Your BIRTH Partners

Registered Nurse Role with Maggie

March 02, 2020 Your BIRTH Partners Season 1 Episode 6
Your BIRTH Partners
Registered Nurse Role with Maggie
Chapters
Your BIRTH Partners
Registered Nurse Role with Maggie
Mar 02, 2020 Season 1 Episode 6
Your BIRTH Partners

This episode dives into the multiple roles nurses play in the birth continuum.  Get to know Maggie Runyon, RNC-OB as she explains her journey as a birth worker and the different ways she has cared for birthing people and their families.  She'll detail what she hopes the future holds for nurses as perinatal healthcare continues to evolve.

Support the show (https://www.paypal.me/yourbirthpartners)

Show Notes Transcript

This episode dives into the multiple roles nurses play in the birth continuum.  Get to know Maggie Runyon, RNC-OB as she explains her journey as a birth worker and the different ways she has cared for birthing people and their families.  She'll detail what she hopes the future holds for nurses as perinatal healthcare continues to evolve.

Support the show (https://www.paypal.me/yourbirthpartners)

Maggie, RNC-OB:

Hello, welcome to Your BIRTH Partners. We are here to break down barriers and cultivate community as we discuss issues that impact pregnancy, birth and postpartum. We welcome you no matter what your background is and are so excited to learn together. Today I had the pleasure of handing the reins over to Angela Mike as she asks me, Maggie Runyon , registered nurse questions about what it means to be a birth nurse. You'll learn more about my background and what drew me to follow and be inspired by birth and you'll also gain greater understanding about the roles that nurses play during pregnancy, birth and postpartum. Onto the show!

Angela, CNM:

Good afternoon, Maggie. It's so wonderful seeing you per usual. Um, hello. Just want to ask you a few questions. But first if you could just tell us a little bit about yourself.

Maggie, RNC-OB:

Sure! So, I'm Maggie Runyon. So I have been a nurse for over a decade now, mostly within kind of the maternal child health range. I started out as um, an Army nurse. I did ROTC during college while I was in school and then started out working at Walter Reed, taking care of, you know , wounded warriors coming back from Iraq and Afghanistan and then through the Army's training program was able to become a labor delivery nurse. And then I've, you know, since then I've been able to work in that capacity at a few different healthcare facilities and then also in the home birth setting. And so in addition to that, I mostly identify as labor and delivery nurse, but I've also had the chance of being a nurse educator working with university students to do clinicals and teach college classes online and in person. And I'm also a certified yoga instructor. So I currently lead prenatal yoga about once a week , with women in my community.

Angela, CNM:

You are such a wildflower . I love it. So what brought you into this field?

Maggie, RNC-OB:

Yeah, so I, you know, back when I was in high school , uh, to be honest, you know, watching , reruns of the show ER, were what really brought me to become a nurse. I loved the role that nurses played in that TV show and just seeing the really strong characters, you know, that they were and how they got to spend so much time, you know, with the patients, getting to know them, being intimately involved in that and then still being, you know, incredibly just sharp, intelligent people who are also, you know, working right alongside their, you know, physician colleagues and other providers. And I love that, that balance, you know, kind of between the , the science and the humanity piece of it. So that, you know, brought me to become a nurse. And then during nursing school I had started to think that I, you know , wanted to support moms and babies. I actually thought I wanted to be a NICU nurse. I did my final practicum for nursing school for our last semester in the NICU. And I absolutely loved it. I love taking care of, you know, tiny, fragile babies who need absolutely all the extra love and support that they can get from us. But I started to realize that I, you know, at the same time had watched women giving birth and I just thought like, wow, birth is just such an incredibly powerful process and a miracle every time. And there was just this part of me that felt like, Oh , I want to take care of the mom, you know, the birthing person and the baby. I don't want to just have it be, you know, afterwards when things have gone awry. And so I love that being part of, you know, labor and delivery, it gives me a chance to see birth in so many different different forms and keep it moving. So that's where I, that's kind of where I landed.

Angela, CNM:

Excellent. Well, what do you think has kind of shaped or molded your professional journey?

Maggie, RNC-OB:

So I would say when I did my kind of course through the army and became a, you know, an OB nurse through there, it was like two months in classroom and then two months clinical component involved in it. I really just was just struck by kind of the options that are available. They had a fair, you know, range between, you know, kind of high risk and low risk births. And I, I really wanted to be able to kind of learn more because I realized in that moment like, "Oh, I've done this for four months now and I , I still really don't know as much as I want and need to know to really be able to support birth well." And so then I was really lucky that my next assignment in the army brought me to Fort Polk, Louisiana, which is a tiny community hospital , um , for the army. And because we're small and kind of a pretty remote rural area there, I was able to get just a ton of exposure and really had to hone my practice cause I didn't have as much other kinds of support staff, you know, available. We didn't have separate NICU, we didn't have , um, a lot of other stuff going on and that kind of being thrown in the fire. It really helped me to get comfortable, you know, we have to do some triage visits there and I got to really feel like I started to understand more pregnancy and kind of some of the antenatal care piece of it. And then certainly being able to bond, you know, with people after birth when they, you know, come in through labor and delivery, you get to see someone's baby and then help take care of them and their baby, you know, for the next couple of days. That really solidified how much I love kind of the community piece of birth and really feeling connected to the people. I love being able, I started a community support organization there along with another colleague to help kinda with the transition. And I adore just spending more time with, you know, pregnant people and their babies and you know, kind of being on the journey of, you know, of motherhood and pregnancy, you know, with them. So I feel like those, that very beginning of my OB career really kind of set me on this path to want to focus, you know, on community and also on really getting that, that breadth of understanding, you know, for each of us to know, I know more about, you know, about birth and everything that goes on with it.

Angela, CNM:

Absolutely.

Maggie, RNC-OB:

And then also having, you know, having great support system and colleagues to help to back you up on that so that you can be providing as much, you know , safety as possible.

Angela, CNM:

So how do you think your personal experience, you know, traveling from all these different places and being exposed to all of these different types of settings like play into your personal practice or into your intuition?

Maggie, RNC-OB:

Yeah, so I mean certainly I think for all of us, you know, the longer that you, the longer you practice something, you know, the more you realize you know, and the more you realize you don't know. And so I think as I moved from , um, you know, the community setting and then I worked next in Baltimore in a really high risk population there in the city. And , uh, which was a great, it was a great switch. Having those two experiences back to back really like taught me a ton about kind of seeing when , when something isn't normal and really getting more comfortable with quickly reacting to that and balancing, you know, heavier patient loads so that as a nurse, I feel like I really grew during that experience.

Angela, CNM:

Sure.

Maggie, RNC-OB:

And now working again at a community health setting again , at the hospital that I work at now, you know, we are blessed to generally have kind of lower risk, mostly patient population , um, and you know, some, you know, better staffing ratios. And so I feel like, again, I'm able to really like connect and spend more time with, you know, with my patients while they're in labor. And so I feel like that whole transition, certainly each birth I'm a part of it goes into the next one, you know? And so seeing all of that and you know, the hundreds of births that I've been able to be a part of so far, each of those, you know, leave a little tiny piece that goes and makes me think a little bit more carefully about something the next time. And then, of course, I feel like, you know, the birth of my own children absolutely, you know, has impacted how I think about birth and, you know, the experience of being pregnant. And, and I think probably especially about, you know, being postpartum.

Angela, CNM:

Absolutely.

Maggie, RNC-OB:

I think it's given me a chance to just better connected; I think you understand something differently. Obviously, you know, I think there are wonderful providers who haven't given birth and they do a phenomenal job. But I , I know that I connect differently with my patients now because I've experienced a lot of what they're going through at times. And that helps me to be more empathetic , and to really see, you know, where they're at when I'm sending someone home who's, you know, overdue and really excited about having their baby. And it's not quite time. I am been there. I've , I've been nine days late and my baby's still hasn't come. And so I know how desperately in their heart, they just wanted me time to meet their baby. And so I feel like I'm able to make a deeper connection, you know, with them than I was able to as a, you know, as a very junior nurse before I had my own little ones. And I think intuition absolutely plays a part of it. You know, there's that little, that gut feeling that comes in , um, you know, in both kind of positive and, and you know, potentially negative ways, it's something you just know in your heart like this 'something is just not right about this' and we need to look more carefully at something. And I think that's always, you know, that's that feeling that you trust, and you follow up on and at the same time, sometimes you just, you know, you're looking at everything and you feel like, yep , this is all fine. This is going to be OK . And I think that that will only grow, you know , as I continue to practice and , and see more and experience more and continue to kind of hone that, that inner piece of me.

Speaker 3:

So where do you see yourself in 10 years?

Speaker 2:

[laughter] It's funny. So I felt like as a college student, you know, you did a lot of thinking about, 'Oh my gosh, where are we going to be?' And then, especially as a, you know, as a junior nurse in the army, there's a lot of career focus. And so I think I was always kind of working on, like, the next plan. And so I feel like now I've really gotten to the place that everything that had always been on those plans I have, I've been able to do, which is phenomenal and wonderful. But I've been doing a lot of soul searching about what that kind of next piece looks like. And honestly, this organization, Your BIRTH Partners, is, you know, a huge realization of that. Me feeling like kind of stepping into a new role. So I, I genuinely hope that in 10 years I'm still doing this. I hope I am advocating, you know, for pregnancy and birth and postpartum and helping to connect people. I love being an educator and I love, you know, talking about all of this and helping to learn and share, you know, from other people. So I hope I'm still working as a nurse at the bedside because I love having that connection that I, you know, I can't get that close to birth anywhere else. And so I still really want to be supporting birth there, but ideally, you know, in a decade I'll have, you know, my kids will be teenagers. Good Lord. [laughter] And, I'll be, you know, I'll probably be trying to pursue more of this, you know, more f ull t ime really getting into more advocacy and, you know, education work on a broader scale.

Angela, CNM:

So can you tell us a little bit about your role or profession and a little bit of about the schooling and training that it took.

Maggie, RNC-OB:

Sure. Yeah. So I am, I'm a registered nurse and there's a couple of , you know , different pathways people go through for that. There's people who can come, a registered nurse with an associate's degree, which takes , you know, around two years of school. You can have a bachelor's degree , which takes about four years, and that's the path that I had, you know, pursued. And then there's also people who go, you know, have a different degree and kind of fast track back into a nursing. So there's a lot of different ways to become a nurse. I did four years of school. I went to a college that had a lot of, you know , a liberal arts school, so we had a lot of the, kind of the core things right out of the way, and the last couple of years are more focused on your, you know, your theory classes, learning , um, you know, about the body and how it works and how we interact and care for people. And then, you know, putting that all into play in, you know, hospital and community settings. So I did that piece of it, and then got into the army, like I mentioned before, they , for all of their specialties within the army, they have people go off to, all the nurses go off to, like four months of training to kind of learn more, both, you know, book work and then clinical work. So I was able to do that to really start to kind of master my practice as an OB nurse. And then I have my certification in inpatient obstetrics. So that's essentially, I've just, you know, I did some more studying and through my, you know , professional experience , um, was able to take an exam that just says, you know, kind of shows that I have studied, you know, a lot and know how to care for people in a diverse range of low risk and high risk settings during the obstetrical period. Then as far as other options, you know, for nurses, there's so many things and I've said it, you know , forever. I'm really lucky that it's, this career has afforded me a lot of different, different options. You know, within the profession. I also chose to go back for my master's in nursing education , um, because I really, I love, I love sharing, you know , what I've learned and I love mentoring younger nurses and helping them to kind of find their path through it. So I've been able to work in teaching, you know , people during, during the university school I've taught , um, obstetrical nursing and then done it in the clinical setting a couple of times as well. And then I've taught also a lot of other , some of the generic nursing classes online. So there are nurses who kind of fill all of these different, you know, roles. Um, and you'll see nurses as, you know, clinical educators in hospital settings and, you know, working on the community, connecting people, working for government resources. So there's obviously there's, you know, there's school nurses, there's a million, a million ways you can, you can be as a nurse.

Angela, CNM:

Awesome. That is so, so, so incredible. It's amazing how we, as career-oriented women, are able to balance so many different things , um, to include family. It's amazing how we do that stuff in enough time. So what current professional organizations help to kind of lead or define your practice?

Maggie, RNC-OB:

So, you know, the American Nurses Association is kind of the big, you know, the broadest one that goes, you know , across every, you know, every nurse who's practicing. And I think their, you know, their biggest thing obviously you learn a lot about them when you're in school and kind of focused on it . They have a code of ethics, you know, that they've put out. It has like nine different provisions that they, you know , kind of recommend us to follow and really to kind of live by. And I was looking over it today, kind of thinking about like, 'Oh, what does it really mean to be, you know, a nurse in all these ways.' And I liked the provision. Number eight says, "the nurse collaborates with other health professionals and the public to protect and promote human rights, health, diplomacy and health initiatives." And I feel like that's totally like where I'm at, you know right now, and feeling like I'm really living out that piece of it and really trying to make those connections and grow that community. And then I, within the birth world , AWHONN is the Association for Women's Health Obstetrical and Neonatal Nurses. And so they are our big, you know, they do big conferences, they have a journal, they put out a lot of our kind of professional , kind of guidelines and best practices. They do a lot of like infographics about , um, different ways to educate, you know, patients and clients about what's going on for them during, you know, pregnancy and birth and postpartum. So they're our huge, you know, resource. And then, you know, like you said, also obviously , you know, the World Health Organization, they put out tons of relevant information that really helps us to bring, you know, stuff from all around the world into the U S and see how we can apply stuff there. And then certainly, you know, ACOG for obstetricians and gynecologists. And then , ACNM for like with nurse midwives, we tend to see a lot of their information kind of flows into our practice as well since we work with those colleagues a lot in the hospital setting.

Angela, CNM:

So , your role as an inpatient obstetrical nurse and as a nurse educator , like how does that play out when you are caring for women during the antepartum, intrapartum, and postpartum period?

Maggie, RNC-OB:

Sure. So, you know, we, again, we have a big role, so obviously there's gonna be nurses throughout , um, the antepartum period, you know, working with people when they come in first pregnant. They're going to do a lot of their intakes at, you know, whether it's with providers, whether that's a, you know, an OB or a family medicine physician or a midwife. There's nurses working in , you know, in concert with them to help people to kind of get settled in and get comfortable. Usually you're going to see a nurse at most of your appointments kind of just to check in on your, you know, overall health and you know, see how you're doing. During that antepartum period, we also, you know, we teach a lot of childbirth classes and especially in, you know, in the hospital setting, often those are taught by, you know, nurses. We get to kind of start to develop those relationships. I feel like when I was in Fort Polk, again in that like really intense community setting, it was great cause I think I really got to know a lot of our patients before they came in to labor delivery just between seeing them for, you know, random triage visits and teaching classes. So we get to develop those relationships. And then in, during labor , you know, we're the ones who get to spend typically the most time with you, you know, out of anyone because generally the way the kind of patient and provider ratios go , midwives, OBs, and other physicians often have, you know, several patients they are helping to care for during labor and delivery. And typically our, you know, our nursing assignments are going to be smaller. So, hopefully we're only taking care of, you know, one or two patients at a time. So that lets us really have a lot more hands on time with them and really get to know them a little bit better and understand kind of what their goals and their preferences are for birth and , and hopefully help them to, you know, meet that to the best of our abilities. So we get to spend time with them during that. And then, you know, once babies are, you know, delivered, we're there to help out and, you know, administer any medications that are needed. Help them to bond with their baby, help breastfeeding to know, get off to a start if that's what they're doing or otherwise. Helping them to learn how to bottle feed their baby. Um, so we're, you know, we're at the bedside with them throughout all of that, kind of working through that initial piece. We're helping them to...

Angela, CNM:

Hard work.

Maggie, RNC-OB:

It is. You know, it's meaningful work. They , you are so connected to someone in this just incredibly vulnerable time for them. So it's really an honor to get, to get to know people, you know, that well in such a special way. So we worked through that whole, you know, piece of them getting them comfortable, you know, after the initial period, helping them to kind of transition to how their body feels and works after , you know, pregnancy and delivery and then, you know , we'll also see them for, you know, followup visits , outside, you know, at their provider's office or at, you know, community health clinics as they kind of transition and become a parent.

Angela, CNM:

So what do you think is the most challenging part of your role?

Maggie, RNC-OB:

Okay . Ah , I think the most challenging part is playing, probably playing off of kind of what hospital policy is , and what, and what the patient, you know , wants and what we see is actually, you know, evidence based care. Healthcare is , it's slow to change; it's difficult to get things changed at times. And so sometimes we know that something is, you know, that there's new research out or something is kind of heading in a different way than the way we've always practiced. And it's hard sometimes to get that introduced to the facility you work at, so you really feel like you're kind of giving your , your best self out there and that you're providing the best care and that you're really advocating for what your patient wants and what we know is best for them. So I think that probably that rub between kind of the real world and then the theoretical hospital policy is probably the biggest challenge.

Angela, CNM:

So what if you get share one thing that the birth community knew about your role, what would it be?

Maggie, RNC-OB:

Yeah, I mean I think we're probably lucky out of, you know, the different roles that we're kind of featuring in this series. I think nurses generally are viewed pretty positively by, you know , the world. Most people have a good impression about what we do. I think this is like our 18th year that like the Gallup poll voted nurses as like the most trusted profession, which is such an honor and just, it's so good to know that the hard work that we put into, you know, being a nurse is recognized and that people really appreciate , um, the way that we, that we work. And so I think I wish that for, you know, for birth workers out there to just know that like, we are acting for the patient. You know, we are really trying to advocate and uplift, you know, their voice and what they want, which may be very different than what we ourselves would want, you know, during birth and what, you know, or what we think is even necessarily the, you know, the thing to do. We're really there to help them to be as, you know, as comfortable as they can because they trust us and you know, they know that we're there for them. So when we're interacting with other healthcare providers, absolutely we can make mistakes and mess up and have our own things going on. But you know, the vast majority of time we're really trying to do what, what we're seeing is the best for our patients based on what they want.

Speaker 3:

So what do you think the future of your role is?

Speaker 2:

Uh , you know, I , I love it honestly. So, you know, the world health organization 2020 is the year of the nurse and midwife, which is incredible. It's awesome. And so I love that. I feel like on a national, and an international scale, we are really, you know, recognizing that as just all of the possibilities that exist, you know, within this role. I think nursing is only, you know, I think it's going to continue to be a strong presence. Obviously, you know, throughout healthcare . I think as we continue to see nurses pursuing advanced practice roles, you know, certainly , we continue to get stronger, you know, as a profession. And I think we're just going to see us hopefully pull together more as we realize like the collective power we have as you know, one of the biggest bases of, you know, health care professionals. So I'm excited for that. And I always tell people, I mean, I love being a nurse. I love the flexibility that you know, is inherent in it and as you grow and change and find your passion. So I always tell people who are pursuing it, you know, like, absolutely look into it more. There are so many things that you can do, so many ways for you to impact people's lives. So it's, I truly believe it's one of the best jobs out there.

Angela, CNM:

That is so incredible. Thank you so, so much, Maggie, for sharing. I'm telling you, just listening to you discuss your history, how you came to this profession, and your passion. I'm telling you, it's just, it's so inspiring and it just makes me want to get out there and just work harder and make a big difference and show the world the possibilities in women's healthcare.

Maggie, RNC-OB:

Oh yeah. And thank you. And I really, I feel like that passion that we capture when we're talking amongst ourselves, that's what I want this to be. I want, you know, Your BIRTH Partners to really be this continuation of that conversation on a bigger scale so we can all connect and share that passion and you know, rev each other up so we can do more.

Angela, CNM:

Perfect. Well, thank you so much.

Maggie, RNC-OB:

Yay! All right, well thank you so much for interviewing me and letting me share a little bit more about myself.

Angela, CNM:

Not a problem.

Maggie, RNC-OB:

Talk soon. Thanks, Ang. Thanks for tuning in to Your BIRTH Partners. We love to talk birth and would love to talk about it with you. Please join the conversation by finding us on Facebook, Instagram, or Twitter, we're Your BIRTH Partners on all platforms or comment on our show notes blog yourbirthpartners.org. In particular, we would love to hear from our nurse colleagues, how are you functioning in birth? What is your role in the pregnancy, birth, postpartum continuum, and any questions that our audience has for nurses and their role. Till next time.