Certified Nurse Midwife (CNM) and Women’s Health Nurse Practitioner, Deanna Diulio, discusses the joys and difficulties of delivering infants during the COVID-19 pandemic. She shares her experiences acclimating to changing restrictions on birthing practices and adjusting to this “new normal.” She also describes strategies she uses to escape the stressors of her work and find joy during difficult times.
“Finding Joy: The Health Care Professional’s Journey to Well-being" is a podcast resource developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting well-being among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
The Interprofessional Education Research team wishes to thank the following individuals for their invaluable contributions to this project:
• Dr. Barb Richardson, nurse, educator, and interprofessional champion;
• Cameron Cupp, creator of the “Finding Joy” musical score and current enrollee at WSU Elson S. Floyd College of Medicine;
• Washington State University staff from Marketing and Communications, Financial Services, and the Collaboration for Interprofessional Health Education Research and Scholarship; and
• Claire Martin-Tellis, Executive Producer, and Solen Aref, student intern, who developed the first five episodes of the “Finding Joy” podcast.
This episode of “Finding Joy” was produced by Doug Nadvornick, Program Director, Spokane Public Radio.
If you would like to reach out, please contact our team by sending an email to: firstname.lastname@example.org We also encourage you to visit our podcast blog as well as our team's website at: https://opioideducation.wsu.edu/about/.
This is "Finding Joy: The Health Care Professional's Journey to Wellness and Resiliency." It's a podcast resource developed by the Interprofessional Opioid Curriculum team at Washington State
University. The goal is to promote wellness among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
I’m Doug Nadvornick.
The Covid pandemic has cast a bright spotlight on the people who take care of us. We’ve learned about the pressures they face and the abuse they endure.
Each health care worker has his or her own story. This podcast explores one of those stories.
Deanna Diulio: “My name is Deanna Diulio. I am a certified nurse midwife and women’s health nurse practitioner. I work for Alliance Women’s Health, which is in Tri-Cities, Washington.”
Deanna Diulio: “Midwives provide holistic care to women of all ages. People most often associate midwives with women who deliver babies. It is a heavily female-dominated job, although there are male midwives and we do call them midwives. Midwife means ‘with women.’ We teach them about themselves and their pregnancies and options that they have and try and be partners with them rather than being presiding over them in their pregnancy and dictating what will happen. We ask them what they would like and then try and meet those things with them.”
Like almost everything during the Covid pandemic, the relationship between midwives and expectant mothers has changed. Midwives have had to adjust their practices to protect the mothers, their babies and themselves.
Doug: “When you’re in that birthing room and Covid is all around you, how does the birthing process change?”
Deanna Diulio: “In the very beginning, when there were people who were potentially exposed and we weren’t doing regular testing because that option just wasn’t there, we were wearing all of the things and so you don’t achieve the closeness that we had previously. Midwives provide pregnancy support and so there’s a lot of physical touch and closeness usually that occurs in those scenarios and it just wasn’t possible. I would say it’s marginally better now because we’re testing everybody pretty much on admission and so we know, but I’m still having to wear a mask and if they are positive, I have to wear increased levels and so there’s still that physical barrier of not being able to get by.”
Doug: “Obviously there must have been cases where you knew you were delivering a baby for a woman who had tested positive for Covid. As you walk into that birthing room, what do you think?”
Deanna Diulio: “It’s just fear. It’s unfortunate because it’s a beautiful moment, right? You’re helping bring forth life into this world. It’s a magical moment to be able to be the first person to hold this child when they take their first breath. That’s amazing. But you go in my severely sick woman’s room and you go, ‘Ok, they’re wearing a mask, but, man, they’re breathing out so hard. Is what I have on, is that going to protect me? Am I going to be ok?’ Again, in the very beginning when there were a lot more unknowns, but they were sick and we knew that they had it, I would come home and take off everything and run to the shower before any, my son or my dogs, nobody came near me. Nobody touched me until I was fully clean so I could make sure that I didn’t hurt anybody. It’s just a whole different level of things that we’ve never thought about before. We never would have considered it. Being in obstetrics, things splash on you all the time, all sorts of bodily fluids and you’re like, ok, whatever. It’s a thing. It’s fine. But this is just something. It’s something.”
Deanna Diulio: “If I was in a better place financially and I could say, ‘You know what? I’m not going to practice anymore,’ I totally would have stopped practicing because it was just anxiety-ridden days from wake up to go to bed. I couldn’t go to the gym because the gym was shut down, so very little release of things that were my normal release of stress and anxiety weren’t there anymore.”
Doug: “So how did you deal with it? Did you eat? Did you drink? Did you walk?”
Deanna Diulio: “I did all of the above. I ate way more than I should have. I drank way more than I should have. And then I got to a point where I said this is not helping me. I cannot go on this way. It’s hurting me in a number of ways, mentally and physically, because I have chronic pain issues related to a back injury from back when I was a nurse. And so, if I don’t engage in the regular physical activity I will actually start to hurt, so I started to build my own home gym and just started adding things as I could get them to help me be able to do what I was doing in the gym previously. That’s like my number one go-to. Then, number two, I would say, is going out with friends and gathering. I am of Italian heritage and so, where there is a problem or something existing, we all gather and we have dinner and we talk about it for hours. I certainly couldn’t do much of that at all either.”
Doug: “Do you consider yourself a spiritual person?”
Deanna Diulio: “I would say yes. I do practice Buddhism, so I do meditate. I don’t like to call it praying but I guess that would be the closest connotation is to pray, but chanting and trying to establish enlightenment. That’s not a stress release for me. That’s a habit that I feel that I employ.”
Doug: “Have you done more of that since the pandemic?”
Deanna Diulio: “I actually have done less, believe it or not.”
Doug: “Why, do you think?”
Deanna Diulio: “I just felt I couldn’t physically sit still as much because I didn’t have that activity release, you know, that I was used to. Before I got into my new physical activity regimen, I just couldn’t find a still enough mind to be able to practice.”
Doug: “How does that make you feel now versus then? Do you feel like you’re in a worse place in terms of the cosmos, so to speak, where you’re grounded in yourself than you were before?”
Deanna Diulio: “I feel like there was a gap. I feel like there was a gap in a period of time where I felt more unsettled, more unable to see the future and my place in it. But I feel like it’s come back around now that I’ve gotten my routine back and I can do things more regularly and feel at peace. Then I can practice my meditation and chant better with better release.”
Doug: “When we got to the point where many of us got vaccinated and it felt like we were finally over the top of the hill, did that change the way you did your job? Did you feel safer then?
Deanna Diulio: “The vaccination was a huge relief. It was a huge relief, but for a very brief period of time. I wasn’t very happy with the amount of release in protocol that happened so fast. The governor said, ‘oh, we’re nearly 70% vaccinated so releasing of restrictions. You don’t have to wear masks indoors if you’re vaccinated.’ The population here is very conservative and so there’s not a huge driver belief in some of those things and so the moment that he said masks aren’t required if you’re vaccinated, boy, everybody had no masks on. I was still wearing my mask because I didn’t have faith in other people, which is also kind of a letdown. You want to have faith. You want to believe that other people are good at heart. But I know that that’s not the truth and so I was continuing to wear masks and a lot of people actually made fun of me for continuing to wear a mask. I was like, listen, I had a lung infection several years ago that still nobody has been able to identify to this day and I’m afraid because this thing goes after your lungs and so, even though I’ve been vaccinated, I am still not ready to let down my guard. I did go travel, though, because that is another huge way I really find release in. That’s my happy place. Going and traveling to Hawaii was like, as soon as I was allowed to do that, I’m doing it. I got to go.”
Doug: “How did you feel about getting on an airplane?”
Deanna Diulio: “I was scared out of my mind. But I do know, my father worked for Boeing for almost 40 years and so I do know quite a bit about the construction of those aircraft and I do know about the filtration systems and how fast they actually recirculate the air. That, to me, was actually a little bit of a relief. I feel like the air circulation on the airplanes is better than it is in the hospital. So, while I was concerned about being so close to other people that I didn’t know, I did have at least that comfort of knowing the air infiltration is really good here so I’m probably ok.”
Doug: “Did you ever get to the point where you felt like maybe there is a light at the end of the tunnel where you felt like you were safe?”
Deanna Diulio: “No. Knowing things about viruses and how they behave, it was funny, they said, ‘Oh, it’s just two weeks.’ No. That’s not realistic. ’Six months.’ No. In two more years we’ll probably be in a much better place and that will be the return to normal that people are looking for, but it’s not going to be a return to normal. It’s going to be a new normal. There will be new habits that have been formed and will continue because there’s just another one waiting behind it. So I think there are some things that one should not let their guard down about, like washing hands and, if people are sick, they truly should not go to work or school. That’s finally been recognized. If you have a cough, you should not come to work. Don’t come to work, we don’t want you here. People see, ‘Oh yeah, it’s more than just not feeling well for a few days?’ Yeah, yeah.”
Doug: “We’re talking with Tri-Cities nurse midwife Deanna Dial on the Finding Joy podcast.”
Doug: “Describe what your new normal is.”
Deanna Diulio: “My new normal is swabbing my nares if I come into contact with somebody who’s been sick and I was around them without a mask for any substantial amount of time. Your nares is your nose, sorry. I’ve had my nares swabbed so many times I’ve lost count. That’s something I never thought would be a thing, but yup, it’s normal. I’m vaccinated, but I’ll go swab myself anyway. People are like, can I see your vaccine card? Sure, I don’t care. It’s not an invasion of privacy to me. I don’t consider it an invasion of privacy. Maybe that’s because I’m a medical provider. I’m like, I don’t care. Wearing the PPE, I’m so used to getting that off and on and being just sweltering hot because sometimes deliveries aren’t fast, so sometimes you’re in there for an hour or two and feeling tropical. Those moments, just enjoying them while they’re happening and knowing that there’s not probably going to be any pictures around or just a couple that were snapped on an iPhone by a dad in the moment to capture them. Knowing that I still experience them, the parents, the mother still experience them, they still value that I’m there doing the things that I’m doing, even if they don’t look exactly the same.”
Doug: “The name of this podcast series is called Finding Joy. Where and how do you find joy?”
Deanna Diulio: “In every moment that I can. When patients tell me thank you for doing something, I tell them you’re welcome. I don’t tell them it’s nothing anymore because if that’s special to them, then I want them to know that I recognize it’s special to them and I am thankful for them allowing me to participate in it and that I’m happy to have given them that experience.”
Doug: “Thank you for being so generous with your time. Is there anything I didn’t ask you about that you wanted to say?”
Deanna Diulio: “Medical providers should not be scared to engage in therapy and most of us know a therapist and if we can take advantage of some sort of something in this profession, asking another professional for a courtesy, can you get me in, can you talk to me, that’s important, because we’re like, no, it’s fine, I can handle it. Even if you’re like, ‘Hey, I’m having a great, amazing time,’ I still meet with my therapist once a month, even if I’m doing like, ‘Hey, I’m fantastic.’ He’s like, ‘Good, let’s celebrate you’re doing fantastic and tell me how you got to fantastic so that we can remember when we start to not feel fantastic, what are the things that we can do to start feeling better about the situation.’ It shouldn’t be discounted because a lot of medical providers really frown on that. Oh well, that’s showing some sort of weakness or something it’s not. I think it’s a strength to be able to say I can’t handle this. I need somebody else to help me with it. How can I get back to feeling like me?”
Deanna Diulio is a certified nurse midwife and women’s health nurse practitioner at Alliance Women’s Health in Washington’s Tri-Cities. We thank her for sharing her perspective.
The Interprofessional Opioid Curriculum also wants to thank the following individuals for their contributions to this project:
This episode was produced by Doug Nadvornick from Spokane Public Radio.
If you are interested in sharing your perspective about wellness and resiliency as a healthcare professional or would like to reach out to the Interprofessional Opioid Curriculum team, please send an email to: email@example.com. We also encourage you to visit the team’s website at: https://opioideducation.wsu.edu/ about/.