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Black Perspectives #18: Courtney Pauley (RN – Labor & Delivery)

…It’s the Way You Carry It

SSD: What inspired you to get into Nursing?

CP: My love of science, health, and women’s issues pushed me to go to nursing school. More specifically, it was my desire to become a midwife after learning about the past & the present of the field of obstetrics as it relates to Black women. Our mortality rate [during maternity], nationwide, is 4x higher than white women of the same socioeconomic status. Break that down by locality and you’ll find that rate can be as high as 12x the rate of white women like it is in New York City!!

I am also studying to become an IBCLC—which stands for Internationally Board-Certified Lactation Consultant, which is tangentially related to my work as a labor nurse. I hate to sound like a broken record, but again learning about our past & our present with breastfeeding in this country inspired me to breastfeed my son and to study to become the support that other Black women need on this journey.

Family Photo Op

My gosh, Black people have a long and sordid history with formula and breastfeeding in this country; too much to get into in a short interview. You must learn about the past to get a full understanding of why we are where we are today regarding this topic.

SSD: What do you hope to accomplish as you continue to pursue work in the field of nursing?

CP: I hope to empower families (not just women, but families) to educate and advocate for themselves throughout this vast medical system.

SSD: I hear about nurses being overworked, but I don’t know if that depends on what part of a hospital you work in or not.

Is that true for you? And if so, what do you do to keep your energy up through shifts?

CP: Nurses are being overworked all over the hospital. All units, for the most part. It’s worse at some hospitals over others. I’m in a few Facebook groups for nurses and from the comments from nurses all over the U.S., it is definitely a nationwide problem.

On my unit (Interviewer’s Note: The usage of “on my unit/on the unit/etc.” vs. “in my unit/in the unit/etc.” is common vernacular in nursing — this phrasing is NOT a typo.), we increasingly have 2 labor patients simultaneously but are supposed to be one-to-one. It’s just safer that way. This is because a labor can turn emergent in a matter of minutes. I have to assess the fetal heart strip on the monitors every 15 minutes. What if my other laboring patient wants an epidural? Then, I have to leave one patient, and stay with the newly-epiduralized patient for the next 30-45 minutes straight just in case there’s a problem with her blood pressure or breathing because epidurals can drop blood pressure very quickly – or, if they aren’t put in correctly, could cause her to lose her ability to breathe! And what if one patient is ready to push, but I am helping the other one get an epidural? I have to get someone to watch one of my patients when they also might have 2 labors or some other urgent issue.

It’s frustrating not having enough nurses.

I often end up having to finish charting for two hours after my shift has ended because I had so much patient care I couldn’t sit down to document my work.

There’s more, but that would take all day to explain! Adrenaline is the only thing keeping me going through those super busy days, especially when I don’t get to eat lunch and barely have a moment to drink water.

SSD: Sorry to hear that firsthand from a nurse, but I hope comments like yours above spread to people outside of your industry (and to whoever’s reading this — you’re the first step). Let’s switch it up for a bit…

Many Black People tend to want Black medical care providers if they can get them. Do you see that trend in other racial groups as well? And if so, has that ever caused any friction on your end?

CP: I do believe other races and cultures try to find providers of their own race or culture. They may not be as vocal about it as we are, but I see it. People are fine with a Spanish-speaking patient choosing a provider who speaks Spanish, too. Yet, when it comes to a Black person choosing a Black provider, people get funny about that.

Well, think about it: we speak a certain way, we move a certain way, we have very similar experiences in this country. It makes sense to pair up with someone who gets you.

I am honored to help bring babies Earthside safely…

Courtney Pauley

SSD: Is there a trick you naturally employ or were taught to not get too attached to the kiddos?

Forgive the comparison, but I LOVE puppies – so it would be terrible for me to work at a shelter or a pet store because I’d get too attached. So, yeah – I’m projecting on you – LOL!

CP: Naturally, I get somewhat attached to my patients while they’re in my care – and as long as the shift went well, I don’t dwell much on it at home. But there are harder cases where I take that work “home with me,” mentally.

Like a situation where a patient ended up in a C-section after trying to push her baby out vaginally for hours. Or a case where a patient has so much anxiety from being sexually abused as a child that I worry she will be further traumatized by the vaginal exams and exposure of her private areas during labor & delivery. Talking about the situation with my coworkers helps a lot with the emotional work we have going on in this field.

I don’t get attached to the babies at all. Yes, they are really adorable! But I know the work that goes into caring for a baby, so I know it’s not rainbows and sunshine all day every day. Those adorable babies don’t let you sleep–well, mine didn’t!

SSD: What would you say are the best parts of your job, and what do you think are some of the low parts that people may not know about?

CP: The best part of my work is bearing witness to this special moment in a patient’s life. I am honored to help bring babies Earthside safely, and provide education and emotional support for the parents–whether they’ve had children before or not. The other amazing part is how much there is to learn because there really is so much to this [that] I can’t even explain it all here. I love the learning aspect a lot; I’m never bored.

Courtney Pauley

The lows are the fetal demises/stillbirths, hemorrhages, and unnecessary interventions.

Yes, sometimes we intervene when we don’t need to and that could be a problem depending on the situation. In an urgent or emergent situation, however, we intervene quickly and smoothly.

SSD: I’ve seen articles about people being kind of afraid to have kids right now because of COVID.

Is there anything you’d say to either confirm their decisions or to reassure them that their child would safely be delivered and taken care of as usual (even in our current pandemic environment)?

CP: I don’t know if people are really holding off on having babies due to the pandemic. At my job, we are quite busy!! If there is someone out there worried about delivering safely in this era, I would say to them that even if you have COVID, you have the right to keep your baby in your room with you as long as the baby doesn’t need NICU care.

And please get a doula, even though some hospitals only allow 2 support people and you end up not choosing your doula to come to the bedside you can still have them on the phone or video chat. Doulas are hired support who provide education during pregnancy to prepare you for labor, postpartum, and breastfeeding. They help with labor exercises and they help you advocate for yourself –which is so so important. I can’t stress their importance enough.


SSD: Thank you for the honesty in this interview. I feel like you’re dropping thoughts that people will truly benefit from (given your profession). Anywho — last question…

What’s something about nursing that you know now that you really would’ve liked to know when you started?

CP: What I wish I knew then, that I know now, is that this work is highly stressful. You HAVE to have something grounding you and keeping you here. You need support at home, and you need to work on getting healthy mentally and physically before you hit the floor as a new nurse.

Also, leadership on your unit will make or break you, so choose your work environment carefully. I love my current team because our unit educator, manager, and director are no strangers to taking patients or taking a more active role on the unit to lighten the load on the nurses and therefore give patients better care.

The nurses on my unit try to help each other as much as they can when things get hectic.

The Natural

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