I am currently on my maternity rotation, which I was really excited for. It is so short (only 5 weeks), but so far I have already had a wealth of experiences. The whole rotation has such a different feel for it. After the med/surg rotation, dealing with people just getting out of surgery or with serious medical conditions, and then telemetry where I was in the Intermediate Surgical Intensive Care, and the Surgical intensive care. Here we dealt with people who suffered a severe trauma, which was pretty intense. My most memorable patient was one that was hit my a motorcycle. He was on a ventilator and was sedated on a propofol (diprovan) drip. Does this drug sound familiar to anyone?
Needless to say labor and delivery, and postpartum has a wonderfully different feel to it. There are still some disturbing aspects with how the hospital runs things, and I am continually reminded why I will not have my baby in a hospital setting. The nurses in this unit have been around for way too long. They say it is difficult to get a job in maternity because no one ever leaves it. Needless to say on two of the days we were there, it was very slow and the nurses spend the majority of their time at the nurses station gossiping, painting nails, reading magazines and eating cookies. Is it any wonder they are all overweight? They also spend a ridiculous amount of time making fun of their patients, I'm sure this is a coping mechanism, but come on.
My first day in L and D I observed a c-section. I did not know the patient but was able to go in and just watch the process. It was pretty fascinating to see the baby come out that way. Most fascinating of all was being able to see the entire uterus sitting outside this woman's body, whoa! She had her tubes tied afterward which involved tying a string around to ends of the fallopian tube and then cutting off the tube between the strings.
Later that day I saw another c-section. It was a patient I had been working with all day. She was a young mother (only 20) and was being induced because her baby was very small and not getting proper nutrients from the placenta. Inducing means they give you a drug to "ripen" your cervix and another drug to force contractions of the uterus. This patient received these medications early in the morning and was on a drip all day of oxytocin (which is the hormone that causes contractions). They continually increased the drip of oxytocin throughout the day saying that continued contractions would assist with dilating (the patient was only dilated 3cm). The problem with this is that when there is no recovery time from contractions the baby essentially has no period of recovery. When contractions occur the baby and umbilical cord are squeezed, and no nutrients (glucose) and oxygen are able to get through. This can put the baby in distress. The patient never dilated any further and eventually they called it and took her in for a c-section saying it was a "failed induction". Really? Imagine that. Ugh. The patient was very worried about the c-section thinking she might be able to feel something. I had her almost convinced that she would be able to breast feed, and now with the c-section I am quite sure she won't follow through, because it does make it a bit more difficult. The baby came out fine, and very healthy.
Yesterday I was able to follow a family through the entire birthing process. It was a young couple (both doctors) having their second child. The woman had an epidural, which had to be done twice. Ouch! She was able to get some pain relief from her contractions which is what she wanted. She did not receive any other medications, and once her cervix dilated 10cm she began to push through the contractions. I was surprised at what a huge role the nurse plays in this process. The doctor is in with other patients and does not come in until the head is crowning. I had one leg and the husband had the other. He counted loudly for her through the contractions while she was pushing. I began to see the baby's head, his hair was sticking out! Soon after the doctor came in and finished the process. It was so amazing! I cried along with the family. After the assessment of the baby the woman was able to breast feed immediately. I assisted them with moving up to the floor and thanked them for letting me be a part of their experience. It was truly amazing. I see why nurses never leave!
So the part I don't like, the nurses themselves who have been there too long and don't seem to care about what they are doing, the overuse of interventions, the lack of privacy and ability to make decisions (though you can make your own decisions, the nurse might get smug with you because she knows what's best), the ridiculous amount of c-sections.
I think this is a job I would love to do to get some experience and if I got brave enough, to go back to school for midwifery.
Right now I am thinking very seriously about travel nursing and hope that it is an option for me when I graduate.