I Will be Doing a Mother/Baby Preceptorship in April.

rn/writer, RN · Mar 7, 2012

so what would you like me to be up to speed on if i came onto your floor?
assessment parameters for mom & baby
yeah, you should know what's normal so you'll recognize what isn't.
common meds: pit, oxytocin, pain meds?
definitely learn about pain meds--what and when and why they're given. if you're doing mother/baby, you won't be using pit except for excessive postpartum bleeding. but you could certainly bone up on postpartum hemorrhage and what needs to be done. other items include constipation/hemorrhoid meds, htn meds, anti-itch meds. learn what you can about pca-analgesics (usually morphine or hydromorphone) and duramorph and their side effects (and what to do about them).
swaddling technique
practice till you get it right. this is a wonderful, sanity-saving tool for parents everywhere. some people wrap babies with the arms straight down. i tuck each arm into the blanket on the same side before bringing the blanket over the tummy. to me, this is a more natural position, and they don't fight it as much.
what else?

learn everything you can about breastfeeding, immunizations (particularly hep b and tdap), hyperbilirubinemia (jaundice), low blood sugar in newborns, temperature problems in newborns, skin-to-skin, common problems in the newborn population, how to include dads and other family members in teaching and care, and whatever else your instructor suggests.

if you can visit the unit ahead of time, see if they'll let you look at whatever standing order sets they have so you can familiarize yourself with the terminology and their protocols.

hope it all goes well for you.

Double-Helix, BSN, RN · Mar 7, 2012

Remember that you may have antepartum patients on Mother/Baby. These are patients admitted for premature labor and complications such as preeclampsia that need monitoring. So be familiar with s/s of preeclampsia and eclampsia, medications used for premature labor (as well as side effects and antidotes).

Also be familiar with your response to OB emergencies. Some of the big ones I can think of are a drop in fetal heart rate, placental abruption, prolapsed cord and HELLP syndrome.

Also, consider that you'll be caring for a lot of new parents with a lot of questions. A huge part of your job is education. So make sure you learn as much as possible about newborn care. Here's a list of topics and questions that I'm listing off the top of my head:

Breasfeeding: What position should I hold the baby in? How do I know when the baby is hungry? How often should I be breastfeeding? For how long? Do I need to switch sides during a feeding or can I alternate each feed? Do I wake the baby up to eat? How do I know the baby is getting enough to eat? What if my breasts hurt or my nipples get dry and cracked? Should I pump? How long can I store breastmilk for? Do I need to avoid certain foods and medicines while breastfeeding?

Formula feeding: Ways to decrease milk production and avoid discomfort for moms. How much formula does the baby need? Which formula should I use? How do I mix the formula? How should I warm up bottles? Can I save the unused formula? What if my baby doesn't like the formula?

Dressing: How many clothes does my baby need to be wearing? How will I know if the baby is too cold or too hot? Do they always need a hat? Is it okay to put clothes over the umbilical cord? Do I need to wash all the clothes before my baby wears them? What detergent is best to use?

Bathing: What's the best way to bath my baby? How long before I can give them real baths? How often do they need baths? Should I wash their hair? How do I know if the water is too hot or too cold? What soap should I be using?

Diapering: Be able to demonstrate proper diapering for boys and girls including folding the diaper under the umbilical cord. How often does my baby's diaper need to be changed? What if they get diaper rash? Are cloth diapers better than disposables? What brand of diapers are best?

Soothing: How do I know why the baby is crying? How can I soothe my baby? Do I need to let the baby cry it out? How long should I let them cry? How do I swaddle my baby? What blanket should I use? How long can the baby stay swaddled? Are pacifiers good for the baby? Will pacifiers make it hard to breastfeed?

Sleeping: When should my baby be sleeping in a crib? How long should they sleep? Do I need to wake them up to eat? Is it okay to breast feed while I am in bed? Is it okay to have the baby sleep in bed with me? Should there be toys and blankets in the crib? Are crib bumpers safe?

Postpartum: How do I care for my episiotomy stitches at home? How long should I bleed? Are clots okay? When should I be concerned that I'm bleeding too much? How often do I use the peri-bottle? For how long? When is it safe to have sex again? I have hemorrhoids. How do I care for them? How long should it take to lose the baby weight? When can I start exercising? Can I do sit ups? When do I need to see my doctor? I'm concerned about post-partum depression.

Bandaide, ADN · Mar 8, 2012

Thank you for all the suggestions! I'll be studying up over spring break so I will be ready to go. If anyone has anything else, please feel free to add more.

PinkNBlue, BSN, RN · Mar 13, 2012

Ditto what they said. :) You'll love it. Enjoy!