I had a great day at clinicals, I got to see my first birth!
The laboring woman was a single mom and she only had a friend for support so she was happy that me and a classmate stayed with her all morning. She came in yesterday @ 39 weeks 3 days with ruptured membranes but no contractions. She got cervidil last night and had an epidural in place but her contractions were irregular and as of this morning she was still at 3cm.
Nothing much happened until 1 hour before we had to go a resident came in and started a pitocin drip. After that things went really fast and despite the epidural the mom started to feel the contractions. The resident kept coming back like every 15 minutes to turn up the pitocin but she didn't check her. She explained to us that it was because her membranes had ruptured so long ago that the more cervical checks she had the greater the chance for infection.
About an hour after the pitocin was started the contractions were coming about every 3 minutes and I thought I was going to miss the birth because it was almost time for post-conference. The grandmother showed up around this time but she was also fine with us viewing the birth.
The resident increased the pitocin 4 times and the last time she came in I "innocently"
asked her if the patient had progressed since she had not been checked since very early in the morning. The resident decides to check and what do you know? She was 10cm +1!
Then the drama started the attending came in and tried to kick us out!
He had a really snotty attitude and he jokingly told the family to "kick us out" then he got snotty with us and asked if we had permission from the family to be there. Of course the first thing we did when got there in the A.M was to ask for permission from the family and luckily we had been real nice and had established a rapport with patient, friend, and grandma.
The attending was pi**ed off! He started to talk to them in Spanish because he assumed that my friend and I didn't understand. My friend DOES understand Spanish and she told me what he said so I flat out asked him if he wanted us to leave and he didn't respond.
At that point I decided to pick a corner and make myself very small and be very quiet but I wasn't leaving unless the attending told us flat out to get out of there!
So we didn't leave and guess what? They broked down the bed and mom started pushing and then about 8 residents came in the room and never asked mom or family if they could observe! They just walked in like they owned the place and of course the attending said nothing to them about asking for permission! What a snot...now I know why he wanted us to leave....so that he would have room for his 80-11 residents!
Anyway, it was a wonderful experience and I hope I get to see another birth real soon.
This is the part of nursing that rocks!
My instructor was fully aware of the situation because she was standing directly outside of the door.
I didn't state this in my first post but another resident exchanged words with the clinical instuctor earlier so she knew what was going on. If my clinical instructor felt that we were being innappropriate she would have made us leave.
As far as what was said in the delivery room...it was not in any way a screaming match and the attending never asked me or my classmate to leave.
I flat out asked him if he wanted us to leave and he didn't respond.
I didn't ask him with a hand on one hip while rolling my eyes and neck. I simply asked him a direct question and if for whatever reason he couldn't open his mouth and say "Yes I want you to leave" then that isn't my problem.
Clinical experiences are limited...who is to say the attending would be more welcoming the next time I saw him?
The thing that I am learning about clinicals in general is that you must be proactive and develop a thick skin. Now don't get me wrong, I am not disrespectful or a know it all. I don't jump in and try to do anything that I have not been directed to do so when I say proactive I mean it in the sense of seeking experiences despite the attitude of some of the staff. Sometimes they do not want to be bothered with the students at all.
I understand where they are coming from because who wants to be bothered if they don't have to be. At the same time though I came to learn and if I am not learning something then there is no point in my being there. So sometimes despite the rudeness and cold shoulders of some of the staff I have got to keep asking questions and asking to be allowed to participate wherever I can. You only have so much time as a student to absorb as much as you can.
I do not allow myself to be pushed to the side and I follow the direction of my clinical instructor at all times. Just wait until you are at a clinical site and your instructor gives you your agenda for the day. Go back to her/him and tell him that you left/didn't accomplish what you were told to accomplish because so and so gave you a vibe or said to someone else that they didn't want you there and see what happens next.
Guaranteed you will be told to get back in there and do what you were told to do or it's going to be your b*tt.
Just a heads up for nursing school.
Quote from Hopefull2009
I look at this differently...I wouldn't have got into a "urinating" contest with the resident with the family present.
Yes, you had permission, yes, you had a right to be there...but if the body language of the resident tells you that the he wants you gone, I probably would have left and talked to your clinical instructor, explained the situation and asked what to do, and let them handle it.
You were determined to witness the birth regardless of what was happening around you....great for your instruction, but what about the patient? Should the family have witnessed what appeared to be an argument between healthcare personnel?
Just my .02
Last edit by Lovely_RN on Jun 25, '07
Quote from tntrn
You are possibly correct it may have not been the wiset thing to do I guess I will find out if it comes back to bite me in the rear in the future.
I've got 31 years of experience as a Labor Nurse and in that time have had many students follow me around.
First and foremost, the patient (not her family) is the one who needs to be okay with anybody other than essential staff being there. This includes students, friends, family (even if they've traveled hundreds of miles ) and all the rest. And she's allowed to change her mind whenever she wants.
I did have permission from the family to be there. It was the attending who did not ask permission for all of the residents to come into the room....there were no less than 7 and they did not come in until the head crowned.
However, the doctor can override that for any reason he/she so pleases. Sometimes there's a real necessity for a room to be cleared.
The doctor NEVER directly asked me or my classmate to LEAVE...instead he spoke in Spanish to the family (which he thought we wouldn't understand. I ASKED if he wanted us to leave and he did not respond.
As a student, you probably make more points if you quietly go and later try to get a debrief from the physician as to why he/she made that decision. Or perhaps it's something your clinical instructor might help you with.
Again, my clinical instructor was aware of the situation and was standing directly outside of the room. If she wanted us out of there she would have told us to come immediately.
Remember you are guest at that facility and not part of essential staff. Yes you are there to learn, but part of your education there will be to learn how to interface with a lot of different personalities.
Please do not take this comment the wrong way but while I am a student nurse I have been working for years in other jobs and I had a career before I decided to return to nursing school. I'm youthful but I am not a "young girl" by any means... nursing is going to be my second career and I guess at this point in my life I have an idea of how to interface with other people.
Standing your ground like you did (as a student) may not be the wisest thing. Sometimes it's just not going to happen and you have to live with that.
That said I do thank you for the advice it is something to ponder for this weeks upcoming clincals.
Last edit by Lovely_RN on Jun 25, '07