Nursing support in labour and delivery.

Abstract

Few studies have focused on the amount of support provided by nurses on labour and delivery units. The purpose of this study was to examine the amount of nursing support provided by nurses during the intrapartum period as well as to identify factors that influence the provision of support. Support was operationalized within four categories: physical comfort measures; emotional support; instructional/informational support; and advocacy. The work sampling method was used to determine the percentage of time nurses spent in supportive care activities. Using this approach, each nurse, who met the inclusion criteria, was observed instantaneously at randomly selected times and the activity was recorded. Twelve nurses were observed over six non-consecutive day shifts on a labour unit of a teaching hospital in Montreal. A total of 404 observations were made. Nurses also were interviewed to determine their perceptions of what constituted supportive nursing care as well as the factors that facilitated or inhibited the provision of this care. Findings of the work sampling portion of the study indicated that nurses spent only 12.4% of their total time providing supportive care to labouring women. Interviews with six of the nurses that were observed suggested that their perceptions of the components of supportive care were comparable to what had been identified in the literature and with this study's operational definition of support with one exception: obtaining epidural analgesia was considered a key component of nursing support during labour. Further analysis revealed a major barrier to the provision of supportive care by nurses: the environmental control of labouring women and their partners by health care providers through the use of technology and rigid adherence to policy and procedure. (Abstract shortened by UMI.)