Thursday, Day 1:
Arrived 0800 and changed into green-colored, provided, clean, OR-CWC-ICU scrubs. Then received tour of maternity unit. Then did scavenger hunt. Then watched NYS mandated shaken baby video. Short day.
Friday, Day 2:
Arrived 0630, ate breakfast, changed into green scrubs, and in L&D by 0700 with fellow nursing student Glen to receive report. As it turned out, there were only two labors going on today--one was a very fast labor, which resulted in a delivery I got to see, and the other was an induced labor that was going on when I got there and still going on when I left.
What can I say? I saw a delivery. Babies are wonderful. Seeing them pass through the vagina is humiliating.
Actually, come to think of it, my main impression of the day is of the midwife who managed the delivery. She was great. Anecdote: When inserting the foley catheter post-delivery, she saved the unused specimen container so her daughter could collect insects in it. Visual impression: A little more aggressive and modern looking than this photo from the CVPH website would suggest. Did I get a little crush? And so what?
Anyhow, I'll post here my academic journal entry for the day, hopefully sans HIPAA-violating info:
I woke up early Friday morning to trim my hair before clinicals only to discover what appeared to be the first gray hairs I've noticed. In clinicals, I was treated with complete indifference by the primary nurse to the extent that Glenn and I were addressed as "Glenn" throughout, as in "Glenn, come in here," or the following dialogue:
Glenn: "So I guess we're taking off. Thanks, Nurse#1."
Chris: "Bye, Nurse#1. Nice to meet you."
Nurse#1: "Bye, Glenn."
I've never been so invisible before... And I learned later in the day that Nurse#1 is carrying on with a doctor who lives with his wife and small children... Considering these blows to my ego and sense of community, I'm just glad to have finished the week without precipitating a mid-life crisis. But what about the learning?
Unfortunately, no Cesarean sections were performed this Friday, although a vaginal delivery was observed about 0800 ... This was my first exposure to labor and birthing, and, all dark humor aside, the situation with the nurse was not helpful as I was very unsure how to approach the mother and family… and was trying to follow the nurse's lead. As a result, I did not get involved in vital sign collecting beyond putting a BP cuff on the patient…. I was also not involved in analyzing the fetal monitoring strip, although it was reviewed after the birth.
Perhaps if we had been present during the latent or active stages of labor, there would have been more time to get used to the newness of the situation and develop rapport with the patient and family. Then, I might have been able to provide more comfort and support to the patient and father. These might have included assisting SM into a comfortable position, getting her ice chips and fluids, and encouraging her to focus, breath, and relax. As it was, Glenn and I mostly assisted by holding the patient's legs up and back during the birthing at the instruction of the midwife…
In the immediate post-delivery period, the situation was much the same. I did get… some water, and helped to change her soiled linens to the extent possible. However, most of the post-delivery period was devoted to.... After the midwife determined that she required the assistance of the doctor, the patient was covered with a sheet and left to relax. Any progress towards the post-partum unit was "put on hold," and… The primary nurse also hung a fluid bag in the post-delivery period with Pitocin, the exogenous oxytocin analogue used to promote uterine contractions that decrease the risk of post-partum hemorrhage. Carboprost might be ordered for this same purpose.