Wednesday, July 17, 2013

Summer Semester Part 1 Labor and Delivery and Mental Health!

Whew! Summer's on its way to being over and I never wrote about the first half of my summer semester!! (Or the end of spring for that matter).

From the middle of May to the end of June I was in my Maternity and Mental Health clinicals!

I only had about 5 weeks of each sadly (well sad about L&D being short, not so much about mental health).

Labor and Delivery:

I sadly only got to spend about 2 full days in L&D which sucked because I LOVED it, like I was pretty sure I would. The hospital we had clinicals at is considered a large trauma center so there is a high risk OB unit and therefore much more high risk L&D than other smaller hospitals. There are about 15 L&D rooms and 2 ORs.

I saw two inductions, both with epidurals. I didn't get to see the delivery on my first mom. The second mom I got to witness her vaginal delivery (in four pushes none the less!).

I saw two c-sections when I was doing my NICU observation and pretty much all I can say about c-sections is... UGH violent. They just seem so, brutal the way they rip the mom's apart, cut them, everything.

Procedures accomplished:
- Immediate assessment on baby
- Baby bath
- New baby shots
- Antibiotic ointment in baby's eyes
- In and out catheter on mom
- PP assessment on mom
- Fetal monitor interpretation
- Vitals on baby
- Footprinting baby

Postpartum:
We spent 3 days on the postpartum unit which is definitely a much different pace. Much slower, and more boring in my opinion. Tons of time to work on breastfeeding with moms though, which I did enjoy. You do get a chance to do lots of assessments on babies, though which I didn't have any experience with before. It broke my heart to see the babies being sent to the nursery though. I'd say that it was split about 50/50 on mom's rooming in vs sending their kids to the nursery. The ones that basically lived in the nursery because mom was "tired" pulled at my heart strings. I'm like.. but its this brand new, squishy baby! So that was hard as well.

Procedures accomplished:
- Breastfeeding assistance
- Multiple assessments on newborns
- Change diapers
- Post circumcision care

Observation in the NICU and ultrasounds:
- I got to follow around two different nurses who were called to c-sections where they perceived that baby may have some difficulty. I loved this part of the NICU nurses job, and I think it'd be awesome. But then we took one baby up and the nurse basically became the baby's nurse and she was attempting to start an IV on the baby and that part of a NICU nurse's job is NOT FOR ME. They are so tiny.. and I don't know. Just not my thing. I also watched a PICC line inserted into a baby which was kind weird.

My other observation was with the ultrasound techs in the clinic. So I basically just watched them perform ultrasounds all morning. It was sort of interesting, but also kind of boring to me. Interesting to find out that their job is HARD though, they are the ones who may find out if there has been a fetal demise, if there are anomalies, etc, etc. So it is not all happiness and rainbows.

Mental Health:
Mental health, mental health. I'm still not sure how I feel about this clinical. At times I really liked it and found it very interesting and at other times it was SO BORING and I felt like it was pointless. We did see some interesting cases like mania, schizophrenia, psychosis, etc. So I did enjoy that, because the human brain and mental illness fascinates me.

Our clinicals basically consisted of being assigned a patient, reading their usually 2-3 inch thick hard chart to get information for our care plans and then sitting down to talk with the patients. We were practicing our therapeutic communication (which I found SUPER HARD in the beginning, but it does get easier), and allow the patient to tell their story to someone. I think a lot of students didn't like it because they felt that we weren't "helping them", but I don't know, I hope maybe we helped a little. Or at least we broke up the monotony.

After we accomplished that some of the students would sit around with the patients. One day we colored with a woman who was actively having auditory and visual hallucinations, so that was interesting to see. And another day we did a puzzle with a woman.

I also got to spend one day on the youth unit with two teenage girls which I found quite interesting and another day observing outpatient groups of teens. I definitely feel that if I were going to be a psych nurse I would want it to be with adolescents, because I enjoyed that much more than adults.

Procedures accomplished:
- Vitals
- Mental status exams
(Yeah, that's it)

Care plans:
OH DEAR GOODNESS they were so long for this class. Like 14-20 pages. We were required to do a care plan, mental status exam and a couple of process recordings. The process recordings I felt were incredibly hard because in them you basically write down, verbatim what you said, what they said and what therapeutic techniques you were using (or not using). Sooooo much writing and paperwork.


Overall, I loooooved going to the hospital for L&D each morning, and pretty much dreaded mental health, although I usually ended up enjoying it at least a little bit.

I loved finally being in the setting I could see myself working in (L&D) but was sad that I had such little time to spend and that we couldn't do more.

I do think that the therapeutic communication techniques we learned in mental health will be invaluable in any sort of nursing because communicating with patient is a huge part of a nurse's job. Not to mention that people with mental illnesses are everywhere, in every type of nursing, so it's good to have exposure to that.

Have you already done mental health or L&D? What did you think??

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