
eyes were watery as if they had previously been crying and were about to start back at any
moment. At that moment, it hit me that I had made some very naive assumptions about labor and
delivery. I thought that it was all about happiness and tears of joy. I had prepared myself to know
how to react in a normal situation and not one that would involve death. We did not discuss this

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in the classroom and this was not what I signed up for. I felt numb and could not think of
anything to say to make things better for the couple. I felt like I was only in the way. I even
asked my mentor should I step out of the room during the delivery; however, she explained to me
that although this type of situation is not a frequent occurrence, it does happen. It will break your
heart, but it will also help you grow into a great nurse as you learn how to care for your patient in
good and bad times of life. As I was witnessing the delivery of this still born baby that was
lifeless but looked only as he was sleeping, I felt frozen as a stood without movement as tears
flowing down my face. I wanted to go help my RN mentor and her husband hold her legs and
encourage her to push; however, I did not. I could have made sure that she had extra pillows
behind her back to add some comfort, but I did not. I could have just asked her if she needed
anything, but I didnt. After the baby was delivered, he was placed in the mothers arm and
named after his father. There was not a dry eye in the room.
The mother noticed that I had a cross around my neck and sobbingly asked me was I a
Christian. I told her that I was a Christian. She stated that she was one too and wanted to know
would I pray for her. I moved close to her, held her hand, and cried with her as I prayed. As I
think back on the value of morally, I believed that praying for her was the right thing to do. I
used my actions as a care based approach in showing kindness, compassion, empathy,
attentiveness to an immediate need and request, and showed the patient that I was reliable.
Furthermore, this directly correlates with my current nursing philosophy of being more than just
a paid employee that carries out the orders of doctors and administers medication. I was able to
use my voice, my hands, and my presence to help heal an emotional pain.
This course has helped me to include Katharine Kolcabas Theory of Holistic Comforting
as a theory that could have used in caring for this patient. It directly guides nursing that includes

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the entire well-being of the patient such as: physical, psycho-spiritual, social, and environment;
therefore, the intervention given to the patient would enable the outcome to be measurable and
nurse-sensitive (Journal of Advanced Nursing, 1994, p.1183). Therefore, if I were caring for this
patient now, I would include this theory.
This reflective thinking paper reminded of how unprepared I was emotionally and
showed me my lack of effective critical thinking. I did not have any knowledge of the various
nursing theories and no guidance on which nursing interventions to include for a patient and
family that baby died in the womb. I am reminded of my assumptions that labor and delivery
nurses only experience joyful moments of nursing and how I came to such an out of absurd
truth. It has shown me how much I have changed in my thinking and growth as a nurse. It
reminds me that nursing is not an absolute, and I can have a plan of care; however, I need to
always be ready for unexpected situations. It has reminded that I still want to one day be a labor
and delivery nurse, but not so much now because of the joyous times that I will be able to
witness; however, it is because I want to be there for my patient through any circumstance as I
think like a nurse.

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References

Kolcaba, Katharine, K.Y. (1994). A Theory of Holistic Comfort for Nursing (19), 1183.
Malam, J. (2001). Florence Nightingale. Chicago, IL: Heinemann Library.