#26 Do Labor Nurses Have Trauma with Krysta Dancy, MA, MFT, CD

This is an interesting type of episode because not only do we have a wonderful guest that I’m excited to introduce you to, but it’s just me this week, no Sarah, and so we are changing it all up. Welcome back to Happy Hour with Bundle Birth Nurses. And I have Krysta Dancy with me. And if you haven’t met her, you’re about to.

And we are big Krysta fans over here in the Bundle Birth world. But Krysta, if you just want to introduce yourself real fast and then we’ll jump in to what we’re going to talk about.

Yeah, awesome. Well, I’m big fans of yours, so it’s good. It’s mutual. There’s lots of fanship going around. So, my day job is that I’m a licensed therapist. That’s how I got here. My expertise is in trauma. A while back, I became a certified birth doula and started attending births bedside and then moved on to becoming an educator on the subject for providers and professionals.

So, my passion is the intersection of trauma and birth and all the different ways that it interplays with birth experience, both pre-existing trauma, traumatic birth itself, and then trauma to professionals. So, I’m here to just talk about all of that, which I’m super passionate about.

I’m excited to hear what you have to say. And I think for some behind the scenes, when we booked Krysta, we were like, “Whatever you want to talk about, talk about.” Just because we know whatever she has to say is going to be great. But whatever’s on your heart at the time, and I thought maybe birth trauma, but actually she’s going to really talk about provider trauma and your trauma maybe, as the nurse is listening to this, which some insight, Krysta has classes in our mentorship and we have some on-demand classes of Krysta on our website that are amazing, please check them out.

But when we went to go film her last year or two years ago now almost… I was watched. I know that went fast. I was watching it live and I was thinking, and I was taking notes and I was like, “I have trauma.” And I had no idea at the time that it was possible for me to or how to classify that. And so, yeah, we’re just going to talk about it at a very novice level too, and introduce you to maybe what you’re feeling and what it is. But yeah, so Krysta, if you just want to start with how did you realize professionals had birth trauma?

It wasn’t just on the patient side.

Yeah, yeah. So, I feel like I keep having these moments, these pivotal moments where I say the specialty chose me. And that happened for me at first with patient trauma and that’s where I had decided to attend birth so that I had a better read on what it actually is to be at a birth. So, I’m at a birth as a doula, but understanding I come… day in and day out, I’m doing trauma work.

So, that’s where my expertise comes. And what started to happen over time is that professionals would see me do work with their patients, and then they’d be like, “Oh, you helped them. Well, okay, I’m going to come in too.” So, I was already having a few professionals trickle into my practice that had trauma from their work. They were like, “I don’t know who else will get this.

Let me come see you.” But the big moment was I’m attending the birth of somebody that I’m really close to, and I saw a particular clinical presentation completely changed the way the provider was interacting with the patient. She went from warm and joking and consultative, lots of eye contact and just really great rapport to cold and clipped and looking the other direction, and fearful and tight and irritated. And it completely changed the tone in the room.

And I was staring at her like, “Oh my gosh, I know exactly what I’m looking at because it’s what I’m looking at in my office all day.” She’s having a trauma response in front of me, and I tried all of my tricks to try to get her back. All my therapists do tricks, and I just did not succeed. The closest I could get was, I was asking how long she’d been practicing, and I said, “Gosh, in 25 years, you must have seen this a few times before.” And she just looked at me and really cold, it was like, “Yeah, in 25 years you think?” And that was it.

That was the best I could get. I was like, “Oh, no.” So, the rest of the birth really changed how it unfolded. It changed the interaction, it changed the tone of the room, the clinical decisions that were made. And I went home being like, “Oh my gosh, I’m over here talking about patient trauma, but what I’m missing is that the people in the room giving the patient care are traumatized.”

So, that was the second specialty that chose me because I wanted to understand that better and started trying to dive into a deeper understanding of it and really felt like, “Oh my gosh.” Honestly, for a couple years I didn’t talk much about it because I felt really overwhelmed at the subject, to be honest with you. I felt like I don’t even know where to begin. This feels so huge. And then, I realized, “Well, where we begin is where we begin, which is that the whole system needs trauma-informed revolution from the bottom to the top.”

And since then, now I’ve been able to read the literature on it and do a lot of work in it. This was a decade ago. But not surprisingly, birth nurses have really high rates of trauma from the work they do. And I just don’t think that that’s being acknowledged enough, and I don’t think it’s being given the resources. And one of the reasons you’re going to hear me say that I think that’s such a disappointment is because actually trauma’s highly treatable.

Highly treatable, highly preventable. A little bit of information does a world of good on this issue. So, I’m just really passionate about educating nurses so that they know, “Hey, this isn’t like I can’t help it. Like a foregone conclusion is just going to turn out this way.” Actually, it doesn’t have to.

Yeah. And what are you seeing as the outcome? And this is going to be probably a silly answer, easy, but just so people can hear it. If we don’t treat our trauma, what are you seeing that outcomes of that?

Okay. So, maybe we’ll help to describe exactly what trauma is and why trauma is different than something difficult. So, basically, what creates a traumatic memory, it’s a function of how your memory forms in your mind, bunch of nerdy things, not relevant, but it’s just about memory formation. So, a normal memory, like think about a delicious dinner. You go to the delicious dinner. Anybody who’s heard me talk about this, heard me talk about this before.

Go to a delicious dinner, when you first eat it, every sizzle, every smell, everything is vivid. And if I’m measuring… if I wanted to measure your saliva, you would even salivate to remember it. You would have a physiological response to the memory for a short time after. You go to bed that night, it fades. A few more days, it fades. And by a couple weeks, couple months, you’d really not even remember that you ate there unless something else interesting happened.

If you did remember it, it’d be a fact. Like, “Oh, I’ve eaten there before. I like this one dish that they have. It was really good.” But it’d be a fact, and your body wouldn’t really react anymore. What happens in traumatic memory is that it does not lose. Its vivid, detail, and it really doesn’t lose the bodily reaction. And so, I want to explain that first because then to answer your question, so what happens when a nurse has untreated trauma is that when something triggers the traumatic memory… we see in the movies, it’s like a vibrant flashback.

And it can be where you’re really playing a movie in your mind of the experience, but it also can be what we call a somatic or bodily flashback where suddenly your heart is elevated, you feel queasy, you feel dizzy, you feel anxious, you feel nervous, and maybe you’re not even totally sure why. So, what happens for nurses or providers that have trauma is that if something triggers that traumatic experience, they’re not responding to what’s in the room in front of them anymore. They’re responding to something outside of the room.

And that can mean that they make decisions on the basis of a fear response or an anxiety reaction, not based on what’s happening in the room. And the thing is that when people in a regular life have trauma, mostly what they do is avoid the trigger. And if they can avoid the trigger, then they just go have their happy life and they avoid that trigger ever again. But when you’re a nurse and your trauma took place in your workplace, how are you going to do that?

And so, when I’m talking with nurses in my office, often what I’m hearing is them talk about just even walking on the floor or seeing that they have to work a shift the next day, or a particular room or a particular clinical presentation will give them cold sweats, or suddenly they’re really struggling or they’re really stressed out, or they’re really find themselves zoning out.

And these are all trauma responses. And basically, all they mean is that your nervous system is overwhelmed and your brain is acting as if the trauma is in danger of happening again. And what we know is that OB nurses have about a 25% to 30% rate of trauma currently. Meaning, if I walk on a floor and I gave you all survey, almost one out of three would have PTSD right now.

Wow.

Which is huge, right?

Yeah.

And I would say my experience working with people is that actually there are more of them who are not going to meet every… not going to check every box and say, “I have PTSD.” But they still have a trauma response. They just might not have all of them. And so, if you’re going to start to look at those numbers, I would guess that it’s much higher of just people who have a trauma response, even if they’re not going to meet all the criteria for PTSD.

Right. So, I’m thinking too, maybe I don’t get into cold sweats when someone wants to ambulate when they’re ruptured, but I’m not going to let them ambulate while ruptured because I had a bad outcome. Does that make sense? Does that fit?

Absolutely, yeah. Because basically our brain is very sweet misguided. I was thinking about a little puppy guard dog. It’s trying so hard to do good job, and it’s just barking at everything instead of at the thing you needed to bark at. So, with a trauma, what happens is your brain takes everything surrounding the trauma and says, “This is all bad news. We don’t like any of this.”

And it groups it all into the pile of, “These things are bad news.” So, an example of that would be like, if you’re in a really bad car accident during a certain song playing on the radio, and then you’re in a store later and that song comes on over the speakers, your body suddenly starts to have a reaction to it. Well, that doesn’t make sense, right? But it does to your brain because your brain says, “Whoa, hold up. Last time we heard this song, things were really bad real fast after. So, we are in danger, and this is bad news.”

So, same thing what you’re talking about, Justine, is exactly right. Which is, “Maybe I don’t get cold sweats, but I’m going to get, no.” Right? This hypervigilance of like, “No, you can’t do that. That’s not allowed.” And some people, personality-wise, that’s how they roll. But if you’re somebody who doesn’t, it’s not that way most of the time, and then that presentation shows up.

What’s happening there is, it’s like your brain is going, “Last time this happened, something really bad came after. And so, to prevent it, the bad thing from happening, I’m going to be on high alert for any signs, like the song playing over the loudspeaker, and I’m going to react as if the trauma is in danger of reoccurring to keep us all safe.”

And I’m hearing two things. And then, I’m hearing like, so one, if I’m a nurse listening, I need to work through that, if that’s me. And then, two, I’m feeling so much grace for my colleagues of like, “This is their brain trying to protect them.” And I’m thinking of maybe the providers I work with that don’t allow certain things or are really aggressive about certain practices. I’m like, “What have they seen? What have they gone through?”

Totally right. Yeah, that was my first experience, was a provider who… and I think that that’s the thing that is so important for us to recognize is both are true. Our trauma response can mean that we are making bad clinical judgements, but it also is coming from a place of trying to keep people safe. It’s not coming from a hateful place. It’s not coming from a place that wants to do harm.

Actually, it’s coming from a brain that’s like, “Oh my gosh, I have to keep this patient safe right now, and this is how I keep them safe.” So, it’s both. And it’s like we have a responsibility to understand the way this is impacting our clinical judgment and the way it’s impacting our patient care. But we also can be so gracious to ourselves and our colleagues, like you’re saying.

Think about just numbers-wise case. So, if the rate of prevalence of PTSD among OB staff is in the 25-to-33ish percent range, actually now in COVID it went way higher. So, I don’t know what it is currently, but let’s just say it’s in there for the sake of conversation. How many professionals are in the room at the moment that baby is born on average? I mean, what I’ve seen, it’s five.

Yeah, five.

Three to five.

I would say five.

Okay. So, if every person in there has a 25% to 30% chance of having active PTSD that’s untreated right now, mathematically the likelihood that at least one person in that room or more have untreated PTSD, it’s almost a certainty that at least one of them does.

That feels very overwhelming when you say that number. I’m like, “Oh my gosh.”

Right? Right. It is. This is why I didn’t say anything at first, because it does feel overwhelming to go when I’m looking at the faces of my colleagues and they suddenly get a little weird on me, or they suddenly, we all have that colleague that I hear all my professional clients talk about, that one colleague who makes these calls a certain way or talks a certain way or reacts to a certain clinical presentation a certain way, and everyone knows it.

It is overwhelming and also hears the good news that I just want to say over and over again, it doesn’t have to just be left this way. There’s a lot of therapies we can talk about it, but the upshot is trauma, super treatable, super, super treatable. And that is exciting and good news, and it’s also not something that everyone’s aware of because even people in my psychology profession aren’t aware of it because it’s really newer in more recent decades.

Just like with obstetrics, new information takes a while for everyone to get the memo. It’s the same in my profession. Not everyone has the memo. But trauma is super treatable and it’s highly preventable. So, that’s part of why I go around doing all these long form classes. Because if your central nervous system… you’ve heard me say this so many times, Justine. Your central nervous system gets what it means after a difficult experience. You just sliced to a fraction of a chance that you’re going to end up with PTSD.

You want to share a couple of those little tips here. And I will say that we do have a class you guys Healing Trauma in the Birth Professional that goes in detail of this with Krysta. But yeah, just to leave them, give them a little bit of a taste of how to do that.

Yeah. Okay. So, think about any experience. Two people can go through the same experience. One has trauma, one doesn’t, right? And why is that? Well, the old way of thinking was, “Oh, one of them is tougher than the other one, or one of them is more optimistic than the other one, or whatever it is.” That’s not true.

That’s not true at all. Actually, what it is, it’s a result of memory formation and your memories are formed based on what your central nervous system is getting or not getting. And so, we have different vulnerabilities. And even at certain times of day or after not getting a good night’s sleep or on the heels of another difficult birth, it primes us to be more or less likely to get trauma. So, there’s all these variables both before, during the event, and then immediately after the event that can change how your brain processes it.

And in fact, anybody who sat through my class will start to recognize that they have certainly had experiences in their life where the memory could have become traumatic because they start to identify themselves in the symptoms I talk about. But it didn’t. I can think of births that I attended as a doula where I was having smell flashbacks, or I would try to fall asleep and I would be jerked awake, which is a sign that you might be creating a traumatic memory.

But because I got what I needed, I used certain protocols, then I didn’t. Five days later, I was okay. And it started… and not that I was happy with whatever negative thing happened, but I was okay. It felt past tense. It didn’t feel current like trauma does. So, that’s my long way of saying some of the things that we can do are… I am a really, really big fan of bilateral anything. So, bilateral means right, left. So, anything that alternates right, left. You can take a walk, that’s right, left. One of the easy ways to do it is to stream bilateral music.

Any place you stream music, you can get it for free and you want to listen to it in your headphones. So, that’s alternating right, left. If you can do that in the early days after a difficult experience, you really get a head start on the processing. And part of that is we know that sleep, and particularly REM sleep, helps process difficult experiences and make it less likely that you’ll have trauma. But guess what? Birth professionals don’t get enough of sleep, and particularly REM sleep, because their circadian rhythms get all jacked up from the work that they do.

So, one of my favorite hacks is we can do this bilateral music and headphones, and it’s not as good as REM sleep, but it’s tapping into the same thing as REM sleep. So, it’s a way to cheat. And a lot of people find that actually helps them go to sleep if they’re struggling because it’s so soothing. So, bilateral music, after a hard birth that I’ve attended, I will listen to it on the way home. I will put in my earbuds-

You just have to search bilateral music on Spotify.

Bilateral, yup. You can find it out on Spotify, on YouTube, on Amazon Music, any place you stream, bilateral. They also call it binaural sometimes, B-I-N-A-U, binaural. It doesn’t matter. People ask me, “Which one should I pick?” It doesn’t matter what the music is. Whatever you like, right? Some people literally listen to tones from one side to the other, just like, “Tick, tick, tick.”

It doesn’t matter whatever music you like or enjoy, what matters is that it’s alternating from right to left and right to left. That’s what you’re trying to get after. So, listen to anything you like. I like to listen to nature sounds that are bilateral that go back and forth. It helps organize your brain and it helps prompt better memory consolidation, so you just are less likely to get trauma.

That’s one example of a little bit of knowledge can literally be lifesaving on this topic, which is why I’m always talking about it. It’s like, “I know it sounds overwhelming, and I know it sounds like a bummer, but please come to my talk, even though I know talking about trauma sounds like a bummer because actually there’s a lot of reason to be optimistic.” A lot of reason, ways that we can calm our nervous system and help ourselves.

Well, thank you for that.

Yeah. Well, here’s the other thing, Justine. I was going to say, because here’s the other part of it is not only does trauma is not a result of being not tough, right? Because hi, I first learned about trauma from literal army rangers, and they were real tough. So, it’s not about toughness, it’s not about optimism, it’s about your central nervous system. But here’s the other thing, those who are empathetically connected to their patient’s care are more likely to get trauma. And so, if you’re-

And I think about all my Bundle Birth Nurses, they’re very empathetic. I mean, birth workers in general. And so, if you’re listening to this and feeling overwhelmed, there’s hope, which is what I love about Krysta too. There’s a hope.

Well, And I’m counting on it, right? Because dang, I have attended some rough sideways births, and I think that I’m somebody who’s a little bit prone to the way my brain processes stuff, and because I’m empathetically connected, because I’m a therapist, it’s my job. I think I’m more prone to trauma than your average bear. I use these principles.

I know that it doesn’t have to be a foregone conclusion. And what I want people to know is the old way that we’ve done it is it’s like, “Nurse comes in, nurse gets good care, nurse accumulates trauma, nurse starts to feel burnt out. She’s told to do self-care. Nurse keeps working hard, nurse starts using bad coping mechanisms like excessive alcohol use, and everyone high-fives her. And it’s totally culturally normal because we’re all traumatized.”

And then, at some point, that burnout hits. And then, what happens is, okay, now we’ve burnt out actually the best nurses among us, the most empathetic. So, what I’m here to say is, “No, no, no. Time out. Rewind. Actually, you could treat your nervous system. You could treat the trauma and go back to having joy in your career again. You can go back to feeling calm. You can go back to feeling how you felt at the beginning again, clearheaded, calm, joyful.”

It doesn’t have to go this way. My hope is that institutions are going to start to get the memo and start to invest in this. I’m working on that now because I want them to start investing in this for their people.

And I had cut you off earlier. You talked first about the CNS part of it, and then I think you were going to go into other long-term therapies. And I think that would be how nurses would, like to say I’m listening to this, I’m like, “Well, yeah, I don’t remember an acute incident, but I am absolutely traumatized by what you’re talking about.” What do I do? Oka

So, I’m going to plug the video that I made with you guys. I think that it’s a really good place to start healing trauma because it’ll give you stuff that you can do right away. But what we know about trauma is if we don’t intervene after six weeks, it sticks. After six weeks, if you have PTSD, you’re going to keep having a PTSD response because it’s basically the memory has solidified at this point, your brain has decided this is the way to keep you alive.

And unless something comes in skillfully and convinces it otherwise, it just wants to keep doing it. So, at that point, once we’ve reached that six-weeks or beyond, I’m talking about you, and you know that you recognize yourself. Some of my favorite modalities, I love EMDR, it stands for eye movement desensitization and reprocessing. It’s gone way beyond eye movement now, but that’s the name of it. I also love Brainspotting, which functions on the same ideas.

Both of these used bilateral as a part of the process because we know that it helps. We’ve seen amazing things with… let’s see, somatic experiencing is another therapy that I hear great things about, I know less about. And we’re seeing amazing research being done with things like psilocybin and MDMA and that kind of stuff. But my experience with professionals has been that unless they brought a lot of complex traumas to the profession, they often don’t need those more heavy heading therapies. They’re often really responsive early on.

And so, one of the things that I’ve done is I actually launched… did I tell you that I launched this program for short-term treatment of this? Because-

No.

Yeah, yeah. So, because to answer your question, what I found is I’ll tell people, “Go get EMDR,” which I still really think they should, but it’s not always easy to access, depending on where you’re located and how much time you have, and are you a mom of young kids and all that. So, that’s another option if people are interested in that. Because I believe that, and we’re gathering data to be able to share, I believe that we can actually do something about this on a larger scale.

So, what’s your program? Tell us about it.

So, it’s called Critical Incident Support Program. It’s for birth professionals, and it’s a telehealth, it’s one-to-one, it’s six sessions, and it’s entirely about central nervous system symptom reduction. So, it’s just like, “Let’s get you feeling better ASAP so you can go back to work and feel ready to tackle it.” Because to that point, it is highly treatable. And I don’t say that she’d be like, “Oh, toot my own horn, woo, woo.” But to say, “Hey, I hope this spawns a lot of copycats.

I hope a lot of other people look at it and go, ‘Hey, I think we could do something like this, because it’s actually very actionable and very doable.'” There’s great research, the Poppy program, and the UK has done some work on birth professional trauma and has shown amazing results with just minimal staff education and support. Minimal. So, there’s a lot that we can do, and I think you all are worth it. Yeah.

Thank you.

I want all of you loving wonderful people to be around.

Yeah. So, that’s hopeful. We’ll link all of that you guys here. And I think… would your program be good for those nurses that are listening that’s been more than six weeks?

Yes. Okay. Yep, that’s the idea. Or even if it’s been less, even if you’re just like, “I just need a light line.” Yeah. The sooner the better, really, always on this, but yes.

Okay. So, I have a question then. I had a recent… and there’s a podcast episode on this, but I had a recent interaction with a doctor who did an unconsented episiotomy, and I had a conversation with him, and I have a good enough relationship with him, luckily that I can talk to him. And ultimately, he said, “I am just done and burnt out and don’t care anymore.”

And COVID really messed him up. And I even said, I was like, “If I get you access to a healing trauma for birth workers class, will you listen to it?” And he said, “No, to be honest, I won’t do it.” Which sucks.

That does sucks.

And so, do you have any tips for people like that, providers like that, where you have these nurses that are like, “This doctor needs this, or this midwife needs this.” I guess I’m trying to say an irreceptive one. If you say it this, present it like this, how do we get our providers to also… because they’re not listening to this podcast, but we’re working with them. And so, how do we get it to do it in a professional way, in a respectful way of like, “I see your trauma,” but not saying that. They probably don’t even realize it’s what they’re dealing with.

And then, we don’t want to assume they’re dealing with that too. There’s a lot of layers there.

Yeah, we don’t want to assume. But also, statistically, we can assume. If somebody’s been practicing long enough, the likelihood that they have some trauma is pretty high at a certain point. We can’t always assume that’s what’s influencing their decision, but we know that it’s there. Here’s what I’ll tell you. What I have seen is a lot of openness to this among midwives.

So, I have not seen it be much of an issue between nurses and midwives that often they’re just like, “Oh, thank God. What do you have for me?” I got to do something, right? There’s an openness to that. What I have seen is that there’s less receptivity sometimes from nurses to OBs.

And I think that might be a little bit of what you’re talking about. What I have seen work best is when people themselves go from traumatized to healed, they’re the best walking billboard, right? Because they’re colleagues who know exactly how hard they were influenced or how hard they were affected by this are suddenly able to be like, “Oh my gosh, you’re a different person. And not just happy-go-lucky when you’re talking to me, but on the floor.

I watch you interact with patients and I see stuff that would’ve triggered you. And now you’re like, ‘Okay.’ Or I see that you’re ready to leave the profession, and now I see that you have joy again.” And so, what I see is that those are the inroads. I don’t feel like it goes very well to just try to say it like, “Hey, I see your trauma and I have a resource for you.” I think what works better is to say, “Hey, I recognize in you what I recognize in myself.

Here’s how trauma was affecting me.” Starting with vulnerability. Like, “Here’s how I was really struggling and what helped me.” Unfortunately, there’s a lot of work to be done in obstetric culture in general, around the ability to be vulnerable and not feel afraid of the consequences of that.

Yeah, I hear you. I hear you. I think too, when you were talking, I would say too, if you’re listening to this and you’re like, “Well, I don’t have trauma, so I can’t…” or maybe you don’t know it, but I don’t need to do the work, but I want someone else to maybe just bringing up this conversation we’re having. Like, “Oh, I heard about this.” And chat about it specifically when people are in an earshot and be like, “Wait, what are you talking about?” I think that always helps too.

Yeah. I find that it’s so helpful for, I always lead with the central nervous system information because what I find is that even if we don’t say it out loud or consciously, we’ve all got in our back of our minds this idea that it’s related to optimism or grit or resilience or strength. And so, then it feels like to admit I have trauma means I’m admitting some-

I’m weak or something.

Yeah. I’m admitting something. Actually, it’s your central nervous system. It’s your memory. And it’s totally, totally reparable.

And we like science as nurses too and midwives and doctors, right? And so, you start talking CNS to us and we’re like, “What?”

Brilliant. And here’s other thing too. What I found is that I’m thinking as we’re talking, I ended up in this space working with professional trauma because I started out with patient trauma. So, I felt like the patient trauma angle was sometimes the inroad because it was easier to see in your patient, easier to see the impact of trauma in your patient. And then, that would make you start to go like, “Oh, I see these other… I see it in these other places now.” Yeah.

You mentioned too the idea of being tough. And I’ve been having this… while I’m journaling or thinking about things, I’ve been at conferences, I’ve been writing down specifically, “Why is it so bad to be nice in OB and to be sweet and to be just an excited nurse?” And I put there… and I’ve been writing like, “Well, OB is tough and you have to be tough to make it.”

And I think it’s because we see a lot, and we see a lot that people don’t realize. And I think as an OB nurse, if you’re listening to this, everyone thinks we rock babies. It’s a real thing. We wear pinker purple scrubs. We’re always happy. And it’s like, “Yeah, we are happy a lot of times, but there is a lot of things we see that are not good and really can be traumatic.”

And also, there’s a lot of mistreatments, I believe, on our floors. Like you said, there is a change that needs to happen in the culture of OB. And so, I think this can be revolutionary to that fact of, you can still love your job and be joyful, and love what you do if you work on your mental health and your ability to respond to trauma. And I tell mentees all the time, “Watch healing trauma.” Even if you haven’t had anything happen, the likelihood of you having it happen is high. Right? One in three.

Or even a colleague that you love, being able to give them actually really helpful direction.

Like, “Go take a walk down the hallway. Put my headphones in. Whatever.” And I’m thinking about that. My coworkers recently had an experience that I wish I would’ve been there that night because I think I would’ve sent them down the hallway walking with headphones or doing some of your bilateral movements that I’ve learned myself as well as giving them acts where the class is. But this is, I need you, Krysta, to get into the hospitals.

I need to get into hospitals. You want to tell me how to do it?

Figure it out. Just kidding.

I am so down. We’re just going to keep speaking into the universe. It’s going to occur.

Yes, it will.

Because the truth of the matter is all these lovely people that you’re connecting with through Bundle Birth, some of them are newbies, but not all of them. And also, even the newbies eventually find themselves in positions of leadership and policymaking. And what I’m getting to see now that I’ve been teaching about this for a while is people who came as a student and made an impression, they held onto it, and now they’re in a position to bring trainings to their floor.

They’re in a position to make decisions about time off and to make decisions about how to take good care of their staff. And they have the data I’ve given them to be able to support their decisions to their higher ups. So, this cultural change is happening. The issue is it always happens very slow, but it is happening. And I think that at some point we are going to see people in the high up decision-making inviting in. I mean, look at what you guys have done with physiologic birth. I mean, it’s incredible, if the change is taking place.

And frankly, I mean, some of it is just necessity. The truth of the matter is we already had a staff crisis, a staffing crisis in OB, that was already on the horizon. And every big institution knew it was on the horizon. And then, COVID just way accelerated those numbers, and they’re not slowing down. And so, a lot of facilities maybe five years ago who wouldn’t have necessarily, not that they didn’t care, but they had so much else on their plate, this wasn’t going to rise to the top. Now, what’s rising to the top is like, “We need to keep our staff. We need to keep them happy, and we need to keep them around.”

And so, what I’m starting to see is I’m getting contacted by smart facilities that are recognizing that it is far better to take care of the staff you have rather than have to keep trying to replace them. And the data shows that absenteeism improves, staff turnover improves. When you take care of your staff this way, they stay and they love their job. And I believe that you could probably show that they give good patient care as well. So, I think it’s on the horizon because the need is there and the people are in place.

And also, the numbers are there in a way they weren’t even a couple years ago to say like, “This is actually really worth investing in.” Because yeah, I love that you said that you would do that for your coworker, that you would send them down the hall. And I think that’s a beautiful example of when you guys talking about team underwear. These connections that you are making are where this change happens because you taking care of your coworkers and them taking care of each other, that’s just amazing. And the thing… back to OB is tough.

Yes, it is tough. And so, the care that you have to give is tough. Wouldn’t it be great if the environment was supportive?

Yes.

Since the work is tough, maybe the environment could be kind. It’s just an idea. Yeah.

Just an idea.

Just an idea.

A novel idea.

Maybe because the work is tough enough, we don’t have to be tough.

And I’m thinking too, when you said that OB is tough, if someone is listening to this, you’re maybe isn’t in OB or you’re a nursing student, don’t be too scared. But I think too, if you hear a nurse that says, “I’m in the ER, I’m in ICU,” it’s like, “Oh, that’s tough.” They already automatically assume. And like we were saying earlier, you hear like, “Oh, I’m an L&D.” You’re like, “Aw.” It’s like, “No, it’s not always, ‘Aw.'”

Well, I think… so everything I share in trauma is obviously applicable to all medical specialties. I mean, there’s trauma possible in emergency medicine and all the rest, right? Yeah, of course, there is.

Why I’m so drawn to talking about it as it relates to birth professionals is because birth professionals have a really unique… there’s this… you are on the knife’s edge, literally and metaphorically, between life and death. When you walk into a room… let’s say it this way, when you walk out of a room where there was a bad outcome, where something really terrible and scary happened, often you don’t even have time to drink water or use the bathroom before you walk into the next room where it’s somebody’s best day of their life.

And you need to put on a smile and not overreact and be present and be there with them. And so, what is unique about OB to me is that because you actually… sometimes it is aw, sometimes it is really sweet, but not a lot. A lot is hard. It’s hard work. You work really hard. And then, sometimes it’s that bad outcome.

I feel like there’s something psychologically different that happens for my birth professional clients versus an emergency room doctor who goes there because they’re going to see pathology, goes there knowing they’re going to see death, they’re going to see bleeding. They’re going to see pathology that day because they’re in the emergency room. That’s what they’re there for, versus somebody who’s holding space on one side for this family.

And if everything goes well, they’re just not even going to be remembered the next day. Because if everything goes smoothly, the baby and the family are the center of it, right? And that’s the ideal. And then, when it goes sideways, it can go so sideways that I almost think the shift between the two is in its own challenge. OB is its own psychological wave that you have to surf. Like, “Yay, how beautiful.”

I hope that’s really validating. I hope that’s really validating for people listening because yeah, it is tough. And you’re tough.

In a different way.

If you’re listening to this, you’re tough.

In a different way, yeah. Well, here’s the thing. This is why I love birth workers, right? Because it’s that experience. To me, it’s like this beautiful… there’s a way that person can be tough and they can be really guarded. And they’re tough, they’re hardened, and they’re guarded and they’re tough. But then, there’s the kind of tough that is resilient, that bounces, that doesn’t get hard, that gets soft. That to me is so impressive, that kind of toughness. And that’s the toughness that has to be brought to OB. It’s the toughness that softens.

Totally. I love that analogy of it. It softens and bounces.

Because otherwise, it gets really hard to love your job if you get hardened. I think everybody knows that. But sometimes when we don’t have trauma that’s being addressed, or when we have trauma that’s not being addressed, we feel like, “What other option do I have but to get hardened?” And what I’m here to say is, “You have another option. You can keep loving what you do and keep being the soft tough, and you can keep going.”

Oh, I love that. All of the links will be in the show notes of this call too, you guys, to everything that we can send you to Krysta’s way being the on-demand classes. I’ll post Mentorship. And then, I want to post your program, Krysta. So, I can find that on your website? I will find that.

Yeah, yeah

Yeah, yeah. Is there anything you want to say, just like a sendoff or anything? Last thing to say? No pressure.

No pressure. What I want people to hear me say, because often people will recognize a little bit of themselves and what I’m saying, or they’ll recognize someone they love and what I’m saying, and their head is suddenly someplace else and they don’t hear the other things I say because they’re gone down that rabbit trail. So, come back to me for a moment.

If you recognize yourself or somebody you love in anything I’m saying, whether it’s professional or other you see trauma having an impact, please hear me say that it’s highly treatable and there’s a ton of reason to be optimistic. And that if you were somebody who’s in the throes of untreated PTSD right now, this does not have to become your personal new normal. This does not have to be a permanent state of being. There’s so much hope around this.

Please know that it’s not going to stay like this forever.

Thanks for spending your time with us here during this episode of Happy Hour with Bundle Birth Nurses. If you like what you heard, it helps us if you subscribe, rate, leave a raving review and share this episode with a friend. Now, it’s your turn to take what you learned today, apply it to your life, and take care of yourself. We’ll see you next time.