I'm a first-year nursing student in a part-time program and a first-time poster. Gotta say first that I love this website. It's so informative and supportive. Now if I could just tear myself away from it long enough to study for that next exam...
Anyway, we just started a L&D/postpartum rotation. I LOVE it so far, and I'm thinking that this is the way I want to go, or eventually to some related field like the NICU. This is the first time EVER that I've had a long-term goal in mind for my career, so I'm really excited and I want to do this right. The problem is where I seem to stand as a "student nurse" in relation to the moms and families that I'm trying to care for and educate.
From talking to my instructor, being a postpartum nurse is a challenge anyway because it's hard to work your tasks around family visiting time or mom/baby time. But I find it a bit harder because as someone who is "just" a student nurse, and who is perceived as such by the mom, I have much less authority in the mom's and family's eyes to come in and do my tasks as needed. They are far more receptive to their assigned nurse than to me. This has been true of my other rotations to some degree (mostly in elder care up to now), but it seems more obvious now because there are so many more people affected by a baby's arrival......more emotions that I need to keep in mind (privacy, family bonding, mom's protectiveness and emotional lability postpartum, etc.)...and so many more people who are protective of mom and baby. What I'm finding is that on the mom/family side of things, I feel like an INTRUDER. I hate walking in on a mom's bonding with her baby, or on a family visit, so I can try to get my assessments done. Usually what I find is that when mom is alone and I walk in to do what I need to do, she is pretty open and receptive. But when she's with baby and/or family in the room, the mom gets irritated and annoyed (and sometimes the family does too). It makes assessments and teaching very difficult for me, because I hate being given the hairy eyeball by mom and family despite the fact that I'm doing everything as correctly and gently as I can, and explaining the whole time what I am doing. (The fact that the hospital doesn't really enforce postpartum visiting hours doesn't help much, but oh well.)
Of course, taking care of the babies is easy...they can't really resist your care or assessments or procedures, and they certainly can't talk back! :wink2:
I realize that part of it is my problem. As a first-year, I am still learning to prioritize and juggle (especially with 2 patients now -- mom and baby -- instead of just one), and I could better arrange my tasks so that I get as much done as I can while mom is alone, or at least before the whole family comes to visit. I did better this week, but also didn't expect the baby to be rooming in...which meant a lot less time assessing either mom OR baby because mom or family seemed suspicious that I didn't know what I was doing. I tried to time things around the baby's feedings and periods of alertness; around family visiting; around mom's willingness to be assessed; around the baby's circumcision; and around my boundaries as a student nurse. I know, you're all probably either rolling your eyes
or laughing at me
...after all, welcome to nursing!! I have said this before and I'll say it again: I don't know how nurses do it. I missed so many things in the process of juggling, though I tried not to. I tried to find my instructor several times so she could observe certain things that I was doing (also giving me more "clout" at the same time with her in the room), but with 5 other students to tend to, she couldn't always be there when I needed her... So that just made it harder to get things done.
This past week was the second week in a row that I didn't get all my assessments done because family was visiting way before regular visiting hours. I talked to my instructor about this, and she did concede that as a student nurse, I have to walk a fine line. If I was mom's regular nurse, I could push harder to get things accomplished. But as a student nurse, not only do I not have that kind of authority, but I also don't want to piss off the patients and families, who would then complain to the hospital about the student nurse who is a pain in the behind, and then my instructor would have to defend me AND the nursing program, etc. etc. etc.
I'm not really sure what I'm looking for here. I mostly need some assurance that THINGS WILL GET BETTER WITH TIME!! I only have a couple more days for this rotation, then it's on to Pedi, where I'm sure similar clashes between my "student" status and parents and family will arise. I definitely need more experience juggling tasks, and being assertive enough to get things done, but with tact and finesse (and without overstepping my bounds as a student). Any tips, experiences, etc. that anyone has would be greatly appreciated!! A friend of mine (a med/surg nurse for 5 years) says that once I'm an RN, I'll be able to go in and do what I need to do with more authority...but I don't know if I can wait that long, I do have to pass clinical
Oct 2, '06
Quote from jov
It ought to be terrific that the hospital doesn't enforce postpartum visiting hours....
I know, I know...:imbar that really did come out wrong. I'm just frustrated right now, but certainly dads (or whoever the mother designates as her partner/primary support person) should have the right to visit whenever they want. I guess I'm just surprised to see a horde of family members descending on the PP unit way before visiting hours start...not my experience with previous rotations (like I said, we've done mostly elder care up to now).
Quote from jov
Other than that, perhaps you could become part of the entire experience for the new mom and her baby. Are you asking her about her feelings about this experience? How her care has been? How her care experience could be improved? What does daddy think about the new little one? What are they worried most about? Are you ooing and aaing over the little one? If family is there, i.e. grandma, do you really MEET grandma, and spend a little time with her too, getting feedback? Seems to me this is a perfect opportunity for lots and lots of patient teaching, student nurse or not. I don't ever remember bristling at any nurse who came in to give me care in the L&D/Recovery rooms. It's a department that's mostly just happy all over!
I do try to go beyond the usual assessment and actually talk to the moms about their feelings, how well they are prepared for the new baby (emotionally; is the room ready at home; how does family feel about the new arrival; etc.) I'm still pretty new at this (plus not a great conversationalist in general) and when I do ask these kinds of questions, I find myself getting distracted from the physical assessment. I'm still at the point where there are questions I forget to ask on the first time around, and once I start juggling tasks, I never get back to the discussion
I really do want to spend time with mom and family, getting their idea of the whole event, because I've been through childbirth myself, with all the excitement and change and some of the mixed emotions that come with it...and I think I can teach quite a bit. But honestly, once I get a vibe of "would you just leave us ALONE" from the family, that's it, it kind of scares me off. It shouldn't, and that's my problem, not the patient's...something I need to work on.
Last edit by nightingale1969 on Oct 2, '06