I am so thrilled to share this conversation with you! My dear friend Tiffany has been a Labor + Delivery Nurse for over 12 years. She has been an incredible friend of mine for almost ten years. Our families are friends and we had our babies at the same time (Jack in January 2019, her second girl, Tai in February 2019). She has also been a tremendous resource in women’s health, pregnancy, birth, and motherhood.

She graciously answered my request to pick her brain and share her knowledge with all of you. A handful of you submitted questions, too, and it brought so much to the conversation. My hope is that you enjoy and learn something new! Labor + Delivery Nurses are literal angels on earth and Tiff is no exception.

• Tell us a little bit about yourself! (How long have you been a nurse, what inspired you to get into nursing about your family, what you like to do for fun etc.)

My name is Tiffany and I am married to a wonderful man named Ryan. Ryan sells soil fumigation and so our schedules are a little insane as I am a full-time nightshift nurse. We have two beautiful little girls, Eva is 6 and just finished Kindergarten this year, and Tai is 2, she’s our spitfire and keeps us on our toes. We live in Richland, WA. I grew up in Tri-Cities and Ryan grew up on an Indian reservation nearby. I initially thought I wanted to teach kindergarten or possibly be a hairdresser. After a trip to Europe with my grandparents, I decided I wanted travel to be a part of my life and I wasn’t sure that would be in the budget with either one of those careers. My high school was offering a program for people taking an AP class for students interested in careers in the medical field. In that program, you were able to rotate through the hospital and follow different job specialties. It was during that internship that I found my calling. Labor + Delivery was where my heart belonged. I graduated from Washington State University with a Bachelor’s Degree in Nursing and started my career at Trios in the Family Birthing Center. I’ve been there 12 years and I still absolutely love my job! 

• What does your typical work shift look like?

I work 12-hour shifts. My unit does set matrix scheduling so you work the same set shifts month to month. My matrix is 6-night shifts in a row and then I have 8 days off. I work as the charge nurse some shifts and then work as a labor and postpartum nurse the rest of the time. The charge nurse role is assigned each month on a rotating basis by our director. You have to have at least two years of labor experience to do the charge roll.  The charge nurse makes assignments for the shift. Labor and postpartum nurses “catch” healthy babies, is the baby’s nurse at the delivery, and then handle any issues that may arise. 

• Do you help with all types of births? Just vaginal births?

In my unit when you are labor trained you are also trained to do C-sections and be a circulator in the operating room. If my patient is laboring and then needs a C-section I stay with her the whole time. 

• What is the difference between the labor + delivery overnight from the daytime nurses?

There truly is no difference on my unit between a day shift nurse and a night shift nurse. There are certain tasks we preform just on nights or just on days but the basic requirements of care are the same. 

• What’s the difference between an OBGYN or midwife from an L+D nurse?

In our hospital our OBGYN’s see their own patients and come in and deliver them unless they are not “on-call” for that evening or weekend. Our physicians are broken up into groups based on what office or clinic they work for and each of them rotates through and takes “on-call” for nights and weekends on a rotating basis so they don’t end up not having time with their families. Our midwives are mixed in with our OBGYN clinics and they are backed by an OBGYN. Most of them take their own patients regardless of nights/weekends. Our L&D nurse team is who you see the moment you walk into the hospital for your delivery. We are by your side in 12-hour shift increments. We are following doctor’s orders for your care and we call your doctor when you are ready to deliver. Generally, you will see your doctor/midwife once maybe twice before delivery, and then once a day after delivery before your discharge. Obviously, there are variations for this. Many of our midwives are coaching their patients through labor. Once you enter the hospital it’s the nursing team you see most. 

• What are the best things or items parents can bring with them to the hospital? Especially now with COVID-19 restrictions?

We do not have restrictions on what you can bring to the hospital in regard to COVID-19. This varies at each hospital based on their COVID-19 guidelines. Our biggest restriction right now is our visitor restrictions which have eased up as WA and our country is starting to open up. We now allow two visitors at the bedside at a time and they are allowed to swap out. All visitors must wear masks. All of our staff (vaccinated or not) are also required to wear masks.

In regards to what to bring for labor:

• If you do not want to wear a hospital gown, we allow you to wear a gown or pajama set of your own.
• We provide you with a big water cup.
• If you are NOT a scheduled C-section, we tell you to have a big meal before you arrive. We provide small refrigerators in each of our rooms, so we advise that you bring snacks.
• If you are into aromatherapy or oils you may bring those with you, although be careful with peppermint near your breasts if you plan to breastfeed, it can decrease your supply. 
• You could add a playlist of music that you like to your phone and maybe bring small speakers. 
• Small toiletries are a good idea. We do not have conditioner or anything outside of soap, shampoo, lotion, generic deodorant.
• I brought my own pillow and a small blanket for me as I find comfort in these things from home. Some people think it’s too much to bring those items. I also did not want to wear a hospital gown after delivery and so brought some yoga pants that are a size or two larger than my normal to wear with a comfy top and breastfeeding bra/tank if you are choosing to nurse your baby. I know a lot of people don’t like to wear tight things and so instead they bring baggy sweats or pajama sets to wear after delivery.
• We provide you with big peri pads and mesh panties. I brought wide waist banded underwear of my own. They were supposed to fold over on top, but I wore them not folded as I had a C-section.
• An abdominal binder is a must if you’re having a C-section. My hospital provides one to our C-section mamas, but I bought a second one off Amazon that fit me better.
• Bring your breast pump if there’s a chance your baby might end up in NICU. Best to start using your own pump from the beginning.
• A nipple shield (for moms who have delivered/breastfed before and plan to again) if you have needed one in the past. With COVID-19, these things are sometimes in short supply. 
• We provide most items you need for the baby (diapers, wipes, etc.) so just a go-home outfit, a couple receiving blankets, and a car seat.
• I just tell people to think about comfort objects that you can’t do without. The rest is just similar to staying in a hotel.

• What should parents expect with COVID-19 restrictions? It may vary from hospital to hospital but are there any standard practices I should know about ahead of time?

I touched on the COVID-19 restrictions in some of my other responses. I would truly recommend you call your particular hospital and ask about their restrictions. You might even ask specifically to speak to someone in Labor and Delivery because restrictions can be different department to department not just hospital to hospital

• I am having a C-section. What recovery items do I need post-procedure at the hospital and at home?

• I think high-waisted underwear similar to these Motherhood Maternity Women’s 3 Pack Fold Over Brief Panties so that the waistband sits over where your incision is instead of laying directly over your incision.
• I could not live without my abdominal binder. We provide them in the hospital but I purchased this one online that I liked better. The key with the binder is that you get one that fits you correctly, and you wear it correctly. It should be low enough on your hips that your incision is covered and that the bottom edge of the binder isn’t rubbing on your incision.
• Be sure after surgery that you are moving enough to move gas around in your body (passing gas etc) but not so much that you’re overdoing it.  I said in one of the other answers that I bought yoga pants that were a couple sizes larger then I normally wear as I wanted the support and the comfort of the wideband on top to put over my binder.
• Ask your nurse to teach you how to get in and out of bed without using your tummy muscles. If there are stairs in your house try your hardest to only make one or two trips up/downstairs in a day.
• A boppy or nursing pillow to try to take direct pressure off of your incision. 

• How do I prepare my husband for labor and delivery? He’s more nervous and anxious than I am!

Preparing your husband can be difficult. Now that our world is opening up, we are holding prenatal classes again so that might be a good option for prep. You may try some videos online to see how he might tolerate watching some of the more intense procedures such as epidural placement, and/or videos of delivery both vaginal and C-section. It’s always a good idea to warn the nurse if dad tends to be on the queasy/apprehensive side so we can ask him to sit down for certain procedures or help talk him through coping or give him an easy job to help during the process of labor. I always tell the parents-to-be to try to have real conversations about how you cope with pain and how he might best be able to assist/help. 

• What would L+D nurses love as a thank you gift? You are all saints!

It’s pretty common for people to bring in food-related items (cookies, cakes, doughnuts, etc). Some people do small grab bags with pens, granola bars, chapstick, etc. I have also seen gift cards be given, reusable water bottles, flowers. We are a pretty easy bunch to please!

• What is the most challenging part of your job?

I would have to say the most challenging part of my job is when we have a loss (fetal demise). It is heart wrenching and so incredibly painful to watch these families suffer such great sorrow and heart break. In a very strange way there is a piece of me that is honored to work with these families helping and guiding to walk through this most devastating time. These families and babies hold a very big piece of my heart and are with me forever. 

• What is the most rewarding part of your job?

Watching and helping to bring life into this world is the most amazing gift and I get to do it for my job! My patients make my work easy and I just can’t explain how fun and amazing it can be! I feel grateful for the opportunity to be a small part of these enormous milestones in people’s lives!