A year at U of R

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Thursday, September 07, 2006

Labor & Delivery clinical

I walked out of the first day of the new clinical rotation thinking, "Everyone on the planet should be a nurse." They told us that the labor and delivery rotation is a one chance in a lifetime type of experience. I wish everyone could experience it.

All of the seminal events of life; birth, death, health, illness, families, emotion, used to be commonplace at home. A hundred years ago, births seemed a more integrated part of daily life. Now they are all hidden away in six story, billion dollar buildings with parking garages that charge by the hour.

The difference between the nurses role and the MD's role in labor and delivery is marked. The nurses are there non-stop with the patients, as long as it takes. They know the patient, the meds, and all the details. They take the mother all the way up to the birth. A doctor or midwife just comes in at the last minute to "catch" the baby. Which job would you prefer?

This clinical is supposed to be more observation, but today was definitely hands on. In addition to inserting my first foley catheter, I took the mother's temperature several times, helped change linens, wiped her forehead with cool washcloths, and assessed the average fetal heartrate and spacing of contractions based on telemetry data. I got to talk with the family members, and I even did a little teaching. I explained to them what pitocin is, and the effect it would have. I could follow the medical jargon of the nurses and doctors better than the family, so although I knew very little about the birthing process, I could occasionally translate a little for the family.

In one day, I observed an epidural injection, deaccelerations of a fetal heartrate, insertion of an IUPC, amnio infusions, administration of pitocin, and bolus infusions. Wow. Although I didn't actually get to see a birth, I saw plenty of life for one day.