NS about to start OB rotation. Any advise?

SillyStudent, ASN, RN · Apr 24, 2008

Bring tissues. The first time I got to 'help' with a delivery, (I was a 'leg holder' while she pushed) I had tears running down my face by the time the baby crowned. It's a powerful experience to watch. The mom was touched by it....so glad she didn't think I was a nut!

zahryia, LPN · Apr 24, 2008

Honestly, your kindness is the biggest thing you can bring to the unit. If all you do is get water for the laboring mom and listen, you've done a lot. And that's assuming you can give her water.:uhoh21:

Watch your facial expression. You're going to see lots of blood and fluids and poop. You don't want the mom to be anymore anxious than she already is.

Of course, it's a learning experience, so I would just be open to the experience. Try to learn as much EFM as you can before the clinical. That type of thing is hard to learn on the spot. You want to know that before the rotation.

Good luck! You'll be fine.

P.S. Don't pick up the baby like it's an alien.

brighella · Apr 24, 2008

I'll tell you what my OB clinical professor told all of us the begining of this semester. "It doesnt matter how cute it is, that baby just came out of her bloody hoohah. If you dont know her well enough to touch her hoohah without gloves, dont be picking up the baby without em." That being said assume pretty much any surface you touch will be contaminated...grandma and daddy still touch on the new baby then push the curtains around, open the doors, take things from drawers, push the buttons on elevators etc etc. I learned the hard way...i had gloves on but then auscultated the baby and put the stethoscope back around my neck, and proceded to get the thermometer, move a chair out of my way, all with baby gloves on. She just watched me do it, then talked to me later, urging decontamination, and only half joking. Whoops! Now im definitely conscious...almost paranoid about washing my hands. The facial expression advice was good too - gotta get a poker face dude! :)

Sarah

bookworm1 · Apr 24, 2008

I just finished my OB rotation this week. Some advice a kind physician gave me as I was watching a C-sect: "step aside, you are directly in the line of fire". I stepped to the side just as the doc made the incision into the uterus and was just missed the spray of blood and amniotic fluid. The doc was laughing her butt off, but my classmate was turning all shades of green. It was great:bugeyes:. Also, compare textbook norms to the real world norms. Keep the real norms in the back of your head, but remember the textbook norms for exams! The other thing I had difficulty with: don't be judgmental-even when you see the teen dad trying to give his 2 hour old infant a cheeto...took alot to bite my tongue and kindly inform dad that cheeto's are inappropriate for all babies. Babies prefer bottles with formula-oh that poor baby:crying2: . Right after that, we came into the room to discover he had left baby alone on the sofa while he was across the room talking on the phone bragging about his status as father:banghead:.

mcubed45 · Apr 25, 2008

The other thing I had difficulty with: don't be judgmental-even when you see the teen dad trying to give his 2 hour old infant a cheeto...took alot to bite my tongue and kindly inform dad that cheeto's are inappropriate for all babies. Babies prefer bottles with formula-oh that poor baby:crying2: . Right after that, we came into the room to discover he had left baby alone on the sofa while he was across the room talking on the phone bragging about his status as father:banghead:.

wow. it still boggles my mind that you need a license to operate a motor vehicle but ANYONE can be a parent....

sorry, guess that's bein judgemental but those poor kids...

Calzonan RN · Apr 28, 2008

I just finished NS last December so I may be a little more aware of students in my unit because of that. Some advice, not just for OB but for any rotation, learn as much as you can!!!! I can't believe the number of students I see just standing around chatting with fellow students and doing nothing, they're just letting this opportunity pass them by. Believe me, when you're on your own you'll wish you had more experience!! Take any opportunity you can get to practice your skills, attach yourself to your preceptor if possible, that means if they're sitting there 'just charting' watch how they're wording things, ask them questions, become a sponge, :lol2: . Let the other nurses know that if they have any skills they need to do, you'll be more than happy to do them (provided it's okay with the unit/school).

Read up and be prepared before clinicals, this way you'll understand/retain more. If there really is nothing going on at the time, then practice reviewing strips, see if you can find the baseline and ctx frequency. There's always something to do/see on an OB unit, take advantage of this great opportunity!!

NurseNora, BSN, RN · Apr 28, 2008

I vividly remember the student who, when I offered her the opportunity to put a cath in my patient, said "No thanks, I've done one." I didn't offer her anything else. Trust me, it's easier to do things myself than to supervise a student doing them. If someone offers you an experience, take it if it's something you're allowed to do.

Feel free to ask questions, but not necessarily in front of the patient. If necessary, have a note pad in your pocket and write your questions. You won't get a lot of understanding of fetal monitoring, that takes lots of time on the job, but you should know the normal range of the fetal heart beat, and the 4 basic patterns: accelerations are sharp increases in the heart rate associated with fetal movement and are good; variable decelerations are V or W shaped drops in the fetal heart rate and are usually not as bad as they look, they're from compression of the cord; early decelerations are small dips in the heart rate that mirror contractions and are benign; late decelerations are small dips in the rate that occur late in the contractions and are bad, they're from uteroplacental insufficiency which means that the placenta, the organ of respiration for the fetus is not functioning well enough to keep the baby oxygenated. No one will expect you to read a strip, but it's a good idea to have some sense of what's going on. Be prepared to hold a leg, or give back pressure or get ice chips, or even coach breathing.

As for the teaching you'll do, infant saftey is always a big need. Dads and some moms will leave the baby in the middle of the bed or couch as a previous poster mentioned, after all, they can't even roll over!! Not so, they can roll by accident, they can also scooch themselves across a bed and onto the floor. Know about the Back to Bed emphasis. Grandmothers may want to put babies on their sides or stomach. That's what they were taught when the new mom was a baby, but now all infants are to be put to sleep on their backs and it has decreased the incidence of SIDS.

Anyway, have fun, OB is great. By the way, a broken ammonia ampule in the room helps clear a room of the smell of poop or vomitus.

Elvish, BSN, DNP, RN, NP · Apr 29, 2008

Anyway, have fun, OB is great. By the way, a broken ammonia ampule in the room helps clear a room of the smell of poop or vomitus.

Also, if you put it in the hat, helps new pp moms who can't pee. :)