So if you have been following my blog thus far, you know that I have been shuffled around a lot this term between paediatrics, paediatric emerg, adult emerg, mommy/baby (ok there was nothing going on the day I was there, so you probably haven't heard about that), and now, finally, I have been assigned to labour and delivery. I'll spend a measly 3 shifts there (1 for which I have already completed) but at least it's an experience, or so they tell me.
I didn't tell you that I have completed my last content course of my nursing degree. I have some seminars later this week and next, but overall, I'm pretty much done most of my nursing degree! Now only if I can survive the next few weeks of exams and assignments, I'm free!
Ok back to labour and delivery. Today seemed like it would shape into a pretty boring day. On the board there were three women delivering. One was at 2cm dilated, 1 was almost there at 9cm (but one of my group-mates would get that experience as he was going to PACU instead of labour and delivery the next day), and the other was just there for a ?labour. The one nurse with the 9cm dilated woman had to train new staff, so we lost out on watching that one. So, with 6 of us needing to get some experience with L&D, it didn't look so good. However, there was a scheduled c-section that day, so things were looking up.
It turned out that most of us were able to assist with this delivery. One of my classmates scrubbed in and helped the scrub nurse with the section and tubal ligation. Another classmate followed the circulating nurse. Yet another classmate stood back and also followed the circulating nurse. THEN, there were two of us assigned to the baby assessment area, plus our instructor who would guide us through the assessment.
It was my job to do the initial assessment on the newborn baby. Essentially, the baby would be taken out of utero, given to the circulating nurse, who then would take the baby into another, smaller room to get it ready to see mom again. During this time you need to do 2 apgar* scales, one within 1 minute after birth, and one 5 minutes later. You also need to clean the baby off, to get it dry, put the hat on him/her, assess breathing and heart rates (and quality), give erythromycin to the eyes, and a vitamin K injection into the thigh. THEN you need to shorten the cord (if need be), diaper the kid, and swaddle him/her. All of this should be done fairly quickly, so that baby can get back to mom.
*the Apgar scale was developed to assess the health of a newborn. The scores range from 0-10, with each of the 5 categories having a maximum score of 2. It involves appearance, pulse, grimace, activity and respiration.
Of course with a student doing the assessment, I think it took twice as long as it probably should have taken, but I must say that it was a very interesting experience! Good thing there was no problem with the baby, as even with all the first responder training I have completed, if something went wrong I think I still would have freaked a bit. Of course my instructor was there (she's an RN and a midwife so she looks after babies all the time), but still, it was a tense situation.
I enjoyed it today... I would have got to see another c-section but I had to leave for an appointment. I'll update you further how tomorrow goes.