NSG355LReflectiveJournal

RachelMarkovich
Thislastclinical,on9/28/2015,Iwasassignedlaboranddelivery.Ihavetosayitwasbyfarmy
favoritedayofclinical,butnotforthereasonsyoumightthink.UponarrivalIwaswhiskedawayto
changeintonewscrubsandwatchaCesareanBirth.WhenIwalkedintotheoperatingroomthey
wereabouttodothesurgicalpause.IhadseenaCSectiononYouTubepriortothisexperience,but
nothingcomparestowatchingitperson;IwatchedinaweasthenurseinsertedtheFoleycatheter
withextremeconfidencethatwilltakemequitesometimetomatch.Iwasmesmerizedbythe
cutting,thepulling,theclipping,thecauterizing,thesuctioning,andfinallythebirthingofthebaby
boy.IstayedintheORaslongasthepatientdid,andthenfollowedhertoherroomwheremynurse
stayedforthenexthourtodoPACUduties:takingvitalsigns,watchingthemothersheartrateand
pulseox,massagingthefundus,talkingwiththepatient,documenting,andadmiringthebabyupon
hisarrival.Assoonasshewastransferredtothecareofapostpartumnursewewentovertothe
L&Dnursesstationtoprepareforthepatientabouttocomeinforaninduction.Oncethepatientwas
admittedweworkedwithherforawhile,andthengottoseethemidwifeinaction.ThenextthingI
knewitwaslunchtimeandIgottositdown!IrealizedthatIhadbeensobusyIhadbarelysatdown
allmorning,andthatisthereasonwhyitwasmyfavoriteclinical.InallmyclinicalexperiencesIhave
hadsomuchdowntimeanditsreallyboring.ForthefirsttimeonMondayIwascompletelyoccupied
fromthemomentIwalkedintothehospitaluntilthemomentIleft.SureIwasexhausted,butitwas
exhilarating.
Nowfortheactualassignment
1. Withoursecondpatient,shehadalotofanxietyregardingchildbirthandwasevenmore
anxiousabouttheinduction.Asthemidwifeexaminedhercervixshegotquiteemotionaland
tensedup.Sheputherheadbackastearspoureddownherfacethisisnotthebirthshe
envisioned.OriginallytheFoleybulbwasntoffered,justthePitocin,butthewaythemidwife

NSG355LReflectiveJournal
RachelMarkovich
presentedthebulbitgavethepatientasenseofcontroloverthesituationandmaybeaway
toavoidthePitocin.
2. Inoticedthatwhenourpatientbegantobenoticeablydistressedboththenurseandmidwife
wereextremelygentlewithher.Mynursewasrubbingherarmwhilethemidwifeexamined
hercervixandplacedthebulb.Themidwifeherselfwasreassuringthepatientthatitwas
goingtobeokayandthatprettysoontheywouldbegoinghomewithababy.Allofusknew
thatthepatientwasgoingtoneedPitocinaftertheFoleybulb,butthatwasntabruptlysaid,
ratheritwasimpliedandweeasedthepatientintoitwhiletheFoleybulbwasdoingitsmagic.
3. Wehavebarelytouchedonanythinginclassasidefromthephysiologicalbirthingprocess.I
knewaheadoftimethatitisextremelyemotional,butIhadneitherseenitnorrespondedto
it.IalsowasunawareoftheutilizationoftheFoleybulb.
4. Primarilyitispreparedmetocarefortheapprehensivemotherwhohascomeinforan
inductionbothemotionallyandphysiologically.Ilearnedtheoptionsthatareavailableand
howtopresentthemtotheanxiousmotherandfather.IimagineIwillhandleanother
situationalmostthesamewaywithkind,reassuringwords,physicaltouchwhere
appropriate,andexcellentnursingcare.