Source: Science of Caring, a publication of the UCSF School of Nursing
Laurie Jurkiewicz is a certified nurse-midwife and assistant clinical professor in the UC San Francisco Department of Obstetrics, Gynecology & Reproductive Sciences. As a nurse-midwife and women's health nurse practitioner, Jurkiewicz provides care for the diverse population of women who choose San Francisco General Hospital's midwifery service for their pregnancies or seek women's health services from the Women's Options Center. An advocate for CenteringPregnancy – an innovative model for group prenatal care – Jurkiewicz also coordinates CenteringPregnancy groups for the San Francisco Homeless Prenatal Program and travels around the state assisting other groups in setting up CenteringPregnancy programs.
(Photos by Elisabeth Fall. Text by Diana Austin and Elisabeth Fall.)
Nurse-midwife Laurie Jurkiewicz talks with a new mother. "One thing I'm really proud about, working here at San Francisco General Hospital, is we see people from all over the world. Many of us know or learn multiple languages so we can better serve our patients. We are the melting pot."
The labor and delivery team, which includes physicians and the head nurse, huddles to discuss the status of their patients. "My mother was part of the feminist movement in the early '70s, and that made a huge impression on me. When I told her I was going into nursing, she said, 'That's not a very feminist thing to do. What are you going to do, change bedpans and dispense meds all day?' I said, 'Mom, this is a profession that's full of women! It's probably the most feminist profession there could be.' I went to nursing school and never looked back. It was by far one of the best decisions I've ever made."
Jurkiewicz discusses a patient with a physician. “Burnout is such an issue in health care because of the pressure to do more with less. You have to put in a tremendous amount of effort in an 8-hour day or 12-hour shift. In nursing, the interaction with colleagues, with patients and with patients’ families is where the satisfaction is, but if you’re burned out,you’re no good for anybody."
Consulting with fellow CNM Andrea Pfeffer as shifts change at SFGH: "I enjoy the diversity of the patients, the other faculty and the energy of the students. Teaching reinforces my passion for my work."
Jurkiewicz takes a break by looking out on the new San Francisco General Hospital structure set to open in 2015. "You might have three patients in labor, postpartum rounds, people coming through triage needing to be seen. You may have different students at the same time who need support. It's hard sometimes not to get worked up, but I've noticed a difference since I started meditating. I'm a lot calm...[better] able to listen and just take things in instead of doing. I feel with patients, being able to listen more is so helpful."
The nurse-midwife addresses a new mother's concerns about breastfeeding. "The transition from being pregnant to being a new mother is such a vulnerable time, so I just want her to feel like she's being cared for and that she has dignity. If she's feeling good about herself in that moment, maybe she can carry that forth and string together a lot of other moments when she'll feel like, 'I'm good here.'"
In the 1990s, Jurkiewicz went to Africa with the Peace Corps and taught in a hospital-based nursing program in Malawi. "When you go to a place like Malawi that's so under-resourced, you think about health in a much more basic way. You ask: 'What's really important here?' I was in a village-based hospital; there was so much death and desperation, a lot of poverty and a lot of malnutrition. I saw that sadness. It was amazing to me that people still found time to have a sense of humor, found time to talk to one another, be kind to one another. I guess that's perspective."
With student midwife Jyesha Wren (left) and MEPN student Brianna Singleton (right): "Teaching is all about communication. When I'm interacting with students, it's so important that I communicate clearly. When it's 2 o'clock in the morning and you're trying to tell them how to suture, you try to make sure your tiredness and frustration aren't coming through. The idea is to communicate something that might be difficult in a very compassionate and clear way that doesn't have too many extras; extra words take extra energy. Precision is key."
With UCSF nursing student Kristin Giroux and a patient: "My wish for students is that they remain curious and open. So much of birth is really around culture: culture of the hospital, culture of the individual. The hospital culture is quite strong, and part of being curious and open is being willing to ask the question: 'Why am I doing this? Is it because that is what I am used to?' The way babies are born won't change, but what we do around it most likely will."
"Midwifery commands my whole self my thinking self, my emotional self, the part of me that's good with my hands – every part of me. This is what I was meant to do."
For some, prenatal care is a community affair posted by PRI's The World
UCSF Nurse-Midwives at SFGH and Med Center ObGyn Collaborate with Physicians for High-Quality Maternity Care
CenteringPregnancy: a Group Model for Prenatal Care to Empower and Engage Women – Led by UCSF Certified Nurse Midwives
Certified Nurse-midwifery program at San Francisco General Hospital
Centering Pregnancy at the UCSF Women's Health Resource Center
SFGH Obstetrics Clinical Quality Measures (PDF)