Toni Macklin
May 2024
Labor & Delivery
University of Virginia Health
United States




Toni was with us every single step of the way. She held S's hand, advocated for her and her wishes, and provided the energy, positivity, and caring that enabled us to move through the undesired c-section.
My daughter, S, delivered her first baby in the very early hours of this morning.  Although the entire care team, including an extraordinarily wonderful physician team, was dedicated, thoughtful, loving, and supportive, what Toni did for my daughter was something that I will never forget and always appreciate.

S had a long, painful, exhaustive labor.  She was induced with her first baby at 39 weeks.  It was hard for me to see her suffering so much, but I was proud that she was able to rally at each step and keep herself together.  When Toni came on last night, we had already enjoyed really fantastic nursing care and would not have even imagined that it was possible to be more impressed.  S is an older first-time mom with a handful of extenuating health concerns, including anxiety issues.  She was exhausted, sad, and frustrated, vacillating between unreasonable expectations of herself and her idealized delivery plan and her own inner strength.

Toni was with us every single step of the way. She held S's hand, advocated for her and her wishes, and provided the energy, positivity, and caring that enabled us to move through the undesired c-section. I could see that S's strength was waning.  She was suffering from a panic attack. My son-in-law was distraught at S's suffering. Toni had real and calm conversation with S. She talked her down and refocused her. She lent her own emotional strength to my baby when she was unable to rally and provide that for herself. She reminded the care team at each step of what S's desires were. She checked to ensure that everyone was on the same page the entire time, always stepping in to validate that we all knew and understood each thing.

Most impressive to me is that she did this with extreme kindness at all times. She was reassuring in every way. I work in health care. I am a finance director with a 35+ year career in hospital systems. While I have enjoyed very good nursing care at every step in every system that I have worked in, I also know that not every patient and family has enjoyed the level of careful support that my family and I have received at my own facilities. It is a difficult thing to provide really quality patient care in a short-staffed reality with financial constraints that we all face in the industry. Care teams are stretched to their capacity and we have limitations of resources that often stand in opposition to our deeply held devotion to our patients and communities. We are all doing our best every day to be an organization that we can be proud of. Bad things can happen despite our best efforts, but our experience with Toni, and everyone in L&D, was everything that we want from our care teams and the very best example of loving, safe, supportive patient care.


I presented to triage on Labor and Delivery at 2:30 am on a Monday morning. At that point, I was having contractions every 2-3 minutes, had already been in labor for 24 hours, and was incredibly exhausted. Based on the pattern and intensity of my contractions, I was sure I was well on my way to having my baby SOON. Toni wasn't the nurse designated to triage, but she was helping the busy triage nurse by completing my admission screenings and vitals. Between contractions, I made my labor hopes clear to her (to have an unmedicated labor, as natural as possible). She was so warm and made me feel seen and validated during that quick conversation. She left my room once the nurse was able to take over again. When the resident did a dilation check, I was somehow still only 1cm dilated and 40% effaced despite my contraction pattern. Based on those numbers, I was unable to be admitted and ended up staying in triage for hours and hours, waiting to progress enough to qualify for admission. I cannot explain how hopeless and alone my husband and I felt during those dark hours. We were both so exhausted I was incredibly nauseous and didn't know what to do to get my labor moving along. We had a doula, but she wasn't allowed to come into L+D until I was admitted. It was so hard.

About three hours later (around 5:30 am), Toni popped into my room again with a birth ball and a peanut ball, saying, "We've got to open your pelvis!" I wasn't even her patient, but she made a point to circle back to me all the way in triage and assist me in progressing. She reviewed positions using the assistive devices and got me set me up with the peanut ball. Her kindness, enthusiasm, and support truly made such a difference for me during a scary and alone time. When the midwife came in two hours later, I had progressed a few more centimeters and was able to be admitted. Toni provided so much reassurance and comfort to me during an incredibly hard time, and I wasn't even her patient!