HOW do you say no as a patient, when can you say no and how does it all work. We want to be sure that you UNDERSTAND that you can say no at any time and the hospital staff are just there to support you!
Today’s guest is Mandy Irby (second time Mandy is on, she was also on this episode on how to go into labor). She’s The Birth Nurse on Youtube and on Instagram and does trauma-sensitive nursing and childbirth education in the Roanoake, VA area (and also does Spinning Babies classes — which are super cool).
This episode is actually also a Youtube video on her channel, Mandy asks a few questions I don’t ask (but stay tuned for my lightning round question for her). 🙂 Stay tuned til’ the VERY end for mine. 🙂
Big thanks to this week’s sponsor The Online Prenatal Class for Couples — get informed so YOU can drive your own bus {figuratively, I do not teach how to drive busses}. Remember to use the coupon code mentioned in the episode. Have you seen the reviews?
This post was inspired by my 5 Labor Tips Webinar that talks a lot about informed consent.
Please remember that informed consent involves discussing:
- Risks
- Benefits
- Alternatives
You are entitled to that during ANY intervention, and it is 100% fine to ask for it.
Things mentioned in this podcast:
- Painful Vaginal Exams (yes, you can say no to those as well)
- What does your labor nurse know you don’t know
- Choosing your Doctor
- Talking to your doctor at your first appointment
Other things you might find interesting:
- Pain Management in Labor
- 5 Things that happen to your Baby After Delivery
- Nervous About Labor
- Who should be in the room at delivery?
- Basic Delivery Vocabulary
- Delivery Room Rules
- A Peek Inside the Nurse Brain
- Pregnancy Emergencies
Podcast Producer: Drew Erickson
Check out my other pregnancy podcasts:
Listen to all my podcasts:
Transcription:
Hilary Erickson 0:00
Hey guys! Welcome back to the Pulling Curls Podcast. Today, on Episode 27, we’re talking about saying no. This is a Nancy Reagan and the fight against drugs back in 1984. We’re talking about saying no as a pregnant patient. When can you say no? How do you say no? What do you say no to? I have one of my favorite nurse friends coming on. This is her second time on the podcast. Let’s untangle it.
Welcome to the Pulling Curls Podcast, where we untangle everything from pregnancy, parenting, home routines, even some family travel because, heavens knows! Our lives are tangled. I’m your host, Hilary Erickson.
Before we get started, I kind of want to share one of our reviews! SeaMoss36 came on to Apple podcasts and said, “fun and practical. I love listening to Hilary she’s always so real and funny. At the same time, her show is really informative and she breaks things down into things you can actually do in your life.” I hope today’s podcast is definitely one of those for my pregnant friends. That was me talking, not SeaMoss. “Episodes are usually pretty short, always. As she is great about getting to the point. Definitely worth the listen.” Although, today’s episode isn’t probably super short, but I’m excited for it anyway! I hope you are too. Okay guys, and I have an awesome easter egg at the end of this episode. The very end. So, stay tuned.
This episode of The Pulling Curls Podcast is sponsored by the Online Prenatal Class for Couples. It simplifies understanding labor so you can have a more relaxed pregnancy and birth taught by a highly experienced labor and delivery nurse. And can be done wherever you are whenever you want. No more arranging busy schedules to fit in a prenatal class. Save 15% with the coupon code UNTANGLED. You can find out more at pullingcurls.com in the menu under COURSES or in this episode’s show notes.
Okay, guys, I think this is a real issue. I get friends who asked me. I get… people who are pushed into things they don’t want to do. I have patients who are pushed into things they don’t want to do by doctors. And we’re a little bit limited on what we can say as a nurse in the room. So today I’m having my friend Mandy Irby on. She is the birth nurse from the YouTubes and the internets and all the good places. She is informed on trauma sensitive care. For patients. And that means we want you to have the best birth possible. It’s not all about healthy mom, healthy baby. It’s also you feeling empowered and excited for your parenting journey through your birth. So today I want to welcome my friend, Mandy Irby. Okay, so how do patients know when they can say no? What do you think, Mandy?
Mandy Irby 2:21
How do they know when they can say no? Because they’ve listened to all your podcasts. And they know that you can always say no.
Hilary Erickson 2:28
Right. I think people are like, “Can I say no to that?” I think they’re thinking, “Can I say no to that? Or will they take my baby away?” But, literally, we- there are very few things we’re going to take your baby away for. Unless you were like, I don’t know don’t resuscitate it, even though it’s crying. I don’t know.
Mandy Irby 2:42
And labor staff don’t take your baby.
Hilary Erickson 2:46
No. So take your baby if we ever saw anything weird. But I mean, even if you decide to do marijuana in your labor room, you could still do that. But we would probably call CBS.
Mandy Irby 2:57
Right. Totally not up to us at that point. But yeah, yeah, following the law is still important. But, is that what you think? I think people and patients, and parents, us being part of that community. Having children wonder, like the consequences and the results of, what if I don’t do this? Because obviously, it’s being asked of me. So, someone thinks that it’s the right answer. And that’s not really the case.
Hilary Erickson 3:23
Right. I think a lot of people don’t realize how many people come into labor with literally no idea what they want about anything.
Mandy Irby 3:29
Yeah.
Hilary Erickson 3:30
And that is at least 75% of my patients. Are just like, whatever, I’ll just do whatever. And so they sort of need guidance towards what most people do.
Mandy Irby 3:38
Mmm-Hmm.
Hilary Erickson 3:39
And so we kind of were like, “Do you want to sign up for immunizations? You can say yes or no.” But then they go, Oh, what do most people do? And I say, well, the American Academy of Pediatrics recommends it, you know, but you can also say, “No, we’ve done it. We’ve done our research, and we don’t want to do that.”
Mandy Irby 3:52
Yeah, yeah. So you’re already clued into or cluing- cluing your listeners into… More information is usually better.
Hilary Erickson 4:04
Right.
Mandy Irby 4:04
Before you get there.
Hilary Erickson 4:05
Yeah. To, to, uh, to not an excess. Because some people have researched like, that we implant transmitters in babies when we do the immunization and I have yet to implant a transmitter.
Mandy Irby 4:17
Oh, wow. Yeah, yeah, it definitely makes a difference where you’re getting the information. That you’re researching. So, I always say though, I always say. The, pregnant person, the woman or the birthing person is the driver. They are the decision maker ultimately. So of course, they, or, your listeners, you can always say no. And then have the discussion. Or at least have the discussion of what would know me.
Hilary Erickson 4:44
Right. Well, some people need to know that- that it’s actually the mom’s choice. So sometimes, you know, if they’re younger, their mom will say, “No, she doesn’t want an epidural.” But it’s really that- the patient’s choice, right?
Mandy Irby 4:56
Yes, the person giving birth.
Hilary Erickson 5:00
Yeah.
Mandy Irby 5:00
Is the driver. and yes for some people, they’ve not been the driver in their lives very much.
Hilary Erickson 5:06
Right.
Mandy Irby 5:07
Yeah, that’s a new role.
Hilary Erickson 5:08
They are backstage passenger.
Mandy Irby 5:11
So…
Hilary Erickson 5:11
Are you just emancipated minors where you live. Yeah, if they’re pregnant we’re not so it’s weird.
Mandy Irby 5:15
Oh, well crap. I don’t I might have misspoke. I’ve looked up the law governing I don’t know what you mean necessarily by that. The law governing the body. So, if a 16 year old is pregnant during her pregnancy and birth and all of her care for herself and for her baby or is up to her. She is the sole person. She is not- does- does not need a guardian to make those decisions, but I’m not sure about beyond that.
Hilary Erickson 5:42
Yeah. No, her mom would sign her consents for her at our hospital.
Mandy Irby 5:46
Oh my goodness.
Hilary Erickson 5:47
Yeah.
Mandy Irby 5:47
Oh,
Hilary Erickson 5:47
It’s weird.
Mandy Irby 5:48
Oh.
Hilary Erickson 5:49
So, essentially the mom will make the choice, but.
Mandy Irby 5:52
A grandmother.
Hilary Erickson 5:53
Yeah. Anyway, just a little tidbit probably not relevant to most of you, but.
Mandy Irby 5:58
But, could you, could that 16 year old be emancipated legally prior to going into the hospital?
Hilary Erickson 6:04
It… I’ve never had that happen.
Mandy Irby 6:06
Possibility.
Hilary Erickson 6:07
Some do have a separate Guardian. Instead of their parents. But there usually is a guardian that I’ve had, although I’m sure they could emancipate themselves. Or I think also if they get married.
Mandy Irby 6:18
Yeah.
Hilary Erickson 6:19
Gosh. So it’s such a tangent. You’re welcome, readers.
Mandy Irby 6:24
This is totally a thing, though. Different states. Yeah, I just teach that. It’s the birthing person. But if you’re a minor, gosh, I hope every single pregnant minor is listening to this because this is this is a big deal.
Hilary Erickson 6:37
Yeah, I would think in our state, I’m sure our providers let them know because also, their parent would have to sign in the office for them like, yeah, it would have happened during their pregnancy for us.
Mandy Irby 6:46
Oh, sure.
Hilary Erickson 6:46
Yeah.
Mandy Irby 6:47
So, what would make saying no hard in labor?
Hilary Erickson 6:52
It’s probably just so we’re kind of intimidating, right? Like, they think we’re in the driver’s seat, but we’re not.
Mandy Irby 6:57
Well, I mean, we’re wearing scrubs or a white coat. We’re standing up. We work there. We’re there every day. We know the rules.
Hilary Erickson 7:05
Right.
Mandy Irby 7:06
Which is funny, because there’s not that many rules. It seems like there’s a lot of rules. But we’re actually really flexible. Heh.
Hilary Erickson 7:14
I mean, on some things, there are some rules that we start to… stand our ground on.
Mandy Irby 7:18
Yeah.
Hilary Erickson 7:18
It’s almost like we’re more like, the bus driver of public transportation. So we go where we normally go, unless you decide to get off that bus. Kind of, right?
Mandy Irby 7:27
Oh, I like that. Yeah. Yeah. So yeah. Just because, you know, like routinely for everybody does not mean that it’s the best decision for that individual. Right. Yeah, that’s a good way to put it. Because hospitals like, they have to have policies and procedures. To help keep people safe and help them take care of thousands and thousands of people.
Hilary Erickson 7:48
Right. And again, the vast majority who have no idea what they want, and have done no research.
Mandy Irby 7:55
Hmm, that’s a really great way to put it. I also think, um, that We’ve been taught by repetition so I know you’re not in the south, but I live in the south, technically. I was not raised in the south, but I was raised female in the US. And I was raised, that by just my repetition like, as female, it’s, life is smoother if, you’re agreeable. You know, life is smoother if, everyone’s happy and, and there are like a lot of reasons why I wouldn’t want to ruffle feathers. You don’t know the consequences. You don’t know what people might think of you. If you even asked like, what if I don’t do that? Because, saying the worst case scenario is not actually the worst case scenario happening. Yeah, saying like, you- you could die. Okay, well, good thing we got that on the table. Like, no one wants that. So what do we do it? What’s the where’s the in between of not this answer, but not dying?
Hilary Erickson 8:52
Right. Well, I think informed consent can be an intimidating. Of itself. Because they’re required to say, “With an epidural,” or they should say, “Or you could die.” Because it is possible that anyone at the hospital could die at any time. It is also possible while you’re at home, that you could die at any time, so.
Mandy Irby 9:11
Yeah, you just don’t have to sign a consent every time you turn on your stove.
Hilary Erickson 9:15
And so, when the doctor or the anesthesiologist comes in and says, you know, “You or your baby could die from this.” That is intimidating, whereas to us, we’re like, we hear that every day, you could die from anything. You’re more likely to die on your car ride to the hospital.
Mandy Irby 9:31
Yeah! But, to hear it five times, while you’re there, you’re like, I’m pretty much gonna die.
Hilary Erickson 9:36
Right. And some people give an informed consent, like, and kind of emphasize that part.
Mandy Irby 9:41
Yeah, yeah. Because, you are signing that you understand the actual risks. Not that, anyone thinks that you’re going to die, but there are actual risks to every intervention that could happen. And true and for so I want to know if the, if the listeners, you’re pregnant people, your followers understand that or have ever heard the risk is death. Like, either buy your baby or of you. And, when you go into surgery, like you expect to sign something that says that. But when someone breaks your water, like you may not be expecting to hear, “or your baby could die.” But, truly with either option. We don’t normally say, “Oh, if we do nothing your baby could die too.” Like, really?
Hilary Erickson 10:29
Right. Well, but that isn’t a truly informed consent. You could say, you know, both options have. And I’ve never heard a doctor given form consent for breaking water ending that. Have you?
Mandy Irby 10:39
Yeah.
Hilary Erickson 10:39
Oh. I’ve heard them say. Well, some doctors, I feel like, bring out death real easily. You know, the fetal monitor strip looks meh, and they’ll be like, “I think your baby could die.” Again, your baby could die at any time. We all could die at any time. And so, it’s hard to know. When, you know. But I have also been in situations where I do think their baby is going to die. And then it’s almost the same spiel. How do they know? So.
Mandy Irby 11:09
Right. This is sticky, because there’s kind of like a lot I want to say about that. But I won’t go into the tangent of, is all that really, like, crying wolf. Is it really necessary to go into all of it? Maybe is it hella scary and confusing for the patient or the client? Yes. Yes. And they are they, the client, you, I’m speaking to the patient, the pregnant people. If you’re in a position of inherent vulnerability, like you are being taken care of the nurse’s role, we state we’re taking care of you. That’s… You’re so vulnerable, like we take care of babies and people can’t take care of themselves. You’re an adult who can absolutely take care of yourself. But, but the language and the positions like you’re on your back, you’re in a bed. For crying out loud, like, of course, you need to be taken care of if you need to be in bed. Well, you don’t necessarily need to be in the bed. But that’s the part of the inherent vulnerability, you’re in a place that you don’t, that’s not familiar to you, you’re wearing a gown. You don’t even have underwear on, you don’t have your bra on. You’re not with your people. You’re not with your smells. You’re not with your food. It seems like everyone else has the upper hand. When really, the staff are kind of looking to you. To drive a ship that you’ve never driven before. In a place you’ve never driven it. And like you said, a lot of times you- you don’t have the education behind every single intervention and every single possibility. So are you going to drive blind and just be like, guessed everything except this one thing? That seems kind of random, but I feel like I need to make a decision. What a crazy spot to be in.
Hilary Erickson 12:46
Yeah. Well, how do you think people know when, maybe they’re really making a poor choice?
Mandy Irby 12:54
I would so love to hear what you say about this.
Hilary Erickson 12:56
So like, I wouldn’t say that we make you sign something. If you were- we will make you sign something that says you are going against medical advice. Now that not sometimes that happens with like the vitamin K shot, or the, I think we have to have them decline the vitamin K shot at our hospital. But you can always ask the nurse, is it routine to have someone sign this? How many of you signed before?
Mandy Irby 13:18
Mmm-hmm. That’s a really good question
Hilary Erickson 13:20
Get in a really sticky situation where we feel like the doctor has said repeatedly, this is going to be a problem. I really need you to think this through. That’s the other thing if the doctor and we’re- and the staff are continuously checking with your choice, and seeing if you want to change your mind. Because as a nurse, we are seeing an outcome. You know, I’m a professional, I’ve done this forever. And so I kind of check in, you know, how do you still feel about the situation, the choice you’ve made? Is there anything you want to change about it? Stuff like that. So I would say signing and then people constantly checking. That’s still your choice.
Mandy Irby 13:54
That’s a good- That’s a good point. and reading the room when you’re in labor. That’s really tough to do so taking people that you trust. With you to kind of, see the facial expressions and things like that. But I also don’t think that the staff make the right choices for each individual. So in, my like, trauma informed lens, I’m like, stop asking the same question you already got the dang answer for. Like was- were they not clear.
Hilary Erickson 14:25
I would say that I have redone that one, maybe two or three times in my whole career though. Remember, like, I see a horrible fetal monitoring strip and they are consistently like, I’m refusing the C section. I’m refusing the C section. Sure. So I feel like at that point, it’s my professional duty to be like, “Just checking in!”
Mandy Irby 14:44
Yeah, and- and I actually check in a lot more often maybe then regular. I don’t know right. Than a lot of people. Just because I just want to make sure we’re on the same page still. Like, because I don’t know this person that well. Like, I see by your face that you’re uncomfortable. I want to make sure it’s the right kind of uncomfortable. Or there’s some tension in the room and I kind of want to like air it out. But I’ve also seen, providers and nurses asked multiple times just to break water. Just because, that is what they normally do. It’s the end of the shift. Things need to be changing. For the next shift, for report, and that, yes, happens. And they want to give. I’m going to I’ve heard of multiple hospital situations, I’m not sure about birth centers, but hospital situations where they change shifts. And the next shift is going to be like, well, WTF, like what happened in your whole shift? And so there’s a pressure to, do something. And so I’ve heard, I’ve heard multiple times when it’s not medically necessary. It’s about Yeah, is this a good idea or not? It’s just as the choice that you want to make and so it kind of seems, pressurey. When it’s really like, we’re not an emergency. Like, be c-. Be clear about an emergency. Like, I feel like you would be like, “So I’ll tell you if I think it’s a big deal. And right now, I kind of think it’s a big deal.” But also I teach like, electronic field monitoring is not diagnostic, we can see a lot of things, that we don’t know about. You know, like, I don’t know if this is going to be a bad outcome. However, if you say, girl, if you were my sister, I would be like, Hey, I cannot tell you this is not going to be a bad outcome. I just want to make sure that we’re clear on this. That’s a good indication. If your nurse is like, uh, if you are my sister, you know, I don’t want to tell people like what I would do. And I- even if they ask them, I’m never like, “Oh, yeah, I totally know.” Because I have no idea. But, to be very clear, and just be like, I want to make sure you really understand in between contractions. And then, I’ll tell you if there’s a change from what I see. And you might see we’re seeing changes which is important for the decision making.
Hilary Erickson 16:56
Yeah, it’s hard to know when you can refuse it. My friend Katie, that I’ve had on the podcast before, she, they were doing all these blood sugars and their machine was so off from the hospital machine, like 10 points, which is a lot on a newborn.
Mandy Irby 17:08
Uh huh.
Hilary Erickson 17:09
And so she was like, “When can I refuse it?” And I was like, “Well, at any time, you can say, I’m done. I’m not going by the policy. I want you to look for symptoms.” Because there’s other things we can look for. It’s just a number. But she was so intimidated by the nurses, which I get. Yeah, you know, she was smart, and they were kind of starting to push formula. She wanted to breastfeed. So it can be really difficult and even trying to give her the words to like how to refuse and not look like a total jerk. Because I don’t want to offend people or you know, they want that nurse on their side later on too. So.
Mandy Irby 17:42
you have a lot to lose, like you’re thinking, “Okay, well if I’m wrong, I’m hurting my baby, my family, my possible future. Fertility, my life.” Like you- you have everything to lose. Oh, yeah, it’s it’s truly sticky. So When you get when you like talk about who do you bring in the hospital or like having a person that you call like people, like your friends can call you. What can your family do? Or, what can your friends do that are with you?
Hilary Erickson 18:11
Yeah, I mean we educated and also if you’re thinking about bringing people, make sure that they can kind of read a room, read a doctor, read a nurse, sometimes the doctor will make a choice and you’ll see the nurse over in the corner. I’ll roll my eyes, you know, over in the corner like a teenager sometimes. Because what they just said was like, You clearly have a golf game.
Mandy Irby 18:33
Oh, gosh.
Hilary Erickson 18:36
We don’t have any doctors now but I have worked with doctors before that had tickets to a sporting event, or whatever.
Mandy Irby 18:41
I hear it all the time. I hear it all the time. That’s like 50 years ago, hundred years ago, but I hear it all the time. Now that you just don’t know. Are we on the same page about. Yes, our goal’s healthy mom, healthy baby. But I also think that’s kind of a lot of BS because there’s so much more to it. And we’re not talking about emotional health at that point because we’re not worried about the babies emotional health. But you’re worried about the birthing person. But like, where are these decisions coming from? Where is your recommendation coming from? Because the birthing person, we can ask what their’s are, but like they don’t know ours. As the staff.
Hilary Erickson 19:16
Well, and if you were like in regular life, and you had a doctor who asked for surgery and you were kind of reticent, you would ask for a second opinion. Yeah. And it is sort of possible to do that in the hospital. I officially really am not allowed to give an opinion. I can kind of give a mehmrrhmehh…
Mandy Irby 19:35
These are your options. What I’ve seen in the past Yeah, we don’t give
Hilary Erickson 19:40
Yeah. And I can call the doctor back for informed consent. So I have a posted I actually have a webinar on informed consent. What your doctor should be offering. Because informed consent includes the risks, the benefits, and the alternatives. And they should go through all of those when they’re doing anything major, apparently breaking water, but mine very rarely do that. They just say we’re gonna break your water.
Mandy Irby 19:59
Sending intervention.
Hilary Erickson 20:01
Yeah. And so, you know, I don’t do it before I put in the IV, do you? Yeah. You say the risks of the benefits of the IV, you are a better nurse than me.
Mandy Irby 20:09
I do. It takes me so long to do in a mission. I do. I do. And I teach nurses and trauma informed care. I teach nurses. Like whole units, of nurses. And I’m like, trauma informed care is consent for touch and consent for intervention every single time. So I, ask if I can do a blood pressure. I don’t do like informed consent for blood pressure, but I do for an IV. Totally.
Hilary Erickson 20:31
I usually just say, Are we good with this? Do you have any questions? But I don’t go the risks and benefits because Mandy is a better nurse than I am.
Mandy Irby 20:37
No, not necessarily. I just, I, as you said, people come in and they don’t know their options. And so I start with that stuff. And this is what I teach when I talk with nurses. When a family is vulnerable, and they’re in the situation and they are like, I don’t know what that heck is up and down. Like it all is so foreign to me and now that I’m in the hospital, It’s like really confusing, practicing making choices. Because I can say, Oh, it’s all it’s your choice. And everyone’s gonna say, like, I could offer two opposing choices. And I’ve had people say yes to both. Or, you know, like, the provider is like, Okay, what do you want to do? They’re like, go ahead. And they’re like, you didn’t, you didn’t say what you wanted to do. And they’re like, whatever. Like, that’s not a choice. That is, like shutting down, or that’s, that’s totally something different. And I help them. Practice making choices. So yes.
Hilary Erickson 21:31
I like that.
Mandy Irby 21:32
I give them a choice on position. And I’m not like, do you want to do this? I’m like, these are two things that you can do. Which one sounds good, or do you want to do none? Yeah, I like that. And, like, I don’t like your stupid peanut ball. I’m like, “Yay, good. You just told me no,” because how is someone going to say no to a provider if they can’t say no to their nurse?
Hilary Erickson 21:52
Well, and I feel like that just extends into parenthood. Right? Like you’re kind of at school with their kid and they’re just like, I don’t know.
Mandy Irby 21:58
I yeah, there’s so many I don’t know. And they’re like, well, they’re looking at me like I’m supposed to figure it out. Like I’m a brand new parent, just tell me what to do. But truly, I don’t want people to tell me what to do. I want them to just give me more information.
Hilary Erickson 22:11
Yeah. Well, I don’t know, when I’m at a store, I want them to be like, that’s the shirt. And I’ll be like, Thank you. Appreciate that.
Mandy Irby 22:17
You and I do the exact same thing. I’m like, I’m going to be on the news in a day. What can I wear a mid-30s make it appropriate? And I’m going to be walking. But in healthcare, no. And in parenthood? No, I mean, I’ll go to my friends and be like, just tell me but not my do-. I don’t want my doctor or my midwife to just give me one choice because they think that’s the best. I don’t want that. We don’t want to get down that rabbit hole. So yeah.
Hilary Erickson 22:40
Well you’re paying them to tell you options, right? I mean, that’s what you would as a general contractor at your house for, right? Like this one’s gonna scratch but it’s prettier. But this wood will withstand the world.
Mandy Irby 22:51
Yes, totally. Um, I looked up so I’m doing a new, like online education for nurses. In 2020, I’m really excited about and I was, I know. I was looking up a few hospital mission statements like labor and delivery. So one in Philadelph- I know. One in Philadelphia says and they want to ensure that your you deliver your children in the manner you wish. And then later they in a video they say patient centered care. So individual and then the next one in Washington State, Labor and delivery unit says individualized care for every pregnancy. So, when people are making decisions and saying no about choices, you’re not necessarily saying no, you’re just saying, “Thanks for your opinion,” or… not even opinion. I understand my options and I’m going to go with this other option or this one option, which is sometimes doing nothing or sometimes declining what is offered but it’s- it’s just a choice. It’s not like refusing or being a bad patient and it’s just making a choice, but when making a choice, that’s you’re telling the hospital you’re telling your center. Exactly how they can give you patient centered care. You’re just giving them tools you’re giving your nurses and you’re giving your provider answers for how you want your deliver your children in the manner you wish. So we’re giving options for what kind of hardwood floors you want, but we don’t know your lifestyle. We don’t know your history, what you’ve been through, what triggers you, what you’re nervous about, like, I don’t know if you’re saying yes, because, you know, you want to be done because your partner’s here from the military, because you don’t want to have a baby on the Friday the 13th, or because you’re afraid you’re gonna hurt somebody’s feelings and you’re actually really terrified to speak. Like, I have no idea that any of that so when you say yes, I’m like, cool, but Well, I mean, we don’t dig into it. Just like your hardwood floor guy’s not gonna be like, “I saw a dog in your backyard. Are you sure?” Right? They don’t know what you’re basing your decision on. So giving answers that are actually factual or asking for more information so that you can make factual decisions, or exactly what your team wants to know. So they can do their mission, give you patient centered care. Otherwise, it’s just Mandy centered care.
Hilary Erickson 25:10
Right. It’s what you would do. And so, and you do sort of go along with like, what most people do, or what, what you think is best, you know, as you go along. So.
Mandy Irby 25:21
What’s recommended? Yeah, by studies of a bunch of different people, and we go with the average. So if you fall outside of the average, or you just want a little more information about it, that’s when, yeah, bringing your friend along, who can be like, maybe we need to ask the nurse a little more information, because they have a different perspective in the room than you. They can get more information that way. You’re bringing the friend that’s like always going to send your plate back. If they get it wrong in the restaurant. And you’re like, I could never do that. But I know. Like my friend Sassy, would be like, just ask them to take off the onions. You bought it, you paid for it. Just ask them. Like bringing that friend who’s like, “Oh, they’re gonna know, you know, when to speak up. That’s a- that’s an awesome team member to have. Just more information. You’re not like fussing.
Hilary Erickson 26:07
Right. So what, I guess like we should go into like, how do you say no? So, at any point in time at any intervention at any, you know, at any point in the road, you can say no. Essentially. Although I was thinking, we’ve had some people refuse to go home. And that is not really something you can say no to because you have to have a doctor’s order to be at the hospital. So, just FYI.
Mandy Irby 26:31
Otherwise you’re like squatting.
Hilary Erickson 26:33
Yeah, we can’t just like, leave you at the hospital. I’ve had some people say, they’ll just pay cash. I’m like, I have no idea how that works. Anyway, I just can’t do anything without a doctor’s order. So, that was the only thing I was thinking of that you really couldn’t say no, you can’t say no to real. That’s a good one. We call security for. But at any point in the line, you can say no. And, so what are some of the good ways for people to to like broach that subject be like, I think You can say I’m uncomfortable with this, you know, if the nurse isn’t, you know, giving you options, you can say I’m uncomfortable with this. Or, you know, when when they go to check you and you see them pulling out the amnihook to break your water, you can say, I don’t want my water broken, and all of that is fine. And I just don’t think people know that they can.
Mandy Irby 27:18
Yeah, I think understanding like the what if, and it’s just getting more information, you’re not necessarily refusing or declining at that point, you’re just like, okay, so if I have an IV, what if I want to go in the water? You know, because if someone says, No, I don’t want an IV, but really, they don’t want an IV placed postpartum when they’re bleeding and their veins are smaller, and they’re holding their baby. Like, there are some situations where I’m like,” Yo, if you’re just going to get it, like there’s an easier time, I can just give me more information about it.” But if they’re just not, if someone’s just like, I don’t want an IV because I want to get in the water. Whoa, you can have both, like this is how we’re going to do that. Hey, I want to check you to see what you’re dilated. So if you don’t want to be checked, or you’re not quite sure it’s warranted, that actually is not enough information to do an intervention, in my opinion. So if someone says hey, I want to check you to see what you’re dilated, but getting more information like, “Okay, so what would be if what would be next if I’m not dilated?” “Oh nothing we would just keep going doing the same thing.” “Okay, well what would be next if I was dilated?” “Oh, nothing we just keep going and doing the same thing.” Okay, so do I want what happens when I have an exam joy when experience that right now because last time you know you’re going through your history of your of your own life. Last time, it made me cramp. Last time, I hallucinated. Last time, I threw up. Last time I, had to get back in the bed, then you actually can weigh your choice. And if someone is super pushy, Adrionno lozado. Put this in clearly and a lot of nurses that I work with. And I have been doing this for a long, long time, just like under the radar. Like if you’re ever concerned about making a decision immediately, you can always just be like, okay, so like for more information. I’m not quite sure what the hospital does. But like. Are we having an emergency situation?
Hilary Erickson 29:01
Hmm.
Mandy Irby 29:02
And if the answer’s no, you could always pee. So go to the bathroom. The cave.
Hilary Erickson 29:07
Yeah, so that gives you the chance to…
Mandy Irby 29:09
Yeah, the cave and your space is shutting the bathroom door. And-
Hilary Erickson 29:13
But I have had doctors who get really ticked off when the patient goes I need to pee and I’m like, “Dude, you- they are paying you a lot of money to wait five minutes.”
Mandy Irby 29:22
Yeah, they get real- Yeah, some people get really ticked off. Because that is like, that does make a lot of things harder. But, worst case scenario, the nurse knows that they’re ticked off the the the birthing person’s already in the bathroom closing the door they’re- They’re like blocking all that ticked off-ness.
Hilary Erickson 29:39
I hope so.
Mandy Irby 29:40
Yeah, we hope so, that they don’t even know. And it’s totally inappropriate to barge in in someone’s bathroom, even though that’s a great place to labor and you may not be peeing or you may have even more clothes on than you did when you were in your bed. It’s just like a social thing.
Hilary Erickson 29:53
Yeah.
Mandy Irby 29:54
Don’t go in the bathroom. So then you get a space. And then, whoever’s ticked off, can cool off. Just go take a walk. If you, if you take forever in the bathroom, like you’re paying for your bathroom time, like come on, get what you need out of your bathroom time. Pee, talk to your partner, invite your nurse in because you’re having like, I need help. Talk in there. Where you feel more comfortable to like get more information in the bathroom rather than in the bed where it’s more vulnerable.
I love that.
Hilary Erickson 30:19
Yeah, nurses go in the bathroom. Doctors don’t go in the bathroom. But you could be like, nurse my IV looks a little funny and then have a conversation. You know, because a lot of people are very intimidated by doctors, but they find nurses less intimidating. And that’s okay, too. We understand that. Yeah, me at one point in my time I found doctors intimidating as well, but that’s over right now. I think if someone’s going to get upset about someone going to the bathroom, I find that intimidating as well. And also like completely inappropriate. So if that were my sister or my friend and someone like had a little fit about an actual human who is holding another baby on top of their bladder holding another human on top of their butter needing to void. If someone has a fit about that, like, my mind is the decision is well, what are my options for having someone else who’s maybe not so upset with me doing a human act? Yeah, needing to pee. And I would just, you know that the conversation might change in the bathroom, if that’s discovered, but you might as well discover it, you know, during an easy question, like an exam question versus, you know, they get angry about something like, that’s, that’s inappropriate, but you get to find out that information and then you get to distance yourself from that.
Mandy Irby 31:36
Yeah, situation.
Hilary Erickson 31:37
And clearly, all of this goes back to finding a doctor that you’re comfortable with, but it’s getting harder and harder. Insurances like I our hospital insurance has such a narrow window of providers, even hospital one. Yeah, so it’s just shocking. It’s hard. We get that. Might not have been able to pick your dream doctor because you didn’t want to pay fifteen bajillion dollars,
Mandy Irby 31:57
Right, because who can do that? Yeah, so do it early I say asking questions is you’re never too early even if you’re not pregnant you’re thinking about you know, having a baby in the future. Go to the mommy groups and and search the doctors because yeah, I think more parents and doulas are like, WTF like this is a service like we leave Amazon reviews we leave restaurant reviews like why not be honest about the person that’s going to be inside your body? And I think more and more people are doing that and and the reviews on websites are going to be different. And you and I both have reviews that are honest and actually come from actual people and we know that but sometimes not all reviews are. So talking to consumers directly right after their experience asking questions like, What did you think about this person? Some things that are great for them but bad for you might come up that a review or just like asking your your provider’s nurse is not- you’re not going to get that information. I think we can help each other.
Hilary Erickson 32:59
And asking a lot Questions of your doctor. And there’s pros first visits because those first visits aren’t quite as important. But you can sure pepper them with questions. Because, you know, then when you know later down the line you have questions about actually things that matter. You’re going to know that they have the temperament to teach, because you want a teacher, you don’t want to tell her.
Mandy Irby 33:20
And you get the practice of, oh, really, you would do? You wouldn’t do that? You would do it. I heard someone else did that. Like, you can practice, your provider being just like your car salesman, like it’s a conversation. And it’s a service, and they want more information from you to help you in your decision making. And it should feel like that even if it’s not important. And early on, you’ll get that vibe. Yeah, or the what if.
Hilary Erickson 33:48
Yeah, well, and I think it’s really important. Insurance has kind of taken away the fact that you are paying these people a good sum of money to deliver your baby. And so they just pay them and so you aren’t handing over a check whereas if You handed them $3,000 up to your delivery, maybe they would realize that Jane is paying me to do this versus they’re just working with insurance companies and fighting the man.
Mandy Irby 34:10
Right? Yeah. And even if you’re not writing a check, you’re still consumer. And it is hard to think about that. I just try to relate it in the same way because it It truly is. But I think I don’t know, I think parents are kind of getting more vocal about it. They’re like, No, I do need to leave a review. No, I do need to, you know, spread this on social media so that even if you’re not friends with them, or you’re not on their Twitter, you can search it later. And it is helpful because, people do have really horrible birth traumatic experiences that they share. Luckily, Whereas before.
Hilary Erickson 34:47
Right, and sometimes deliveries aren’t. What a doctor is great at. We’ve had some doctors who switch they only do surgery and they’re great at surgery and that’s awesome. And and I would pick a different doctor to deliver my baby than to do like take out my uterus? Yeah, yeah, cuz it’s just different. It’s cool that they can do all these different things. But it’s a different thing. You want something different in a natural birth.
Mandy Irby 35:09
Yeah. Then in a you personally that works for you than in a surgery. Yeah,
that makes total sense. Alright guys, I hope this gave Did you have anything else to add Mandy? No, no. Just we talked about when Can people change their mind anytime? What about if you’re in the middle of something?
Hilary Erickson 35:25
You can change your mind at any time and you can if you’ve decided to say no and then all of a sudden you rethink it. Don’t be afraid to be like, you know, I really rethought that vitamin K shot and I think I would like to do it. That’s fine, too. We’re not going to be like Oh, she changed her mind. Hello, we’re nurses we take we can’t even decide where to go to lunch know
Mandy Irby 35:42
what to wear on a podcast video.
Oh, no. What else sick works with Nope, nope. All human.
Hilary Erickson 35:51
Yeah, that’s why they make us just wear Navy scrubs at our hospital. So I just pull them out and stick them on.
Mandy Irby 35:55
So great. Yes, you can change your mind.
Some people might talk about it, but Who cares? Right? Let’s practice getting over like what people think.
Hilary Erickson 36:03
Honestly, I don’t think I would ever think nurse. I mean, they would tell whoever is going to give the shot. Oh, she changed her mind on the vitamin K, we’re going to rip up the Declaration was signed a positive one. So you might have to do a little bit of paperwork. But always realize that you can say no. And then you can change your mind later and say yes, you you are in the driver’s seat. Were just the bus driver on public transit. I like
Mandy Irby 36:25
that. You’re like, Oh, I’m getting off here. This
thing’s getting Cray.
Unknown Speaker 36:28
Right just pull the cord.
Mandy Irby 36:30
I need to stop. I like that a lot. Oh, this has been awesome, Hillary.
Hilary Erickson 36:34
Yeah, I think this was really great. So hopefully guys enjoyed it. Okay, guys, I hope you really liked this episode. Side note, we actually recorded this episode anyway. So if you want to see the video, plus Manny has a couple lightning round questions just about us that you guys might be interested in. I will include those in the show notes. If you want to find those show notes. You can go to pulling curls. com backslash podcast. This is Episode 27. I’m also going to put the links for that informed consent webinar with that is really awesome. He’s going to tell you about kind of how you can talk with your doctor and when you should get informed consent and what it includes. It’s really helpful in this type of situation. Big thanks to our sponsor, the online prenatal class for couples. If you guys are looking for good quality prenatal education, be sure and check it out, because I’m going to share with you how to make good choices. That’s one of the objectives in that class. And so you could make the choice to say no, and you’re going to feel informed and excited about making your own choices driving your own best, right? Of course, Big thanks to Mandy for this talk today. I love talking to her. I always learn and I think about things in a different way. I end up being a different kind of nurse when I come back from these conversations. So I hope you guys enjoyed it too. And you will check her out as well. And of course if you like today’s episode, we’d love a review. We always love a review, but you can also subscribe all those things, share it with your friends on social media. We really appreciate it we drop an episode every Monday and until then I hope you have a tangle free day. Okay, are you ready? Which is your least favorite bodily fluid go
Mandy Irby 37:59
Oh, Not
Hilary Erickson 38:00
Yeah, you kisses 100% mine. Yeah, it is.
Mandy Irby 38:03
Oh yeah. Oh, that’s so funny. There’s so many nurses that are like we could do vomit. No, or whatever.
Hilary Erickson 38:09
All day long. I could do vomit all day long but you asked me to Section A trick. It’s over. Yeah.
Mandy Irby 38:17
Why we’re labor nurse.
Transcribed by https://otter.ai
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