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Working as a nurse while pregnant
By taking proper precautions and always putting safety first, working as a nurse while pregnant is possible. Here are 9 helpful tips for pregnant nurses.
You can thrive during your pregnancy while working as a nurse when you plan ahead and take good care of yourself!
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, its time to get a couple of pairs ASAP.
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 especially 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!
Wear good shoes
Every nurse needs a great pair of shoes to get through a 12 hour shift. But the benefits to 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.
Things to look for in a good pair of nursing shoes.
- Support and stability
- Slip resistance
- Work function
- Price and warranty
During my pregnancy I alternated between 2 pairs of shoes that provided the most comfort, stability, and function I could find. Here were my favorites:
Pack healthy and energizing snacks
During my first trimester 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 everyday 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 healthy to eat.
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 tasted amazing. Never underestimate the hunger of a pregnant nurse! I felt so much better and able to continue working afterwards.
Here are a few easy, fast, and high energy snacks to help your pregnant body stay energized through your 12 hour shifts:
- Trail mix
- Energy bars
- Almond butter and apples
- Peanut butter and jelly sandwiches
- Greek yogurt
- String cheese
- Hard boiled eggs
- Veggies and hummus
Go to bed as early as you can.
You simply cannot sleep too much when you are pregnant. This is a fact.
Here is a sleep secret that got my 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 45 minutes. I set my phone alarm to make sure I was back to work on time. When it 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.
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. 8 hours would be ideal.
Aim for 30 minutes of exercise everyday
It seams counter intuitive, but exercising while pregnant will actually give you more energy to get through a 12 hour shift. In addition, exercise during pregnancy prevents gestational diabetes and hypertension.
(It is important to talk to your doctor about starting any exercise routine during pregnancy. There are rare circumstances when your doctor may not want you to exercise while pregnant.)
Non-impact exercises for pregnant nurses include:
- Prenatal yoga
- Hand weights
- Low impact aerobics
Reconsider working the night shift
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 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.
Talk to your manager about modified duty
As a pregnant nurse it may be necessary to have a modified work assignment. Especially for nurses who work in rigorous units such as the emergency department. The physical demands of pregnancy might be too much for pregnant nurses 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!
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. As a pregnant nurse, you cannot predict the future.
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 6 hours a day. While 6 hours seems like a lot in 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. I thought I had the grit to work all the way through. So, I waited for two weeks before I finally presented my doctors 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 suffered a placental abruption and had an emergency c-section almost 2 months before my due date. It is wise to listen to your doctor’s advice!
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 should – be a time filled with good health, gratitude, abundance and most of all joy.
Recommended reading for the nurse mom:
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, 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 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 are no shortage of occupational hazards for the pregnant nurse within the hospital setting. Working safely is the number one goal.
It is crucial that you 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:
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.
- Notify management of pregnancy
- Wear lead radiation apron
- Step outside of 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.
- 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
Risk for infection
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.
- 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 certain 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
Physicality of nursing while pregnant
Being a nurse while pregnant is especially 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 difficult to fit into tight spaces.
Movement becomes even more awkward for pregnant nurses due to having an altered center of gravity. In addition, 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.
- 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)
- Use patient transfer equipment when available
- Ask for additional staff help with transfers
- Wear compression socks or stockings
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 and/or begin to escalate towards violence. I always had a security guard with me and I stayed a good distance away from patients when I felt that my safety could be at risk. It is likely that I was 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 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 8 months pregnant and I was really struggling with a 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 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 really tired. (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 actually boost your baby’s brain development and make them smarter. Who knew that working a 12 hour shift might actually promote health for both you and your unborn baby?
Good luck to you during your pregnancy and take care of yourself mama!
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