So far, my OB rotation has been going well. Each night, 2 of us go to L&D (Labor and Delivery) and 2 go to the NICU (Neonatal Intensive Care Unit) to observe and follow a nurse. With my last name being the first on the list, I got to go first, with another classmate.
My night in L&D was great...got to see 2 births! I was in the delivery room with a close friend of mine when she delivered her stillborn but that wasn't a happy occasion so that really didn't count as a delivery room experience. This time..we had reason to celebrate!
I followed "Amy" for the first half (since I go to clinical at night from 4-11, I am there during the shift change. Shifts are mainly 7a-7p and 7p-7a) of clinical. She was in the recovery room (there are operating and recovery rooms right there on the floor for the C-sections), recovering a recent C-section. This patient was 41 and also had a tubal ligation (got her tubes tied). I guess she figured at 41 with 2 kids now, the store was CLOSED! The baby had already been taken to the nursery but she had to recover first before being transferred to the mother/baby unit. I can't remember how many weeks of gestation (how may weeks pregnant) the baby was but I'm pretty sure he was born a full-term baby (born between 38 and 42 weeks). Otherwise, the NICU might have received him if he was a preterm (born before 37 weeks) baby, just to make sure everything was ok.
"Amy" assessed the mom to make sure her vital signs were ok and that she could move her extremities (legs) after the wear off of the anesthesia. After everything looked good, instead of waiting for the tech to bring mom over, we just took her to the mother/baby or postpartum (after birth) unit. Her family was all waiting by the nursery, which you have to pass to get to the rooms. Her parents and other family members were there to kiss and greet her. She was also able to see her baby for the first time, which is always a good feeling. Once we got that mom settled in her room and "Amy" gave report to the new nurse that would be taking care of mom, we headed back to L&D.
Overall, it ended up being a good night. I got to see 2 births, vaginally! The first one, I came in about 10 minutes before the baby was born. The mom had already started pushing and while she glanced over at me after I entered the room with "Amy", she was not paying any attention - she was concentrating on pushing that baby out. At one point, the doctor had to give her an episiotomy, which is an incision through the perineum made to enlarge the vagina to help with getting that baby out. Man..when I saw the doctor lift up those scissors, my toes curled. And that lady screamed..even though I'm not sure whether she had an epidural or was going totally natural. Lord help her if she was going natural. But, it's better that the doctor cut her than she tear naturally. But, the "best" part was when after the baby had came out and the baby (a girl) was on the mom's chest and she was now laughing instead of screaming...a gush of fluid rushed out of her! I don't know if all the amniotic fluid, or "bag of waters", hadn't emptied out by then or what..but it was like a hydrant had been opened in her nether region. Even the doctor commented that he almost drowned.
My 2nd birth was a little bit more "civilized". I was able to see it from start to finish, per se. From the first time she started to push (even held her leg) to when the baby boy came out. This mom actually was a bit early (at 34 weeks) so the NICU team came down to be there when he was born. The funniest part was the dad did not move from the head of the bed. He stroked and comforted his wife the entire time..even cracking jokes between contractions. But, did he want to see the head as it crowned...or cut the cord? No way..as he stated "I'm good!" LOL! It's amazing..some guys want nothing to do with that area when it's exposed and pushing out a baby..and others are all up in there with a video camera!
Overall, good experience in the L&D. I also got to see an epidural being put in. While I don't really have a pull to be in L&D like a lot of nursing students..it's definitely an option I wouldn't turn down.
I also had a night in the NICU. It's funny....before I went into nursing school, I always said I wanted to work in the NICU. But, as I started school and worked at the hospital, I became fascinated with other departments like cardiac and the ER. But, last night in the NICU...I am back to being interested in it!
The babies were so small...and sooo sick! A lot of them were born at 25, 26 weeks! Imagine going into labor and delivering that early! There are a lot of multiples in the NICU. A lot of twins..and I got to see one set of triplet girls...so cute! Some of the babies were on CPAP machines to help them with their breathing because a lot of babies are born with respiratory problems. I even saw a baby with an ileostomy! It's no biggie to seen an adult with one..but a baby?!? Hopefully, it won't be permanent and her little bowels will be fixed.
Now for the rest of my time in OB, I'll be in the mother/baby unit..which involves a lot of teaching....boring! LOL! But, I'll enjoy my easy time there for now. Because in a few weeks, things will get really crazy....literally! Psych rotation starts next month!
Thursday, September 9, 2010
Wednesday, September 1, 2010
I want a baby!
Well, no..not really..not exactly. Tonight was my 1st OB (Obstetrics) rotation and it was really cool. When we first got there, we had to get buzzed in by the security guard outside of the floor section -- gotta make sure no one tries to swipe a baby! When we got to the conference room, we each received a packet from the clinical instructor - "Mrs. P" about our rotation, newborn assessment and other things. That's when I found out that this rotation, I'm paired up with another student to have an evening following a L&D nurse and then the next clinical, following a NICU nurse. Hopefully, we won't be following the same nurse!
Then we took a little tour of the floor. We got to see the different rooms such as the delivery room (which were SOO nice! The rooms were huge..had huge bathrooms and showers). We even got to see a room with a jacuzzi for those that want a bathtub to either sit in, deliver in or both. I'm interested in having a water birth or atleast a tub to sit in before I deliver..but we shall see!
Then we watched 2 videos on newborn assessments and then it was off to the nursery! The babies were so cute..and little! There were 2 sets of twins that I ended up seeing during the night. A set of boy twins and a set of girl twins. We got to see "Mrs. P" do a newborn assessment and then we were paired up either with 1 or 2 other students and did our own assessments. Since "Morgan" and "Candace" are not in my clinical group, my other friend "Bianca" and I decided before school started that whatever we had to do in pairs, we would be each other's partners..and that started tonight!
The newborn assessment is really thorough..things you wouldn't even think of checking but would be really important to know! Some of the babies weren't really feeling us assessing them..and they were hungry! When we went to assess their sucking reflex, they were not happy at all to discover that what they thought was a nipple, was actually our gloved fingers! But, they were so cute. We also got to learn how to weigh them, take their measurement and change that lovely diaper full of first stool - meconium!
You know I have to cry atleast once a semester and today almost was that day! There was a first-time dad in the nursery and when his family came up, he went out to greet them and the woman who was clearly his mom was just in pure joyful tears. It's amazing how the life cycle continues and she was seeing her "baby" having his first baby. Brought tears to my eyes..almost! LOL! There was also a baby there that had literally just been born. He was breeched (entering the birth canal with his bottom or feet first, instead of the normal head first) so Mom had come in to have her abdomen externally rotated so to encourage that the baby switch positions. However, during that time, the baby became distressed and an emergency C-section was held. So emergent that the mom was put under general anesthesia (not conscious at all) and the baby delivered. Luckily, the baby was alread at 36 weeks so while he first scored a 5 on the Apgar scale (method to quickly and summarily assess the health of newborn children immediately after childbirth - different criteria given a score of 0, 1 or 2, adding all to total between 0 -10) a minute after birth, luckily he went up to an 8, 5 minutes later.
Speaking of the nursery, we were warned by our teacher and a nurse that no matter what we are discussing about in the nursery, since there are windows all around and families almost always there, just keep on smiling. Imagine looking at all these nursing students surrounding YOUR baby and all of their faces are looking grim, sad or shocking while surrounding YOUR baby! The windows are soundproof so you'll have no idea of why they are looking like that. Same goes for making faces while trying not to laugh at the baby's conehead. Just keep a smile on!
So, the first night in OB was great. I'll keep you posted on any fun things -- like a birth! OB seems cool but I can't see myself doing it, especially in postpartum. I need sick patients! And I'm sure there are different situations and I'm still interested in the NICU. But, for now, not too interested in little people that only eat, sleep and poop the whole time. Then again...add 80 years and that's the other population in the hospital! ;-)
Then we took a little tour of the floor. We got to see the different rooms such as the delivery room (which were SOO nice! The rooms were huge..had huge bathrooms and showers). We even got to see a room with a jacuzzi for those that want a bathtub to either sit in, deliver in or both. I'm interested in having a water birth or atleast a tub to sit in before I deliver..but we shall see!
Then we watched 2 videos on newborn assessments and then it was off to the nursery! The babies were so cute..and little! There were 2 sets of twins that I ended up seeing during the night. A set of boy twins and a set of girl twins. We got to see "Mrs. P" do a newborn assessment and then we were paired up either with 1 or 2 other students and did our own assessments. Since "Morgan" and "Candace" are not in my clinical group, my other friend "Bianca" and I decided before school started that whatever we had to do in pairs, we would be each other's partners..and that started tonight!
The newborn assessment is really thorough..things you wouldn't even think of checking but would be really important to know! Some of the babies weren't really feeling us assessing them..and they were hungry! When we went to assess their sucking reflex, they were not happy at all to discover that what they thought was a nipple, was actually our gloved fingers! But, they were so cute. We also got to learn how to weigh them, take their measurement and change that lovely diaper full of first stool - meconium!
You know I have to cry atleast once a semester and today almost was that day! There was a first-time dad in the nursery and when his family came up, he went out to greet them and the woman who was clearly his mom was just in pure joyful tears. It's amazing how the life cycle continues and she was seeing her "baby" having his first baby. Brought tears to my eyes..almost! LOL! There was also a baby there that had literally just been born. He was breeched (entering the birth canal with his bottom or feet first, instead of the normal head first) so Mom had come in to have her abdomen externally rotated so to encourage that the baby switch positions. However, during that time, the baby became distressed and an emergency C-section was held. So emergent that the mom was put under general anesthesia (not conscious at all) and the baby delivered. Luckily, the baby was alread at 36 weeks so while he first scored a 5 on the Apgar scale (method to quickly and summarily assess the health of newborn children immediately after childbirth - different criteria given a score of 0, 1 or 2, adding all to total between 0 -10) a minute after birth, luckily he went up to an 8, 5 minutes later.
Speaking of the nursery, we were warned by our teacher and a nurse that no matter what we are discussing about in the nursery, since there are windows all around and families almost always there, just keep on smiling. Imagine looking at all these nursing students surrounding YOUR baby and all of their faces are looking grim, sad or shocking while surrounding YOUR baby! The windows are soundproof so you'll have no idea of why they are looking like that. Same goes for making faces while trying not to laugh at the baby's conehead. Just keep a smile on!
So, the first night in OB was great. I'll keep you posted on any fun things -- like a birth! OB seems cool but I can't see myself doing it, especially in postpartum. I need sick patients! And I'm sure there are different situations and I'm still interested in the NICU. But, for now, not too interested in little people that only eat, sleep and poop the whole time. Then again...add 80 years and that's the other population in the hospital! ;-)
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