WEEK 6: NURSERY

This week I did my clinical with an RN in the nursery department. She was in charge of mostly the sick babies ,but as needed took care of the well ones. She was in charge of the baby after it had been delivered ,but work with the delivery in needed situation. She stayed in the labor and delivery wing ,but went in and out of the nursery to transport the baby to and from the mother.

Things I learned this week-

• the different stages of baby triage
• care of a newborn
• job of a neonatal RN

The BEST thing that happened this week was observing the care of newborns that were literally less than a couple hours old. I was able to see a newborn at its youngest stage. It was so small and fragile looking. At it was so sweet being able to watch the family take there first looks at their new twins.

The WORST thing that happened this week was the first day in most of the babies were about to be release and were all sleeping. It was fun because I liked to watch the babies take their last physical exams but they were short and simple ,so they slept most of the time. When the babies slept the nurses charted and were busy.

Overall this week was GOOD.

What I observed..

Baby Incubator

Technology-                                                                                    

Transcutaneous Jaundice Detector

• Transcutaneous Jaundice Detector                           
• baby incubator
• infant radiant warmer

Diagnostic Procedures-

• physical examinations for baby reflexes
• electronic thermometer
• temperature monitor

Therapeutic Procedures-

• Ointment on the eyes withing minutes of delivery to avoid infection that may cause blindness
• infant radiant warmer
• IVs
• ready made formula

Diseases/Disorders-

• Jaundice                                                                   
• premature newborn

Medical Terminology-

• NICU- critical care newborn center.

Other-

• Babies may have purple limbs for up to a few days due to the adjustment of the flow of oxygen from the mother to the blood supply to the lungs to the blood supply.
• Each baby is placed with a monitor that locks all doors if the baby is removed from the hospital.
• The monitor is placed after the baby receives its first bath.

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. To get into the nursery there is another buzzer you have to ring and someone comes to the door and opens it. There are two rooms one is the NICU and the other is for healthy babies. There was from 3 to 8 babies in a room at any given time. There are only the workers and babies allowed in this area. The babies each had a crib and the newborns were placed in a radiant heat warmer to warm up their body to the correct temperature. I remained in this part of the hospital the entire time.

II.The majority of workers were RNs. I saw two neonatal doctors and one technician. The doctors performed the physical diagnostic procedures. The nurses physically cared for all the babies each assigned to a select few and possibly only performing certain procedures for each. The technician charted and restocked supplies within the nursery. The temperature of the baby was crucial so they used a circular disk that they placed upon the baby's stomach that held a constant reading on the baby's temperature. When they brought the baby in for a check up they used an electronic thermometer that read the temperature on the skin. To prevent blindness they placed an ointment on the babies eyes immediately after delivery. Each RN works together with the others to keep each other updated on mother and baby conditions.

III. Premature babies are along enough to be delivered but are slightly under developed. They are usually underdeveloped in there stomach so they must be fed through IVs. If the baby is slightly smaller than a normal baby's range it may be fed formula that will increase the glucose levels to allow it to grow a little. Jaundice is a neonatal skin disease that is derived from a blood transition from the mother's blood to self supplication. The hemoglobin levels may be off causing a slight yellowing of the skin known as jaundice. This is a reversible disease that may be cured with IVs and antibiotics.

IV. Overall I had a good and educationally enlightening experience. In the nursery you may have a lot of downtime when the babies are sleeping so they often ask you to ask them questions. They are all very knowledgeable and give very thorough  explanations.