*This post contains affiliate links. Updated from original post on 11/4/18
Working 12-hour shifts as a nurse can be physically and emotionally demanding, and these challenges are compounded for a nurse who is pregnant.
Pregnant nurses may have concerns about the impact of working long hours on their health and that of their unborn child. They may also worry about exposure to harmful substances, such as radiation, chemicals, or infectious diseases.
I had a lot of questions at the beginning of my first pregnancy when I worked as a nurse:
Would I tolerate being on my feet all day?
What is the best way to prevent dehydration as a pregnant nurse working 12-hour shifts?
How am I going to keep my energy up for my entire shift?!
But by taking proper precautions and always putting safety first, working as a nurse while pregnant is possible. In fact, some nurses work all the way through their pregnancies until a few weeks or days before they give birth. However, it is important to remember that everyone has a different experience, and it is important to speak with your doctor, nurse practitioner, or midwife before making any decisions about what is right for you.
Talk to Your OBGYN About Your Concerns About Working as a Pregnant Nurse
First off, it is always important that you talk to your doctor to discuss any occupational concerns you have during your pregnancy. Continue the dialog at your prenatal appointments as you move along with your pregnancy. If you have questions or concerns in between your appointments, contact your healthcare provider.
It is also crucial that you communicate with hospital management and your charge nurse about your pregnancy. They cannot help you avoid potential pregnancy hazards if they don’t know you are expecting.
Physical Challenges of Working as a Nurse While Pregnant
The physicality of working as a pregnant nurse can be very difficult for some women, especially for those working on high-acuity floors such as the emergency department or intensive care unit. However, many hospital units are able to offer modified duties for pregnant nurses who have instructions from their doctors to stay off their feet.
Fatigue is a common concern for pregnant nurses who work long shifts. Pregnancy can cause fatigue due to hormonal changes and increased physical demands on the body. Long shifts can exacerbate this fatigue.
There are also other physical challenges pregnant nurses should consider during nursing shifts:
Stress
Working night shift or rotating schedules
Heavy lifting
Standing and walking for long periods of time
Managing nausea during shifts
Additional Pregnant Nurse Precautions and Occupational Hazards to Consider
Pregnant nurses may be concerned about exposure to harmful substances in the workplace. Certain chemicals, such as cleaning agents and pesticides, can be toxic to developing fetuses.
Nurses who work in settings where radiation is used, such as radiology departments, may also be concerned about the impact of exposure on their pregnancy.
Furthermore, infectious diseases pose a risk to pregnant nurses and their unborn child, particularly if the nurse is working with patients who have communicable illnesses.
Therefore, it is always important to wear the correct protective equipment or even possibly refrain from working with some patients.
Here is a list of some pregnant nurse precautions to consider:
Radiation from diagnostic imaging
Standing and walking for long periods of time
Working with chemo or other teratogenic medications
Risk of infections such as C-diff, tuberculosis, cytomegalovirus, and influenza
The physicality of working as a pregnant nurse (such as pulling patients up in bed)
Increased risk of varicose veins due to standing for long periods of time
Compression socks and stockings may help pregnant nurses minimize or prevent varicose veins due to standing for long periods of time.
During pregnancy, a mother’s blood volume increases by almost 50%! That’s a lot of extra fluid to be circulating through your body when you are on your feet for 12-hour shifts. This is also why many pregnant women develop varicose veins during pregnancy. if you are a pregnant nurse and haven’t invested in compression socks yet, it’s time to get a couple of pairs ASAP.
Compression socks are often overlooked as a proactive way to prevent some of the chronic issues that come from working in a profession where you are on your feet for such long hours. Pregnant women may benefit from wearing compression stockings or socks during a 12-hour shift for a few reasons:
Prevention of varicose veins
Improved blood flow and decreased risk of blood clots
Decreased swelling of ankles and feet
I was able to continue working as an emergency room nurse up until the beginning of my ninth month of pregnancy because I invested in a few quality pairs of toe to waist compression stockings. I wouldn’t have made it past my 6th month without them!
Pregnant nurses must make sure they have great shoes.
Every nurse needs a great pair of shoes to get through a 12-hour shift. But the benefits of wearing quality nursing shoes during pregnancy it is even more important.
You will be carrying an extra 25-35 pounds and your feet need support to carry that extra weight.
If you thought your feet hurt working as a nurse before pregnancy, wait until you are pregnant! Keep in mind that your feet will swell a little more during pregnancy.
The Reebok Women’s Classic Renaissance Sneaker is an example of a great nursing shoe for pregnant nurses. They are comfortable and supportive, with a slip-resistant sole that fits the activity level of being a nurse. Plus, they have extra cushioning in the right places to help you stay on your feet all day long. The added bonus is they also come at an affordable price.
3. Pack Healthy and Energizing Snacks
Working as a nurse while pregnant requires that you fuel your body with healthy nutrients to keep your energy up!
During my first trimester, when I was pregnant with my second child, I struggled quite a bit with nausea and an overwhelming feeling of “hungover-ness” (without any of the fun the night before). I was also training to be an ER nurse, so it was more important than ever to be alert and focused.
By packing a lunch with nutritious snacks every day, I was able to keep myself energized as well as fend off nausea enough to get through each shift. I just couldn’t go more than 2-3 hours without refueling myself with something.
Admittedly, when I forgot to bring food with me, I would eat peanut butter and jelly sandwiches from the stash we gave our patients. Although they were nothing special, for some reason, they were the best peanut butter and jelly sandwiches I had ever had. Never underestimate the hunger of a pregnant nurse. I always felt better and was able to continue working afterward.
Here are a few easy, fast, and high-energy snacks to help your pregnant body stay energized through your 12-hour shifts:
Consider throwing some healthy snack packs into your work bag for emergencies! It’s better to be prepared than tempted by the vending machine. Good luck, and remember – you got this!
4. Go to Bed Early
Pregnant nurses need their sleep!
You simply cannot sleep too much when you are pregnant. I don’t think there is any scientific evidence to back up my claim about this. However, that was definitely my experience during pregnancy.
Here is a sleep secret that got me through 12-hour shifts during my pregnancy. I would go down to the hospital meditation room during my lunch break, find a comfortable chair and literally pass out for 30 minutes. I set my phone alarm to make sure I was back to work on time. When it went off, I was so deep in REM sleep that sometimes I didn’t even know where I was when I woke up. I was that tired.
The only way you are going to have the energy to make it through your pregnancy while working 12-hour shifts is to make sure you get as much sleep as you possibly can every night- and during the day if needed. Utilize every lunch break you have at work to take mini power naps like I did!
5. Get Some Movement If Everyday (If Your Healthcare Provider Says Its OK)
Prenatal yoga may help pregnant nurses deal with stress throughout their pregnancies.
It seems counterintuitive, but exercising while pregnant may actually give you more energy to get through a 12-hour shift. In addition, exercise during pregnancy can help prevent gestational diabetes and hypertension.
(It is important to talk to your doctor about starting any exercise routine during pregnancy. There are some circumstances your doctor may advise you not to exercise while pregnant.)
Non-impact exercises for pregnant nurses may include:
Working the night shift can be especially challenging for nurses during their pregnancies. Consider switching to the day shift if you can.
The rigorousness of working 12-hour shifts as a nurse is exhausting as it is. Add pregnancy into the mix and you might find that you are even more tired than ever.
Some pregnant nurses who have already been working the night shift continue with that schedule and do just fine. However, those who have rotating day and night schedules might find it especially hard to switch back to the night shift once they become pregnant.
Talk to your doctor about whether it is safe for you to continue working night shifts. Communicate with your manager about your specific health needs during your pregnancy. You may want to switch to a day-shift-only schedule for the duration of your pregnancy.
7. Talk to Your Manager About Modified Duty
Many facilities are able to offer modified duty for pregnant nurses who can’t be on their feet all day.
As a pregnant nurse, it may be necessary to have a modified work assignment, especially for those who work in rigorous units such as the emergency department. The physical demands of pregnancy might be too much for those already struggling with fatigue, nausea, or having to carry so much extra weight.
Talk to your manager to see if there are alternative assignments you can have, such as working at the monitor, organizing paperwork, or auditing patient charts. If these options are not available, consider the possibility of working shorter shifts or working two days a week instead of three.
Remember, always ask for help if you need it!
8. Communicate With Management About Your Intended Time to go on Maternity Leave
It is important to keep open communication with administration about when you intend to go on maternity leave. Although with pregnancy, you can’t predict the future, and babies tend to come when they are ready. Things happen and you may have to leave early anyway, but keeping communication open istypically not a bad idea.
When I was pregnant with my daughter, I had every intention of working up until my 38th week. But when I had my appointment at 31 weeks, my doctor thought it was best that I didn’t work on my feet for more than six hours a day. While six hours may seem like a lot for most professions, it’s not much for a hospital nurse. Sometimes we are on our feet for 10-12 hours a shift!
Yet, I still didn’t want to go off work because, for some reason, I felt like I was taking advantage of the system – which, in hindsight, I realize was ridiculous. I thought I had the grit to work all the way through.
So, I waited for two weeks before I finally presented my doctor’s note to my manager. When I finally did, I gave it to him with tears in my eyes because I knew he would have to put me on disability at that time. My maternity leave started at that moment.
It was a good thing in the long run because I had a placental abruption two weeks later and had an emergency c-section seven weeks before my due date. It is wise to listen to your doctor’s advice!
9. Enjoy Your Pregnancy
Enjoy your pregnancy!
Pregnancy can and should be a beautiful experience, even when you are a nurse working 12-hour shifts. Far too often, many pregnant nurses focus on the inconveniences and difficulties they face at work during their pregnancies
But with proper precautions, it can – and hopefully is – a time filled with some good health, gratitude, abundance, and most of all, joy.
Working as A Nurse While Pregnant Frequently Asked Questions
Is it safe to work as a nurse while pregnant?
Yes, it can be safe to work as a nurse while pregnant, but it depends on various factors, including the type of work you do, your health condition, and the pregnancy itself. You should always consult with your healthcare provider and employer to assess any potential risks and discuss any necessary adjustments to your work duties or schedule.
How long should nurses work while pregnant?
The duration that a nurse should work while pregnant can vary depending on the individual’s health, pregnancy condition, and the demands of their job. Some nurses may need to reduce their hours or stop working earlier in pregnancy than others. It’s best to discuss this with your healthcare provider and employer to determine the best course of action for your specific situation.
What should I avoid as a pregnant nurse?
As a pregnant nurse, you should avoid any tasks or activities that may be hazardous to your health or the health of your unborn child. These may include exposure to harmful chemicals, radiation, infectious diseases, and heavy lifting or repetitive motions that can cause strain or injury. It’s essential to discuss any potential risks with your healthcare provider and employer to ensure that you can safely perform your job duties.
Should I work 12-hour shifts pregnant?
Working 12-hour shifts while pregnant can be challenging, especially as the pregnancy progresses, and fatigue sets in. It’s important to discuss your work schedule with your healthcare provider and employer to determine the best course of action for your specific situation. They may recommend reducing your hours or taking more frequent breaks to help manage your energy levels and reduce stress.
What jobs are unsafe during pregnancy?
Some jobs may be considered unsafe during pregnancy, depending on the level of physical exertion, exposure to hazards, or risks to the health of the mother and baby. Examples of jobs that may be considered unsafe include those involving heavy lifting, exposure to radiation or chemicals, prolonged standing, or exposure to infectious diseases. It’s crucial to discuss any potential risks with your healthcare provider and employer to determine the best course of action.
Which work should you avoid during pregnancy?
As mentioned earlier, jobs involving heavy lifting, exposure to radiation or chemicals, prolonged standing, or infectious diseases should be avoided during pregnancy. Other jobs that may be physically demanding or high-stress may also be challenging to manage while pregnant.
What week should I stop working during pregnancy?
The ideal week to stop working during pregnancy can vary depending on various factors, including the pregnancy condition, the demands of the job, and the individual’s health. Some women may need to stop working earlier in pregnancy, while others may be able to work until closer to their due date. It’s essential to discuss this with your healthcare provider and employer to determine the best course of action.
What month should a pregnant woman stop working?
Similar to the previous question, the month that a pregnant woman should stop working can vary depending on various factors. Some women may need to stop working as early as the first trimester, while others may be able to work until the end of the second or even third trimester. It’s crucial to discuss this with your healthcare provider and employer to determine the best course of action.
How do you explain leaving a job due to pregnancy?
Explaining leaving a job due to pregnancy should be done with honesty and professionalism. You can simply state that you needed to leave your job to focus on your health and the health of your unborn child. It’s important to be clear and concise in your explanation and to provide any necessary documentation or medical notes as requested.
Maternity leave keeps women in the workforce – When Google increased paid maternity leave from 12 weeks to 18 weeks, the rate at which new moms left the company fell by 50 percent!
Unfortunately, many women in the US only get six weeks of maternity leave (8 weeks if you have a c-section). And if you are a per diem employee like me, none of that time off is paid. For that reason, I worked right up until my 9th month of pregnancy while working as an emergency room nurse at a level 1 trauma center (thank God for pregnancy compression stockings!).
Nurses work extremely hard to care for patients like they would care for a family member, yet when they have a baby of their own, they often have very little time to bond with their flesh and blood. Add the financial strain into the mix and it can become very stressful and overwhelming. So what is a nurse who is also a brand new mom to do?
Well, I have half-glass full mentality. So for the sake of finding solutions to this conundrum that so many women find themselves in, I compiled a list of ways for mothers to plan financially far in advance of baby’s arrival. You must take care of yourself first!
The average paid maternity leave in the USA is only six weeks for a vaginal birth and eight weeks for a c-section. And if you are a per diem RN then chances are that you will not be paid at all while you are on maternity leave.
Saving for maternity leave is crucial for moms so they can spend more time baby bonding and less time worrying about money!
Unpaid maternity leave for nurses: you need to save up in advance!
After my daughter was born in 2015, I went back to work as a per diem nurse (higher hourly rate and more flexibility, but no benefits – including disability or paid maternity leave). Therefore, eighteen months later when I went on maternity leave with my second baby, I had a completely unpaid maternity leave. It made the whole situation much more stressful for me. Thankfully I planned well in advance to minimize the financial burden.
Here is how I managed to save up an additional 20K for my second maternity leave:
#1. Open a new savings account dedicated to maternity leave.
One of the easiest ways to save money is to pay yourself first. When you set up direct deposit for each paycheck, you make saving much easier. That way, you don’t even see the money hitting your checking account. Liquid cash is good, so you can use it when you need it.
Suzie Orman (one of my all-time favorite financial gurus) says that you want to have as much money saved up for as many months as you plan to take off, as well as an eight-month emergency plan. You never know when an emergency can strike, for example, a medical emergency, a job loss, or worse. The faster you can start saving into an account dedicated to maternity leave, the more prepared you will be when it comes.
#2. Make a budget and stick to it.
I prefer more of a no-budget budget strategy. I decide how much I want to save each paycheck and immediately transfer it into an online savings account as soon as payday comes.
I am aware of everything I purchase and review it each month by using a program called Mint to track my expenses. If you aren’t using this, you should be. Since I have started using Mint I have watched my savings rate take off farther than ever. It is incredible how much you can save when you know exactly where your money is going!
I’m always surprised by how many people I talk to who have no idea what they spend in a month. Needless to say, this is a poor strategy for preparing for an unpaid maternity leave. You’ve got to have a plan.
#3. Make more money now or take on extra work.
If you are currently pregnant or even just thinking about it, now is a good time to take on extra hours at work. Especially if you can get overtime pay.
As a nurse, anything over 40 hours of work a week is considered overtime at my hospital. I don’t work overtime anymore now that I have small children, but I did it during my pregnancies just to add a little more to my savings.
Also, some holidays pay time-and-a-half rates. Therefore, I have been known to pick up shifts on Memorial Day, Labor Day, Thanksgiving, or even Christmas. It’s not my favorite thing to do, but my family handles it by celebrating these holidays on the day before or the day after the actual holiday. When children are young, they don’t know what day it is anyway, so this strategy has worked particularly well. It adds up quite a bit when you are saving to be out for a few months.
Nurse maternity leave: how to save up in advance
#4. Cut all recurring expenses that you aren’t using or don’t need.
Look at your monthly expenses and see if there is anywhere that you can reasonably cut. Are you using the 100$ a month gym membership? Or does it make more sense to take daily walks and do online yoga classes at home?
My husband and I talk about money often and try to be responsible about our spending. Saving money is all about establishing priorities and having set goals. This has kept us in good financial health and kept us on the same page with our spending habits.
#5. Look at the easy ways to cut back.
Families dropping from a dual income to a single income usually need to trim expenses somewhere. Make a list of everything you are spending money on, and be honest with yourself about what is an actual need. Here are a few ideas to throw on the table:
Nix the coffee cart habit = save $4 a day
Pack your lunches = save $12 a day
Cancel the cable you are barely using anyway = save $80 a month
Cook your meals at home instead of ordering take out = potentially $100’s in savings per month (if you eat out a lot)
Go on a 3-6 month spending freeze on things that are not an actual “need” = $$$
Do you see my point here? There is A LOT of money to be saved if you just pay more attention to what you are spending money on.
I do consider myself somewhat of an expert on “trimming the fat” on my own spending habits since paying off a large amount of student loan debt in a short amount of time. Saving money for maternity leave as a nurse was a very similar experience.
There are so many items that I was told I had to have for baby #1. Many of them are “nice to have items” that I barely even used (I’m looking at you grocery cart baby cover I only used three times!). Many of these supposed “must-have items” from my baby registry are currently being stored away in my garage and will, at best, find a new home in our local Goodwill.
I remember looking through Pinterest at lists of “must-haves” for the new mom. They are long and mostly unnecessary. Stay away from those lists!
For example, I was told that I “needed” the newborn insert for our stroller. But for the first few months I was using her car seat in her stroller. By the time I went to use the insert, she has already grown out of it. Same went for the ergo baby newborn insert- I didn’t even need it until she was too big to fit in it anyway.
If you need something, then go ahead and get it. These are just my thoughts as a second-time mom with a lot of baby registry regret. Except for a double stroller and a crib, I can’t think of any other BIG items I will need for our new baby.
#7. Consider the extra expenses that come with a new baby.
There will be some extra expenses after the baby is born. Some of the big ones for us are diapers, wipes, food, and additional childcare. None of these things are cheap, so it’s good to be prepared for the expenses in advance.
You could always decide to go the cloth diaper route. I know people who have done this and it does save quite a bit of money. That, however, was not in our savings plan. Some things of convenience are worth the money, and that was one for us.
Other significant expenses include childcare enrichment classes (MyGym, recreation classes, music classes, etc.) if that is something you are interested in.
Childcare is our single biggest expense besides housing. In fact, if I didn’t have a higher hourly rate that I get from being a per diem nurse, it might not even make financial sense for me to work as an RN. We have a nanny that comes every Monday and Wednesday, so those are the days that I work at the hospital (plus one day on the weekend when my husband is home to watch the kids). If you have family that can help on days you work, that would be a huge financial saving.
I have read that the average baby costs their parents $300,000 from the time they are born until the time they turn 18. And that doesn’t even include a college education! I don’t know about you, but that makes me think about how we budget our money. (We have college funds set up for both of our kids, which started the day they were born, but we are still going to encourage them to achieve scholarships!)
#8. Think about the big picture.
Having a baby is one of the most amazing human experiences I have ever had. I love being a Mom. However, it can also be stressful at times, even with the most thoughtful preparation.
At the end of the day you can only do the best you can. Saving for unpaid maternity leave is just one of the things I did to try and ease the financial loss that comes with having a baby. It is wise to try and eliminate as much stress as you can so you can joyfully relish in the awesomeness that comes with having a new baby.
Now, if only I could invent a healthy way to live on increments of 2 hours of sleep or less, I would be golden! Best wishes to you and your growing family.
Are there any other tips on saving money for maternity leave as a nurse you would add to this list? Leave a comment!
P.S. HEY, NURSES! Remember to sign up to receive your FREE E-BOOK “The Nurse’s Guide To Health & Self Care” in the sign-up box below! (scroll down)
*Updated on 4/9/20 to include pregnant nurse precautions for COVID-19. *Affiliate links.
As an ER nurse who delivered my second baby in early 2018, I have done a lot of research about pregnant nurse precautions to be aware of when you work in a hospital. My goal was to make sure that it was safe for me to continue working in such a physically demanding environment with so many potential occupational hazards.
Fortunately, I was able to work safely right up until a few weeks before giving birth. As a per diem nurse, I did not have any maternity or disability benefits, so I wanted to save up as much money as possible before I went out on leave. Thankfully, I was able to do just that. But safety was still my number one concern. I hope this information can help other nurses stay safe during their pregnancies as well.
Talk to your OBGYN
First off, you must talk to your doctor to discuss any occupational concerns you have during your pregnancy. Continue the dialog at your prenatal appointments as you move along your pregnancy. If you have questions in between your appointments, then contact your doctor.
My goal in writing this is not to make pregnant nurses afraid to work in the hospital. I am so glad that I was able to safely work as a pregnant nurse for as long as I did. Still, there is no shortage of occupational hazards for the pregnant nurse within the hospital setting. Working safely is the number one goal.
You must communicate with management and your charge nurse about your pregnancy. They cannot help you avoid potential pregnancy hazards if they don’t know that you are expecting.
Pregnant nurse precautions and hazards to consider:
COVID-19
The novel coronavirus (COVID-19) has many pregnant healthcare providers, especially frontline nurses, uniquely concerned. Because COVID-19 is so new, there hasn’t been enough time to study its effects on breastfeeding or pregnant women. Also, many nurses who are working directly with COVID-19 patients say they don’t have enough personal protective equipment (PPE) to protect them from the virus safely. That maybe even more problematic for pregnant nurses who directly care for COVID-19 patients.
“We do not have information from published scientific reports about susceptibility of pregnant women to COVID-19. Pregnant women experience immunologic and physiologic changes which might make them more susceptible to viral respiratory infections, including COVID-19. Pregnant women also might be at risk for severe illness, morbidity, or mortality compared to the general population as observed in cases of other related coronavirus infections [including severe acute respiratory syndrome coronavirus (SARS-CoV)* and Middle East respiratory syndrome coronavirus (MERS-CoV)] and other viral respiratory infections, such as influenza, during pregnancy.”
On pregnant healthcare personal and COVID-19, the CDC stated:
“Pregnant healthcare personnel (HCP) should follow risk assessment and infection control guidelines for HCP exposed to patients with suspected or confirmed COVID-19. Adherence to recommended infection prevention and control practices is an important part of protecting all HCP in healthcare settings. Information on COVID-19 in pregnancy is very limited; facilities may want to consider limiting exposure of pregnant HCP to patients with confirmed or suspected COVID-19, especially during higher risk procedures (e.g., aerosol-generating procedures) if feasible based on staffing availability.”
Essentially, the CDC does not know at this time if pregnant women are at a higher risk when working with COVID-19 patients because the evidence is limited. As a precaution, pregnant women may want to consider working in lower-risk areas where they have less exposure to COVID-19 patients.
The most important take away is to always take care of yourself first. You can’t care for your family and your patients if you become sick.
Radiation from diagnostic imaging
In the ER and on most floor units within the hospital, patients often receive portable X-rays at the bedside. So naturally, I was concerned about radiation exposure and how it could impact the health of my unborn child. I felt it was wise to air on the side of safety by not exposing myself to unnecessary radiation during pregnancy.
If you are in an area where x-rays are being taken, you must wear a lead radiation apron to protect yourself, especially if you are within six feet of the machine. If possible, it is also a good idea to step outside the room while the image is taken.
In my nursing experience, x-ray technicians usually notify anyone within the vicinity of where imaging is being taken. I was able to leave the area for a few minutes, whether I was wearing a lead apron or not.
Key takeaways:
Notify management of pregnancy
Wear lead radiation apron
Step outside of the room when portable x-rays are taking place
Dangers from working with chemo or other teratogenic medications
There is evidence that handling some medications, such as chemotherapy drugs, can cause adverse reproductive outcomes, including fetal loss, miscarriage, infertility, and preterm births. In addition, it may cause learning disabilities in babies exposed to some drugs if nurses are exposed during pregnancy.
Wearing protective equipment, such as gowns, masks, and gloves, can minimize occupational risk to a pregnant nurse. However, it does not completely eradicate it.
Nurses working in oncology or other areas where antineoplastics are prescribed may want to speak with management about the safest way to continue working. In addition, you can insist on getting help from co-workers or management to give teratogenic medications to patients. Moving to another work area may be a consideration if safety for the fetus is still a concern.
Key takeaways:
Wear protective equipment when giving medications
Ask for help from co-workers when working with teratogenic medications
Consider temporarily working in another area of the hospital during pregnancy as your management allows
As a pregnant ER nurse, I was very concerned with the risk of infection from patients such as c-diff, tuberculosis, cytomegalovirus, and influenza during my pregnancy. Since the ER is often the first stop in the hospital for sick patients, I often didn’t know that a patient had a contagious infection until after they had been admitted. By then it was too late to protect myself if I hadn’t already.
Pregnant women need to be especially proactive with protective equipment and hand hygiene. It is ideal for all hospital employees to have their measles, mumps, and varicella-zoster vaccinations before pregnancy (most facilities require these vaccinations to work anyway). Hep B and influenza vaccination can also safely be administered during pregnancy.
As an added precaution, I made sure to change my clothes and shoes before leaving the hospital to minimize the risk of work-to-home contamination. The first thing I did upon getting home was take a shower to rid myself of any other possible bugs I could have inadvertently carried home with me.
Key takeaways:
Stay up to date in all vaccines including the yearly flu vaccine
Adhere to strict universal precautions and hand hygiene
Request job modification to minimize exposure to specific patient populations
Minimize work-to-home contamination by changing work clothes and shoes before going home
Shower as soon as you get home from work
The physicality of nursing while pregnant
Being a nurse while pregnant is exceptionally hard work. Not only are we on our feet for up to 12 hours a day, but pregnant nurses are also carrying an extra 25-plus pounds towards the latter part of pregnancy. Additionally, the extra girth makes it significantly more challenging to fit into tight spaces.
Movement becomes even more awkward for pregnant nurses due to having an altered center of gravity. Also, high serum levels of progesterone and relaxin loosen muscles, ligaments, and connective tissues. For nurses who do a lot of heavy, repetitive work requiring lifting, pulling, or pushing their risk of musculoskeletal injury is increased.
It is wise for pregnant nurses to use patient transfer equipment and to ask co-workers for help with moving patients. However, if your work situation is still too physical for you to manage safely during pregnancy, you may want to consider a modified duty in a lower risk setting with a less physical patient load.
On another note, pregnant nurses also have a higher risk of developing varicose veins due to an increase in total blood volume caused by pregnancy. The added blood volume, combined with being on one’s feet all day, leads to poor circulation, puffy legs, and swollen ankles. Compression socks or stockings can help reduce the risk of blood clots and varicose veins as well as prevent swelling.
Key takeaways:
Pregnant nurses may want to inquire about modified duty
Understand how the altered center of gravity and hormonal changes in pregnancy predispose a nurse to injury (despite using best lifting practices)
I worked in our ER psychiatric hold area several times throughout my pregnancy. There were a few incidences where I had patients verbally threaten me or begin to escalate towards violence. I always had a security guard with me, and I stayed a reasonable distance away from patients when I felt that my safety could be at risk. I was likely overly cautious at times, but it is better to be safe than sorry.
Violence against nurses is not uncommon, especially in the ER setting. Stay vigilant and keep away from any potentially threatening situations. If a patient is escalating towards violence, then leave and call for help immediately.
Working during flu season
The CDC recommends that pregnant women get a flu shot. Not only do hormone changes during pregnancy often make pregnant women more susceptible to getting the flu, but a common flu symptom is a fever, which may be associated with neural tube defects and other adverse outcomes for a developing baby. Getting vaccinated can also help protect a baby after birth from flu through passive immunity.
My experience: The flu season in December 2017 was unusually bad. Many patients came to our ER for flu symptoms. Unfortunately, almost every nurse was infected with the flu or a cold at least once during the season. Myself, included.
At the time, I was over eight months pregnant, and I was struggling with how horrible I felt. I always get a flu shot to reduce my chances of getting sick during flu season. However, if I ever got pregnant again, I might consider starting my maternity leave towards the beginning of the flu season – especially, if I was that close to my due date.
An unexpected benefit of working as a nurse during pregnancy
One of the best gifts that pregnancy gave me was that it forced me to not be sedentary on days that I felt fatigued. (Although while you are carrying an extra 25-35 pounds of extra weight, you may not consider it a benefit).
Many studies show that not moving enough during pregnancy is bad for both mom and baby. If fact, exercise during pregnancy can boost your baby’s brain development and make them smarter. Who knew that working a 12-hour shift might promote health for both you and your unborn baby?
Good luck to you during your pregnancy and take care of yourself!
I experienced a silent placental abruption when I was 33 weeks pregnant with my daughter.
In case you are wondering what that is, I’ll explain: a placental abruption occurs when the placenta (the lifeline delivering blood, oxygen and nutrients to our baby) peels away from the uterus. It deprives the fetus of oxygen and causes the mother to hemorrhage internally.
One week before I had our daughter via emergency c-section at 33 weeks.
The most common symptoms of placental abruption are bleeding and abdominal pain. Because I had neither symptom it was considered a silent placental abruption. It was especially unusual in my situation because I had no risk factors.
I got the flu about 5 days before my silent placental abruption was discovered.
As a nurse I knew that just having a cold or flu generally doesn’t hurt an unborn baby and may even give her a few extra antibodies. I decided the best thing to do was rest and drink lots of fluids.
But to my surprise, two days later I wasn’t feeling better and had worsening fatigue, dizziness, a horrible sore throat, and a headache.
I called the OB floor at our hospital and was directed to an advice nurse.
After a 30 minute phone interview and a detailed discussion about my symptoms I was instructed to stay home. I just had the flu, she said. I should rest and drink lots of fluids. So I took the advice and tried to rest as much as I could.
Fast forward two more days and my dizziness and symptoms were only getting worse. I was even having difficulty walking from one side of the house to the other. So again, I called the OB unit at my hospital because I thought for sure they would want me to come in.
I spoke with both the on-call OBGYN on the unit and another advice nurse. After another detailed discussion about my symptoms I was again instructed to stay home. “Please do not come to the hospital,” the doctor stated clearly. “There is nothing we can do for you.”
I tried to explain the best I could that I was extremely weak and short of breath when walking more then 20 feet. I didn’t have a fever, but I had never felt more sick in my life. They told me I just had the flu and needed to “ride it out.”
So I laid in my bed and cried for 30 minutes because every inch of my body was hurting so much that I could barely stand it anymore. I had a hard time catching my breath.
(Later we found out that the reason I felt so horrible was that my hemoglobin was extraordinarily low due to the silent placental abruption already having started. My hemoglobin (the oxygen carrying component of a blood cell) at that time was 6 grams per deciliter. The normal level is 12.0 to 15.5 grams.)
I laid down for an hour and started doing “kick counts.”
The American Congress of Obstetricians and Gynecologists (ACOG) recommends that you time how long it takes you to feel 10 kicks, flutters, swishes, or rolls. Ideally, you want to feel at least 10 movements within 2 hours. Usually a mom can feel 10 movements in less time than that.
But I only felt 4 or 5 movements in that hour period. But my body was so sick and achy that I wasn’t sure exactly what I was feeling, so I drank two large glasses of orange juice and ate a small bag of gummy Lifesavers. I was determined to sugar-shock my baby into giving me more fetal movements.
I began counting kicks for a second hour. But after about 40 minutes I still only counted about 3-4 pretty weak kicks. At that point I decided I wanted to see a doctor, even if they thought I was overreacting.
I called my husband and asked him to come home and drive me to the hospital.
When we arrived at the labor and delivery unit I was immediately given a mask and asked why I came to the hospital after I was specifically told not to. I was once again reminded that I was bringing my flu into the hospital and putting patients at risk for infection. They were clearly frustrated with me by the tone of their voices. I kept thinking “am I not a patient too?”
I explained my symptoms once again and told them that I thought the baby should be kicking more. They put me in a room and we waited for the on-call OBGYN.
When she arrived she did an ultrasound. I could tell by the look on her face that something was very wrong. She stated very clearly that she was extremely concerned about our baby’s safety. This is what she told us:
I had almost no amniotic fluid.
The little amount of amniotic fluid that was there was the wrong color and she couldn’t explain why.
Our baby’s fetal heart rate was “not reassuring” which is another way of saying that our baby was alive but in distress.
It was likely I would have an emergency C-section imminently.
She didn’t know at that time I was actually having a silent placental abruption. Apparently it is very hard to diagnose on ultrasound.
(We later found out that the amniotic fluid was showing as the wrong color because it was actually blood, not amniotic fluid. I had already been bleeding into my uterus and our daughter had been swallowing blood. After the C-section they pumped 15 cc’s of blood out of our daughter’s stomach and she pooped blood for the next few days.)
A team of preemie doctors came in to prepare us.
The preemie doctors explained in detail what would most likely happen to our daughter since she was coming out 7 weeks early. They said it was likely that our daughter would not be able to breathe on her own and that she would need to be intubated (using a machine that breathes for her). In the case that I didn’t hear her cry after delivery, they wanted to make sure I was prepared for that possibility.
We were also told to prepare for 30 days in the NICU, which was the average length of stay for a “33 weeker.” They initially wanted to try delaying a c-section for 48 hours so they could give me steroids to help develop our baby’s lungs develop faster. But we weren’t able to wait that long.
Within a few hours things got much worse.
Soon, I started hemorrhaging and was having what felt like one long contraction that wouldn’t stop.
Our OB determined that I was not actually in labor as my cervix was completely closed. She thought it was best to take the baby out right then because something was very wrong, but she didn’t know exactly what yet. I was wheeled across the hall for the emergency C-section.
Our daughter, Zoe Grace, was born.
Zoe came out at 4 pounds, 3 ounces. After being suctioned, she let out a tiny little cry that I will never forget. It was the best and most beautiful sound I had ever heard in my life.
The doctor was able to confirm during the c-section that I had a placental abruption. My placenta was 30% detached from my uterus.
The next day our neonatologist told us that Zoe had no signs of brain damage and we had a “very healthy baby considering the circumstances.” He then let me know bluntly, and in no censored way that “babies born under my circumstances usually don’t survive and the mothers often don’t do that well either.” He basically told me he couldn’t believe that she had no brain damage.
We were so grateful for the excellent care she received in the NICU.
We were so grateful for the excellent care Zoe got in the NICU.
Admittedly, I was shocked when I saw her for the first time. She was in an incubator hooked up to so many IV’s and tubes. And she was so very tiny.
For the first 48 hours I was not allowed to hold her. That was so hard for me! But, I could put my hands in the incubator and place one hand on the top of her head and one on her feet. I remember telling her how proud we were of her. She was a tough little gal right from the start. “Tiny but mighty” was what the doctor said. What a wonderful feeling it was to finally be able to finally hold her on her third day of life.
Zoe had an oral-gastric feeding tube for nutrition since she was unable to eat for the first 7 days on her own. I would pump breast milk and give it to the nurses so they could feed her through her OG tube.
She was also receiving TPN (IV nutrition) and lipids (fats) through 2 IV lines. That was probably the most difficult part to watch. Preemie veins are so tiny that it would often take an hour of poking to get the IV in. And they didn’t last very long so she was constantly being stuck with needles.
She was on oxygen and a cpap machine for the first week to help her continue breathing on her own. She was also kept under a bilirubin light for 5 days to treat her jaundice.
2nd week in the NICU. Zoe earned the nickname “tiny but mighty.”
Zoe got a little stronger every day.
Our “tiny but mighty” preemie started doing more on her own, like eating through a preemie nipple and no longer needing the IV nutrition.
We were shocked on our 9th day in the NICU when we were informed that Zoe would be discharged the next day. I knew she was doing well, but we were told that due to her stage of prematurity that she would stay for at least a month. She was so tiny I couldn’t believe they were letting us take her home.
My experience taught me a few things…
Mothers need to trust their instincts. We know much more then we give ourselves credit for.
Kick counts are very important after 28 weeks gestation. If you feel less than the normal amount of kicks then you should see your OBGYN immediately.
Having a healthy baby is a gift. Not everyone gets to have that.
I can’t imagine what my life would be like now if I hadn’t gone into the hospital that evening, especially after being told not to by the staff. My life would have been turned up-side-down. I am so glad that I trusted my instincts that night!
I am so blessed that I get to be a mom.
Not everyone gets to have healthy baby, or a baby at all for that matter. Whenever I find myself getting frustrated with the difficulties that come with parenthood, I think about how close we were to not getting to have Zoe at all. That puts it all into perspective for me.
Our baby Zoe is turned 3 years old on Halloween. She loves Elmo so she decided to choose Elmo as her Halloween costume. In honor of her birthday our family dressed up as the whole Sesame Street gang. My husband was Cookie Monster, I was Big Bird, and our 9-month-old son, Oliver, was Ernie. It was a wonderful celebration that I especially treasured because I know just how lucky I am to have two “tiny but mighty” kiddos.
I’m officially in the “nesting phase” of pregnancy.
The American Pregnancy Organization describes nesting as when pregnant women feel the “overwhelming desire to get your home ready for your new baby.”
That is exactly me in a nutshell right about now.
I am “nesting” just like this mama bird trying to get her home organized for her babies
I had my 30 week appointment a few days ago. Our little man is measuring at 32 weeks and is already weighing in at a hefty 4lbs 7oz. That’s already more then our daughter Zoe weighed at birth and she was 7 weeks early! So it already looks like I’m going to have a big baby boy.
Aside from feeling like a blimp I would say everything is pretty great. I am still able to work without restrictions (I do however have to wear compression stockings to get through 12 hour ER shifts).
So now I’m embracing my new nesting phase.
Just in the past week I have really gotten down to business:
My house has never been so clean and organized.
Our house never really gets super messy, but I have been feeling the urge to clean and organize much more then usual. For example, before 7:30am this morning I had already vacuumed the house, finished a load of laundry and organized the kitchen cupboards.
Don’t get me wrong, I like a clean house. But I am way more into cleaning and organizing this week then I have been in a really long time.
I organized all my to-do lists on Trello
I am 99% paperless and hate having lists floating around my house. If it isn’t able to be easily accessed on my phone then I might as well not even have it. Especially now that I am a mom. Paper lists just aren’t practical anymore.
Recently I discovered an amazing app called Trello and it has revolutionized my organization and planning skills. Trello basically allows me to organize and prioritizes my to-do lists and projects using boards, lists and cards. It’s all on my phone and easy to access.
I easily organized my personal boards by: grocery lists, random to-do lists, house projects, new baby to do-lists, and blog to do list. Each list can be broken down into separate cards and you can make notes on each one.
For example, my blog board is separated into 3 separate topics: mom, nurse and website to-do. I can further organize my mom board into additional topics : baby/kid, mom, pregnancy, health, environmental. Then each of those is broken down with individual “cards” that I can add specific tasks to.
It sounds confusing but it is seriously the best for people who like to be organized and efficient. It has really helped enhance my “nesting” abilities.
I am purging anything I dont’ use or need.
I am really trying to minimize the stuff in our house. If it is not serving a purpose of bringing me joy in some way, it is leaving the Jividen household.
This week’s priority was my closet. If I haven’t worn it in a year, it got tossed. In fact, I have never owned so few clothes in my life. And it actually feels really good. Everything I have now I actually wear (or will wear as soon as I’m not a pregnant mama anymore).
Next stop: the garage! That will be a much bigger task.
I organized my kid’s closet.
Our kids are going to share a room for the foreseeable future (wish me luck on this one). Fortunately, the room has a nice sized walk-in closet with plenty of room for both kid’s wardrobes and storage.
Each child now has there own very organized side of the closet, split right down the middle. I even organized all their clothing by size and season. Nesting win.
In preparation for baby #2 I boxed up all of our daughter’s outgrown baby clothes into large bins, and they are ready for delivery to my other soon-to-be mama friends. They surely must also be in nesting mode and organizing like crazy like I am.
I had a 2nd crib delivered tonight.
Thank god for Amazon Prime. What in the world did mom’s do before it existed?
I am only 2.5 weeks away for the time I gave birth to Zoe at 33 weeks and 7 weeks prematurely. So I really don’t see this as jumping the gun at all because babies really can show up at any time.
Zoe may be a little confused as to why she has 2 cribs in her room now, but that’s OK. It will give her time to get used to it before another small human comes in.
We are buying a new car this weekend.
A Subaru Outback to be exact. After about a year of research into what the safest automobile is for small children, the Subaru Outback keeps coming back as the clear winner. I had one once before when I lived in Denver and they really are dependable and safe cars.
We will be donating my husbands car this weekend too.
My Christmas decorations are ready to be put up.
My nesting list includes decorating for Christmas as soon as it is socially acceptable. How can I resist when this little face is so excited about decorations?
This one has been HUGE for me this week. In my nesting frenzy, I am so excited to get ready for the holidays. Especially now that our 2 year old daughter is so ecstatic about special events and decorations. It just makes it so much more fun for me.
Seriously, if it wasn’t considered inappropriate I would have starting putting up our tree tonight (3 weeks before Thanksgiving). I just ordered a new, much larger tree since we have the space for it now and it was just delivered this afternoon.
On my Trello app I have already listed which new tree decorations I will be purchasing this week. I am so excited to get them and decorate that I can barely wait.
I’m not sure where this burst of extra energy is coming from.
But I’m going with it until the baby tells me I’m tired again. It’s not like I have any extra time or anything. I’m still working almost 40 hours a week as an emergency room nurse and I have a very energetic toddler at home.
I have read that there is an evolutionary component to the nesting phase that women have during there pregnancies. Apparently there have been several studies done on this maternal phenomenon. I experienced the same thing during my first pregnancy with my daughter. Only I had way more time to do it!
Whatever it is that is giving my ever-growing body an extra kick, Ill take it. I’m sure it won’t be long until I’m too big to even want to do a lot of these things. Until then, I will continue nesting away!
Feeling your baby move can be one of the most exciting parts of a pregnancy. Its nice to have some confirmation that there is actually a tiny human in there!
But did you know that counting your baby’s kicks can help make sure they are healthy and possibly even prevent a tragedy?
There is strong evidence that counting fetal movements can reduce perinatal mortality in pregnancy.
Doing kick counts actually saved our baby girl’s life. If I hadn’t done them I wouldn’t have suspected that there was something terribly wrong and I wouldn’t have gone into the hospital.
When do moms start feeling fetal movements?
According to the American Pregnancy Organization you should start to feel some fetal movement between 18-25 weeks into pregnancy. For first-time moms, it may occur closer to 25 weeks, and for second or third-time moms, it may occur closer to 18 weeks or even a little earlier.
Why are fetal kick counts important?
Our daughter was not moving as much while doing fetal kick counts during my first pregnancy. Intervention at that time was life saving.
My own OB/GYN has expressed the same information to me. Especially ever since my placental abruption during my first pregnancy at 33 weeks.
Now that I am due in January with our baby boy, there is a part of me that is afraid that some sort of catastrophe could happen again. But I am doing daily kick counts and I am reassured that our baby boy is kicking quite frequently. If for some reason he slows down or stops I know to go right to the hospital to have things checked out.
When will I feel the most movement?
Moms generally find that the baby is most active between the hours of 9pm and 1am due to declining blood sugar levels. You my also feel more fetal movement after meals or eating sugary foods.
I have always felt that it is easier to feel the baby move when I lay down and pay closer attention. It is also a nice time for baby bonding and just getting some well-deserved mommy rest. When I am busy and moving around a lot it is harder to pay attention to what is going on inside my uterus.
How should kick counts been done?
The American Congress of Obstetricians and Gynecologists (ACOG) recommends that you time how long it takes you to feel 10 kicks, flutters, swishes, or rolls. Ideally, you want to feel at least 10 movements within 2 hours. You will likely feel 10 movements in less time than that.
How to do kick counts:
1. Lay on your left side.
2. Count how many minutes it takes for you to feel 10 fetal movements (once you get to ten you can stop counting).
3. Do this once a day around the same time. I do it right before bedtime when my daughter is already asleep so I am not interrupted.
Charting fetal kick counts
There are dozens of kick count apps to choose from, but this is the one I use.
You can use a calendar chart to document how many minutes it takes for you to feel 10 fetal movements. If your baby does not move at least 10 times in 2 hours or there is a sudden decrease in movement, you should contact your doctor right away.
There are dozens of fetal kick count apps available to make this even easier.
Having an app makes it so much easier. You can just set the time that you want to start doing kick counts and then tap on the phone each time you feel a kick. When you get to 10 kicks, the app tells you that you are done and records the total amount of time it took. The app also records the history of all your kick counting sessions so it is easy to review and see if there have been any decreases in activity.
Kick counting is an easy way to monitor baby’s well being in the womb.
Timely intervention after a mother complained of decreased fetal movements and the baby was found to be compromised on further evaluation has helped save many babies. I know from first hand experience that doing fetal kick counts can help divert a catastrophic event. It is always better to be safe then sorry!
Happy (and safe) pregnancy and thank you for reading!
