A nursing passion for postpartum

While Andrea Ulmer, RN, IBCLC, didn’t always plan or dream of going into nursing, she found her calling once she made the decision to enter the college. She works in postpartum at Royal University Hospital in Saskatoon and the passion and love she puts into her work deserve to be highlighted. In addition to having a huge heart and a desire to help women as much as she can, she recently added to her skillset and became an International Board Certified Lactation Consultant. Here is her story.

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Q: Did you always want to work in postpartum? How did you come to work in that area?

You could say being a nursing student taught me a lot about what I did not want to do with this career. What areas I never saw myself working in. I really had no idea what areas did or did not interest me when I first started the program. I was not exposed to postpartum till 3rd year and I was nervous in the beginning. I specifically remember being absolutely terrified to bathe a newborn!

It was in 4th year that I fell in love. There is no question in my mind the RN I was placed with as my preceptor had a direct impact on my career; she was the nurse I wanted to be. My first shift with her I was extremely nervous. She appeared as though having me as her sidekick was likely as fun as having rocks in your shoes; annoying! But we grew to work well together and I am forever grateful for everything that woman taught me. I was fortunate enough to work alongside her as a colleague for several years until she retired, and it was an absolute honour. It is safe to say she had a major impact on my choice to stay on postpartum.

I also remember vividly having an interview with the manager at the time when I was considering working there as a Grad Nurse. Coming out of nursing, many expect new grads to take jobs on medical or surgical floors to gain experience and maintain skills. Now I knew I did not want to do that, but the pressure and comments made had me second guess my path. When I mentioned this in my interview, this manager simply asked me “is that the nurse you want to be? Do you want to be the nurse with those skills?” And I answered with confidence” no”. And her reply was then “why would you choose an area you do not enjoy to keep skills you do not want?” She was the first person that gave me the feeling that it was ok to choose postpartum as a new grad. It felt like permission to choose a path less traveled. Without her I would not be where I am today, so I owe a lot to her as well. Plus she gave me a job so she’s high on my list of wonderful women!

Q: What do you love most about working in postpartum?

Oh where to start?! I get the pleasure and sometimes challenge of working with people from all walks of life. I have the privilege of being a part of some of the most important moments in families lives. I have witnessed unimaginable joy, and also heartbreaking and devastating sorrow. While each shift has similar routines and expectations, there is not one day the same as the next.

Helping families get to know their newborns is truly a gift. I cannot describe what it feels like to witness the joy in a mom’s face when her baby latches well for the first time. Or when a dad tucks his baby in skin to skin and he/she stops crying. I have laughed with families, I have cried with families, and I have been honoured to participate in many monumental memories with each of the families I have encountered.

I am also exposed to so many different cultural and personal beliefs, I am learning something new every day.

Q: What do you find most challenging about working on postpartum?

The general complaint that I think most nurses across the board would say is staffing. I am forever saying that we could be providing so much more for our families with the proper resources and time. When we are short staffed, or left to run at a busy pace based on our current models, the care we provide and the families’ experience suffers. And I never feel ok with that. Nothing feels worse than walking out at the end of a shift knowing there was so much more that needed to be done in that 12 hours for those families. It’s hard knowing what kind of nurse you have the ability to be, but working in such limiting environments and not having the opportunity to give your full potential.

Another challenge is differing opinions, practices, and approaches amongst coworkers. Again, I think this is found in any area of work. There will always be people doing one thing two different ways. Postpartum is an area with great leeway in terms of practice. I can go to work and give 95% of my efforts, and have the following nurse come on providing very little but essentially getting the same things accomplished. Only the experience for the family can be drastically changed based on who they interact with. It’s proven to be extremely hard to uphold standards in terms of providing the absolute best for the patients. I would say that is my greatest battle there. But I just keep showing up and try to give my best effort every time. It’s all I can do.

Q: Has becoming a mom impacted how you view your work on postpartum? How?

Absolutely yes. Before having a child I could only imagine what it felt like, could only assume what the sleeplessness and sore nipples and torn vagina was really all about. And then I experienced it. All of it!

My personal breastfeeding journey was not a pretty one. I went into it with the idea of “if it works, great, and if not, I am not going to wear myself down working for it”. I had witnessed so many women put so much pressure on themselves, and I swore that would not be me. And then, it was me. It started off alright, though there was some discomfort. Now being a postpartum nurse who happens to be extremely stubborn and struggles greatly with asking for help, I battled through the beginning and probably could have benefited from some advice. But by about the 4th month, my supply started to dwindle and my son’s weight gain was slowing. And I tried really hard to keep it going, taking domperidone and pumping every chance I got. But it was not enough, and on Dec 28th, 2010 I was standing in line at Walmart buying formula and crying. The girl behind me asked how old my baby was and when I said almost 5 months, she made a comment about why I was not breastfeeding. So here I was, trying to explain to a complete stranger that I had trouble with supply, and her response was “I had so much milk I could have fed other kids as well as my own”..oh the defeat, and the utter disappointment I felt was enough to send me into a spiral of sadness. Clearly it is a moment that has stuck with me, I remember the damn date!

So coming back to work, I vowed that if I had a mom willing to break her back to try and breastfeed, I would break my back right alongside her. I would come to know the strong desire to make it work, and the willingness to do anything for it. My heart still bleeds for those that struggle, and I often share my own story when it seems appropriate to do so. Sometimes a woman just needs to hear she’s not alone.

It’s also helped to have the ability to relate to labour stories. Again, knowing there are no two labours the same in this world, but hearing similar stories or symptoms to my own has been a great way to connect with patients.

Q: Why did you decide to become a Lactation Consultant:

I had a moment with a patient just over a year ago now. It was a quiet shift and I had lots of time to dedicate to each family. There was one couple I was working with who had just had their first baby. She was having a very hard time latching the baby and it was an uphill effort the whole time. At one point she asked me “are all the nurses up here LC’s?” And when I replied “no” she said “well you are great at your job then, thank you so much for helping me”…and it was truly my light bulb moment. It’s the best part of my job, when I have the time to do it. So why am I not focusing on it. Two days later I was going to a breast pump presentation with one of our LC’s and I blurted it out in the elevator with her that I wanted to pursue it. That was January of 2016, and 11 months later I have successfully been certified as an LC! It was a real ride…

Ultimately, breastfeeding can account for the majority of the work we do on postpartum, and if the proper supports are in place, it can be a real game changer in terms of a mother’s successful journey. I came to find out I want to play an even bigger role in that area of practice. I want to be a part of their journeys, good or bad.

Q: How do you think now being an IBCLC will impact your work?

I think it will keep me accountable to do my single best every single time for each mom I come in contact with. Sure, that is something I have always strived for, but now it’s professionally necessary and expected. It’s also an area of practice I have seen myself enjoying more in the last few years. I am excited to see where it can take me, how it can improve my practice, push me to be better for all the mom’s that want the chance to breastfeed their babies. Plus I don’t know how I’m going to do it, but I want to impact the way we practice as staff on postpartum. One of our long time and well respected LC’s just retired. She was an absolute trailblazer in that field. She made change happen. I can only hope to be half of what she was to the profession. I want to improve the way things are for women entering our facility. No matter what you choose, or how you choose to do it, I want everyone to feel respected, accepted, and heard. I feel like earning this certification is only the beginning to the work that needs to happen. But I’m excited to do my part.

 

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