What to expect on OB/psych/peds rotations?

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we're starting these 3 rotations soon and i just wanted an idea of what to expect. i understand that it will be different depending on the sites i go to but what were some of your experiences?

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I have only done mental health, and have been on the med surg floor. The psyc program is very interesting, but my least favorite part of being in mental health was being in a lock down unit...can't leave to go to the bathroom with out asking someone to let you out. Another hard thing is the 3 feet away from the client, no touch zone(if you need to take vitals they are done at the nursing station), no going anywhere without a partner(either another student or your clinical instructor). A lot of times the paitent doesn't want to talk to you, so they go and hide in their room. The spinouts were very interesting, got to go to a psyc doctors office and sat thru some of his appointments, very eye opening and sad. Also went to a rehab center, which was very neat, it was a unlocked voluntary place for drug and alcahol rehab...the other place was a community center for the mentaly ill, where they can come and go thru groups and help them get used to being out in the community.(its very sad, state and federal cuts have hurt these centers, almost to the point of closing down) All in all very interesting, but the care plan is hard(at least for me) you have to know all the axis's and about the DSM-4...good luck! I am back to the med-surg floor and hopefully the spinouts will be fun...

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Specializes in Pediatric Pulmonology and Allergy.

I'm starting psych rotation today so I'll let you know how that goes.

OB--Depending on your clinical site, you'll probably rotate through L&D, triage, postpartum, nursery and NICU, if you're lucky. Maybe you'll get to observe a cesarean as well. You might also spend some time in a women's health or prenatal clinic. How much you'll do depends on your instructor and your skills. My OB rotation was not that great--I didn't observe a single birth, and spent most of the time in PP or nursery, where I fed and burped a lot of babies and changed diapers. I did get to give my first injection ever in OB (that was our first rotation).

Peds--very similar to Med-Surg except your patients are smaller. You'll be seeing the gamut of health conditions. We saw lots of asthma, sickle cell, appendectomy, fractures, dehydration and other common conditions that afflict children. You'll need to do a regular head-to-toe assessment and learn to communicate with either the kids or their parents, depending on the situation. Be prepared for some heartbreaking situations as well, like kids that are never going to get better or abuse (the worst). We took care of one 6mo baby who was in PVS after being bashed against a wall. :madface::madface::madface:

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Specializes in ER, progressive care.

so far I have only had MH & OB/L&D...I will have peds in the fall.

For both classes we had no clinical prep work. For MH I was at the VA once/week. Lectures covered MH drugs as well as MH disorders. My class had a lot of busy work - we had to do Springboard posts (go online on a website, log in and post on a little forum answering questions each week, citing at least 2 nursing journal articles with each post. Then we had to respond to two peers and include more nursing journal articles). We also had to complete "4 alternative experiences." Two of them had to be interactive experiences - such as going to a meeting, group therapy session, attending a speaker (r/t MH) or shadowing a psych nurse. For the other two, we could read a book or watch a movie that dealt with a mental illness (there are TONS out there!) We had to write about these experiences. We didn't have a formal "paper" for this class; instead, we had to complete 2 process recordings (due at separate times) along with an analysis with each one. For clinical, we utilized therapeutic communication - we would sit and talk with patients in the dayroom or sometimes play games with them. Honestly, I found MH to be very dry and boring. Most people do from my experience!

For OB/L&D, we were on two units - postpartum and L&D. I started out in postpartum, which was nice because I was terrified of my OB rotation and PP just sort of "eased" me into it. You are responsible for two patients - both mom & baby. If she had twins or triplets, then you three-four patients. We had to formulate a nursing diagnosis with interventions for EACH PATIENT. We did q4h assessments/vital signs. We made sure babies were fed at the right time. PP is a lot of teaching - teaching how to care for the baby, breast feeding, etc etc etc. The OB assessment isn't as involved as a typical head-to-toe assessment on a med-surg unit. We used the BUBBLE-HE mnemonic: Breasts (look, palpate, are they tender? look at discharge, etc), Uterus (should feel HARD - a boggy uterus is bad!), Bladder (are they urinating ok? what's their output?), Bowel (any BM? passing gas?), Lochia (type and amount), Episiotomy (if applicable), Homan's Sign & Emotional status (having a new baby can bring about a wealth of emotions - see how they are coping). We measured newborn inputs and outputs. If mom already has children, you probably won't do a lot of teaching because they already know to care for an infant and how to feed them, etc etc etc. Medications are mostly on a prn basis. On days where I had nothing to do I would hang out in the nursery all day :)

For L&D, you pretty much just make sure mom is comfortable. You will learn about fetal monitoring (accelerations, early decelerations, late decelerations). When mom is in labor, you'll basically coach her through the birthing process. I volunteered to hold a leg when I saw my first lady partsl birth. If this is her first child, expect mom to be in labor for 2-3 hours. If she has had multiple children, the labor process is usually much shorter. You will monitor vital signs, especially if they have an epidural. Once the baby is out you will suction out their mouth and nose and obtain APGAR scores on them and clean them off. You will also administer erythromycin ophthalmic ointment and vitamin K injection. You will also probably see a C-section during this rotation, too. Other than newborn meds, I never administered meds when I was in L&D - a lot of L&D is observation, from my experience anyway!

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I'll c&p my response from a similar thread regarding maternity....We only had an OB rotation and I hated every minute of it. Ok, mostly every minute....yeah the babies are cute and it was great teaching a 17 year old how to breastfeed. But overall, didn't like it and counted down the days until it was over. Reason, I'm a natural type parent/person....an American OB setting is anything but. However, most people like their OB rotation so I'm sure you'll do fine. Good luck!

As for psych, it was an interesting rotation. I always heard of these kinds of people and you see certain things on movies, but to see them in real life right in front of you was quite the experience. The first night I was scared to death, lol. Anyway...good luck!

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Specializes in Psych.
Be prepared for some heartbreaking situations as well, like kids that are never going to get better or abuse (the worst). We took care of one 6mo baby who was in PVS after being bashed against a wall. :madface::madface::madface:

I am more nervous about this type of situation than anything else in nursing school. I don't get squeamish, nothing else bothers me (well, maybe except personality disorders in nursing instructors :mad:) but I don't know how I'm going to to if I have to deal with a baby dying or terminally ill, etc. Very sensitive topic for me. :crying2::crying2:

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I'm in the middle of psych right now. It's an interesting environment but the nurses don't do much with the patients at all. In class, we're learning about therapeutic communication, leading groups, etc., but in reality, nurses don't do any of that. They do the intake evals, pass out meds, and chart. At the hospital we're at, the behavioral health advocates (social workers or psychology degrees) do all the patient interaction, lead the groups, and such. So we're spending all of our time with them, not the nurses. I asked our clinical instructor who has 15 years experience as a psych nurse about it, and she said that's how it is at most places.

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In our psych rotation, we each were assigned a client in an inpatient children's hospital. Our clinical was 6 hours a day twice a week. (This included meeting beforehand and discussing etc and discussion/charting at the end.)

Each of us interacted primarily with our assigned client, and had full access to their whole chart and information from the nurses and mental health techs involved in their care. A lot of the stories were heartbreaking, but it was an amazingly worthwhile experience.

Throughout our rotation with them, we compiled a four dimensional assessment and a care plan with at least three nursing diagnoses (and all those associated components.) At the end of the rotation, we gave a presentation on our client, presenting their background, dsm IV diagnoses, medications, nursing diagnoses, examples of the phases of the working relationship, therapeutic communication, our diagnoses and treatments, etc.....

During lecture three times a week, we learned all of the stuff that we then applied directly in clinical. Wonderful experience.

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