labor and delivery!

oh my.

oh me.

lucky me. happy am i.

i got the most sweet placement for my senior practicum (internship) at Hopkins on the Labor and Delivery unit!!!

it’s been a great week, my practicum is going very well-

#1. i have the most fabulous preceptor. ever. hands down. ever.

#2. pregnant women.

#3. babies.

#4. my schedule rocks. (i haven’t used that adjective since jr high, so you know it’s good)

#5. other shallow perks… no more nursing uniform that makes you feel like a twelve year old who definitely should not be trusted with a needle… surgical scrubs. woot woot. no more care plans,  also, no more boring black clogs, my new clogs are pinkish with flowers… like a party on my feet. i love them.

today was a bit of a slow day on the Labor and delivery unit, so my superstar preceptor and I went to the nursery, to, you know, rock babies, and feed babies, and swaddle them, and tell them how cute their squishy little faces were (oh, and do mean things like give vaccines, and assess their vitals, and hook them up to little EKG’s and pulse oximeters to monitor their heart and respiratory rate, and oxygen saturation level… making sure they were healthy enough to make it home with mom).

what a day… sooo hard (i’m being sarcastic)

it was the best. who says, i love that i spent 12 hours of a beautiful summer saturday at the hospital? (me)

i haven’t seen many births yet, probably due to the fact that JHH is a level three tertiary care hospital. basically meaning: 85% (ish) high risk pregnancies. some of the women coming in shouldn’t be giving birth yet for reasons such as the gestational age of the baby isn’t high enough, so they are being monitored and kept from delivering as long as possible. i get exposure to pretty complex cases, complicated disorders described in our text books, or disorders i hadn’t even heard of.

i see a lot of sad cases, more than I had expected to see on an L&D unit (with very my limited experience), but that’s one of the many beauties of nursing… being able to directly care for the patient and their family through difficult times.

having the family open up and trust you and having a positive impact on their lives is extremely rewarding. it makes all those damn care plans worth it.

~ will update you soon on my great post nursing school life/preview of real RN life, life.

it’s freaking fabulous. truly.

ha! take that

http://www.msnbc.msn.com/id/33483153/ns/health-pregnancy/

I’ve been working on the labor and delivery unit for a month now…watch this video, http://vimeo.com/6344770 (at least the beginning where the nurse describes what happens typically when a woman comes in).

It’s true. The cascade I’ve seen for nearly every patient is this:  early first stage labor (came in probably too early), IV fluids, continuous fetal monitoring, toco (to measure contractions) mom is now allowed to get up and is stuck in bed due to continuous monitoring, slow progressing labor (most likely due to being stuck in bed and laying on her back), several vaginal exams, artificially rupture her membranes, pitocin, epidural, foley catheter… then either (pushing with and epidural- which can be ineffective so you get: episotomies, tearing, both, neither (hopefully) or the vacuum, maybe some fetal distress (heart rate decreases) and then the ever convenient Cesarean birth.) Hire a doula and midwife, and statistically your chances of this ‘cascade’ happening go down, down down. (I posted some journal references so you can look them up if you’d like, those are only three of MANY studies done. I don’t have the time to write them all out, but you get the point.) You don’t have to be afraid of hospitals or docs. That’s not the point.

Just be educated and then be empowered ladies.

References.

Ballen, L. & Fulcher, A. (2006) Nurses and doulas: Comlemntary roles to provide optimal maternity care. Journal of Obstetric, Gynecologic and Neonatal Nursing, 35, 304-311.

Scott, K. D., Klaus, P. H., & Klaus, M.H. (1999) The obstetrical and postpartum benefits of continuous support during childbirth. Journal of Women’s Health & Gender-Based Medicine, 8, 1257-1264

VanZandt, S., Edward, L., & Jordan, E. (2003). Lower epidural anesthesia use associated with labor support by student nurse doulas: Implications for intrapartal practice. Complemntary Therapies in Clinical Practice. 11, 153-160

ladies. this blog is for you.

Ever since I started taking Nursing the Childbearing Family and doing my clinicals on the Labor and Delivery unit, I have somehow become the self proclaimed expert of obstetrics. Seriously, advice that you didn’t ask for, keeps falling out of my mouth, such as, “Take folic acid- NOW. I don’t care if you’re not planning on being pregnant yet, just do it. Seriously!”  See? I can’t help it! I’m all full of opinions and often find myself wishing that I could take all my friends and shrink them down to pocket sized people so I could bring them to class and the hospital.

But alas, that is impossible… I was going to blog about some “opinions” I now have, like,

Ask your doctor if he is experienced in vaginal deliveries with an intact perineum, (that is, can he do it without an episiotomy). Ask this before you pick him.  Don’t go to the hospital just because your water breaks, wait until your contractions are  regular and about 3-5 minutes apart- that’s if you don’t want to be a likely candidate for a cesarean section. (30.1% in the US and climbing… ) Vegan pregnancy? Yes. If you are pregnant, take classes and educate yourself about the birthing process. You’ll feel empowered by your body, instead of scared when those contractions hit and you want to give up. Watch The business of Being Born before you get pregnant. Hire a doula. Consider a midwife.

but I will refrain from spouting off too much advice… don’t want to seem so radical that you don’t believe me! Hahaha

More to come. Especially if you are of childbearing age and you are on my cell phone contact list.

hi!

Someday, I’m going to prove that studying actually does burn a TON of calories (the more complex the material- the more calories you burn)- if I can’t prove that, then I’m going to prove that working on a Labor and Delivery unit all day long increases your appetite-  because it has something to do with vicarious longings or some form of subconscious pregger’s-belly-envy. I have no idea…But I’ll figure it out and get back to you someday.

That was my back to school introduction!

So yes, I’m back , and it’s taken a week and a half for me to be say with honesty this next sentence…”I’m excited about this semester!”

My brain has never been asked to be stretched further, the workload has not been this intense- and yes, probably due to the constant running around, or the biking around everywhere on my new bike -(Yay!), there is now my continuous need for sustenance! And seriously- studying Pharmacology and trying to remember drug-this and drug-that… it makes me quite famished!

But as I eluded to earlier, there is another reason (perhaps!?) for my famish’ed’ness. Labor and Delivery! I LOVE my classes this semester- namely my OB and Birth Companions classes. Pregnant women are lovely- and babies- what can I say about new beautiful babies-I’ll just sighhhhhhhh…instead………..

On my first day when I got to see a delivery- I practically passed out- not because of all the blood or the placenta that was placed in the blue tray in front of me, but because I was in love. I think I floated home from the hospital that night and my feet didn’t touch down until the next day. Labor and delivery is making my semester.

Then there’s birth companions- Amazing! I am so excited! By the end of the class we qualify to be Doulas (birth companions). The even better thing- is that they are internationally recognized through DONA, and this is very conducive for my goals, so this is good! (DONA site)

What else? What else? There’s my bike. Love her. She’s taking me all around the city and this has exponentially increased my satisfaction with my geographical locale.

I guess I could ramble on and on about other amzing things that have happened this semester- involving Dentists, a marathon, Mya (!), and my sweet class at the school of public heath on Humanitarian Emergencies….but… I think I’ll spare you the details or write about them later.

Peace- Rachel