Labor and delivery nurses' perceptions of caring for childbearing women in nurse-managed birthing units.

PURPOSE: To identify the perceptions of nurses caring for women giving birth in nurse-managed, highly technological birthing environments. METHODS: A purposive sample of 18 perinatal nurses employed at four different in-hospital birthing centers utilizing nurse-managed labor models participated in audio-taped interviews. Interviews were transcribed and analyzed for themes. RESULTS: Themes included (1) nurses' aversion to birth plans, (2) barriers to the provision of supportive care for birthing women, (3) differences in caring for women who are medicated versus those who are unmedicated, and (4) the rewards of caring for birthing women. Although practicing in very busy, highly technological birthing units, many study participants seemed to focus on the value of predictability and efficiency guiding the provision of nursing care to birthing women. NURSING IMPLICATIONS: Women's birth experiences are heavily influenced by perinatal nurses and their care, yet the voices of these nurses have not been represented fully in nursing research. Nurses in this study reported multiple challenges in the provision of supportive care for their patients, and a wider dialogue on this topic within perinatal nursing is warranted. More research is needed on this topic, and intervention studies documenting innovative methods of teaching, orienting, and continually educating these nurses should be undertaken.