WEEK 5: LABOR AND DELIVERY

Patient Room

This week I did my clinical observations with a labor and delivery nurse. She was in charge of two labor patients. She was in charge of every step that the patient took in succession of the labor. She stayed in the nurses station which was across from the patients room and she never left this area. 

 

 

Things I learned this week-

• The vast amount of fluids, IVs, and medicines needed per patient 

• individual job of each nurse

• The steps in a labor

The BEST thing that happened this week was being able to see an epidural and the progression of a labor as it got closer and closer to delivery time. The epidural seemed intensely painful ,but the patient was able to endure it.  I didn't actually get to see a delivery but that was highly unlikely since we only have an hour there and these types of things take hours upon hours.

The WORST thing that happened this week was the slow day on Monday due to antepartum patients. They didn't want any of the patients to have their babies because they weren't ready yet. That day all we really could do was go around and monitor the patients and adjust their medications accordingly.

Overall this week was:                                            GOOD

What I Observed

 

Fetal Monitor

Technology-

• Toe Pulse oximeter
  

• Fetal Monitor

• Epidural pump

  

  Toe Pulse Oximeter

Diagnostic Procedures-

• Cervical test

• Pulse analysis

• Fetal Monitor contraction analysis

Therapeutic Procedures-

•  Injections into arm

• Epidural

• IVs

Diseases/Disorders-

• Postpartum

• In labor

• Antepartum

Medical Terminology-

• Postpartum- after having the baby

• Antepartum- they are early and the doctors are trying to prevent labor.

  
  

Other-

• Each nurse is only allowed to be assigned 2 labor patients and up to 6 antepartum/postpartum patients.

  
  

  
  

  
  

  I. I worked at the labor and delivery/nursery wing which is locked off and only allows entry when you ring the buzzer and the camera turns on and you speak into the speaker then they let you in. Each of the patient rooms looked like a bedroom, rather than just the basics it had wooden architectural beams around the bed. Each room had a bed, a baby cleaning and warming station, a closet with supplies, a bathroom with a shower, a couch and some side tables. When the nurse needed any supplies aside from the medication she found it in the patient's closet. Each patient was hooked up to a fetal monitor, a pulse oximeter, and an IV pump. I remained in this part of the hospital the entire period.

  II. The majority of workers there were labor and delivery nurses or postpartum nurses.I did get to see the anesthesiologist but only when he was administering the epidural and I only ran into one doctor during the entire week. Each nurse was in charge of a couple patients each mostly due to the shortage of pregnant patients, given that they were at maximum occupancy they would each have 2 labor patients and up to 6 antepartum/ postpartum. To monitor the baby they use a fetal monitor which is hooked up to all the computers and sounds an alarm with any irregularity. Every few hours the doctor or nurse does a cervical test that measures how many cm they have dilated. Before administering any of the many drugs given to the mother the nurse fully informs them of what it is and how it will effect them. To ensure patient safety (more specifically the safety of the baby) the baby is given an electronic band and if they are taken out of that wing an alarm will sound and all of the exit doors in the hospital will immediately auto lock.

  III. The anesthesiologist gave the mother an epidural. He sterilized her back, then punctured her skin 5 times with a numbing shot, then took out this thick long needle and forcibly pushed it into her skin, then injected the fluid, then strung a coil looking tube into the thick needle, then taped it down twice and injected more fluid into it then connected it to a pump.The whole time he was doing this the mother was continually having contractions every few minutes. In the end it paid off because ten minutes later she was numb from the waist down. After the epidural she was given a catheter since she wasn't gonna be able to really control her bladder. From observing it a second time I was able to learn more about the sterilized field and how to preserve it.

  IV. This week I had a good week. Monday I only had antepartum patients ,but Wednesday there was a woman already in labor. I got to see an epidural which was pretty exciting and extremely painful looking. Although Monday was mostly charting it paid off because Wednesday was all the exciting activities.