jingles,
Yup, nurses will usually know gyane's preference. For my #1, nurses told me my gynae prefers mothers to be able to feel some of the contractions and be able to push better. So they did not increase the epi dose when I requested for it at 8-9cm dilated.
For the episotomy, gynae injected local anethesic before cut and sew. So I didn't feel any pain, but I did have some sensation during the sewing part.
I didn't have any bad experience with the epi. The doc admistering it was great, came withing 10mins of my request for epidural, no pinch or pain during the administering, no shivering etc. But did puke once. I was sitting up cross legged and carrying my daughter once they got me to my room and walking as per normal they next day when catheter was removed