My first clinical rotation in the hospital was in Labor and Delivery. I was nervous to begin this clinical because I have little experience handling babies. However, out of all the clinical rotations assigned, I was looking forward to this one the most — I’m not even sure why! This clinical rotation lasted only seven weeks; however, during this time, I learned so much information and hands-on skills that built off of the theories we heard in lectures. I’ve noticed, though, that no matter how many lecture classes I attended, once I placed myself in a real life situation where my skills are used, that’s when I am truly put to the test. However, after this first seven week rotation, I feel confident in my ability to apply my skills to patients.
The first skill I was able to work on in this clinical rotation was my basic health assessment skill. On the Labor and Delivery floor, in essence, you have two patients: the mother and the baby. We did assessments on the mother and baby every 3 hours, and sometimes more often if the baby was premature or had health problems, such as low birth weight. The neonatal assessments included vital signs and a general head-to-toe assessment. I was able to practice using a neonatal stethoscope, which is so tiny. Listening to the heart and lung sounds of a newborn proves much more difficult because they are often squirmy. Also, I noticed that hearing heart and lung sounds requires a finer ear because the baby often cries or grunts, which can interfere with listening. It takes much practice to be able to listen for what you need to hear. For maternal assessments, we also completed vital signs and a postpartum assessment, which included palpating the uterus and breasts after delivery.
Of course, one of the most amazing aspects of the obstetrics rotation is the opportunity to experience a birth of a baby. I was fortunate enough to participate in two vaginal births and multiple Cesarean sections (one with twins!). I felt very privileged that so many patients were willing to allow me to be a part of their birthing experience. On days I was scheduled to a patient requiring a Cesarean section, I was not only able to practice taking vital signs and assessments, but I also learned how the operating room is run for this special, yet serious surgery. I was able to practice sterile technique and be a support person for the patient during the insertion of the spinal anesthetic and during the operation itself. I felt very special that I was needed during this time.
In addition to maternal and newborn assessments and sterile technique, I was also able to practice skills such as urinary catheterization, medication administration, intramuscular and subcutaneous injections and electronic charting. I certainly have not mastered these skills, but I definitely feel more confident performing these skills than I did at the beginning of the semester. I am eager to use the skills I practiced in Labor and Delivery in my Medical-Surgical and Pediatrics rotations, which will begin in Winter 2012 though I will miss the nurses I was paired with and their instruction, advice and personal stories.