One woman's path through doula training, childrearing, and a computer science Ph. D. program

Friday, September 23, 2011

Why I'll never be a nurse

I'll be honest.  My research direction has been making me curious.  Could I be a nurse, or a midwife, or even an obstetrician?  I am already a doula, and I have more book-knowledge of labor, birth, and the early postpartum period, including surgery, than many of the nursing students I have met.  Each time I have attended a birth so far, my curiosity was tickled: is this for me?

When I was invited to attend a labor support workshop, part of a nursing student course in midwifery taught by one of my research collaborators, I was excited.  Walking up to the building and passing dozens of men and women dressed in scrubs, walking quickly along both sides of the sunny street, engaged in conversation or talking on cell phones, I thought: with a small difference, a slight twist of fate, that could have been me.

To the workshop I arrived on time, took a seat, and looked about the room.  It was filled with students just like me: young (I would like to think I am young, despite being older than most of the students in the room), energetic, eager to learn.  I asked around and learned that everyone had already chosen a specialty.  The woman sitting beside me would become a nurse practitioner, the man beside her will be an "acute" nurse (that is, working with very ill patients), and the woman across the table will go on to an administrative position.

I was interested in this, and was especially interested in the students' experiences in different classes.  One student talked about her last class, which was about oncology.  I liked the idea of the "grand tour" of specializations that every student submits to, no matter his or her interest, and thought that something similar for computer science (or, more broadly, computing and electronics) would be excellent.  I knew I would be a computer engineer even before I took my first computer engineering course -- but the course sealed my love and I declared my major.  But other students were not so lucky to have found their niche as smoothly as I did.  Would they have benefitted from a grand tour, exposing them to electrical engineering, programming languages, assembly language, high-level database design, and robotics?

Later, I asked my colleague, who was teaching the class, how it is that everyone already knows what they will be at the end of the three-year program.  She explained that students choose their specialties before they even apply.  Once applied and accepted, they cannot switch, and if switching to another program (such as midwifery, as often happens as a result of this birthing class), they must withdraw from the program and re-apply.

"Yikes," I said.  "That's heartless!"

"Yes, it is difficult," she replied.  "There is no way to know for certain before you apply what you will be good at, or what you will even enjoy as a profession."

I spent all day in the hospital classroom among the students learning about birth support, and what it means to support a woman in birth.  Having undergone doula training and having read everything possible on the subject, I could answer the rhetorical questions about the mother and how to support her.  But I was pleased to learn about the relationships between the clinicians and to hear, from a midwife who practices in a hospital, how the medical pieces of birth fit together and work.

I did not know, for example, about the rigid hierarchy that exists between nursing students, nurses, clinician instructors, and providers.  But on learning of it, I thought it was lovely.  Every student that belongs in the program occupies a very specific place in it.  As a student, you always know where your place is and to whom to turn with questions.  And whom you mentor.  You know where your responsibility lies, and (more importantly) where your responsibility ends, and where you escalate your issue or question to someone else, someone farther up the hierarchy.

In computer science, we do not have this.  You wade through your program, sometimes overtaking your peers, and other times falling back.  You graduate, sometimes ahead of your peers, sometimes behind them.  You get a job, and depending on the work and the company and the culture, you are left to fend for yourself.  You are given a stack of tasks, sometimes poorly-defined, and are left to figure them out on your own, because you are, after all, a college graduate.  You are a computer scientist.  When you have questions, you ask anybody and everybody and hope for the best, or you ask no one at all.  Mentoring relationships are forged, usually accidentally, sometimes forcedly -- and frequently, not at all.  The stereotype of the computer scientist working alone, always alone, is sadly true, but never desired.  Nobody likes to work in a vacuum.

So, I thought these relationships which were so rigid and unquestioning were also beautiful, like lace that ties all these students who will be graduates together and to their peers and superiors.

As I looked around the room in the second half of the workshop, I saw some faces still eagerly listening, taking it all in.  Other faces were contorted in horror -- the horror of the memory of what a woman's vagina actually does.  The explanation came moments before.  And then it hit me: Nurses learn not to fear their jobs.  They do not come in to the practice unfearing.  First they learn to conceal their fear, and then they learn not to fear.

At the end of the workshop, I left for another hospital, where I attended a volunteer doula meeting.  I am in the process of becoming a volunteer with this teaching hospital (in which many of the students from the workshop will be training).  In the meeting, issues came up which highlighted some doulas' misunderstanding of the nursing relationship to the patient and to the provider.  For example, doulas do not always understand why certain procedures are necessary and argue on behalf of their clients in inopportune ways.  Continuous fetal monitoring is always required with an epidural because the baby is at risk when drugs are crossing the placental barrier, yet sometimes, through their own ignorance and not through any malicious means, doulas may argue with the nurses.  I was surprised to learn this because I thought as a doula, my job is not to argue with anybody, and especially on behalf of the mother -- to create a calm atmosphere regardless of the situation at hand.

But really, what the doula meeting taught me was that doulas are seriously unprepared.  A workshop covering the basics of nursing and the clinician relationships is absolutely essential.  I am glad I profited from such a workshop, and wish more doulas had a similar opportunity.

I came home that night exhausted.  I had spent the majority of the day in hospitals.  The monotony of artificial lighting, artificial air, and artificial manner (for example, nurses hiding their boredom) was too much for me.  All this talk about birth and babies, a topic that I absolutely adore and consider a fundamental cornerstone to my own work, had, for the first time ever, completely drained me.  At home, I was conscious of the desire to reunite with my computer, to pull out my notebook, and to design, code, engineer, and think.

And for the first time since embarking on my research, I realized: Nursing, midwifery, and obstetrics -- maybe these are not for me.

I am a technical woman.

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