Friday, August 13, 2010

Labor and Delivery

Last Saturday I was assigned to the Labor and Delivery unit at UCI. Excited? Yes, extremely! I woke up ready to assist with some deliveries. Vanessa and I had joked that when it was our turn to be in L&D, there would be no births. I didn't think it would actually come true!
After being assigned to our nurses we were informed about the patient load only to be surprised to hear that every labor room was filled along with the OBER and the recovery rooms held laboring moms. I was assigned to a great nurse, Linda. She briefed me on our patient and we headed into the room. Our patient was an `18 year old primigravida mom....meaning it was her first pregnancy. She had a history of PIH, pregnancy induced hypertension, and was on a magsulfate drip. While Mag prevents her from having a seizure, it slows contractions as well as there is a potential for toxicity. Her deep tendon reflexes, respiratory rate, and urine output needed to be monitored frequently. She was on a pitocin drip that we increased every hour. While her membranes had been ruptured for hours, her labor was very slow to progress. 

Linda wanted to make sure I saw a epidural so she sent me to the recovery room where a laboring mom was patiently waiting for hers. I was instructed to hold the mom in my arms during the insertion. Her anxiety spiked as she watched the anesthesiologist set up his sterile field. He was an intern and his attending was there to supervise. After trying the first insertion it was not in the right location. So, he tried again on the opposite side of the spinal cord. I got a little light headed but it ended up being ok!

Reading a fetal heart monitor and contraction strip is new to me. Linda sat down with me and broke it down. She was a great teacher and I learned alot from her that day. By the end of the day not one of the patients had advanced in their labor. Seriously?! Yes, no lying here. Go figure it would happen on my day! But I did get to help my patient as she went through her epidural. Although this time I had to hold the fetal monitor on her belly while she was hunched over on the side of the bed. There I was for 20 minutes in a squatting position with my hand holding the monitor on her belly. Needless to say  my hand fell asleep and it was numb up to my shoulder!

Although I did not actually see a birth that day, I walked away with more knowledge than I had learned in lecture that week! That is the best part about UCI being a teaching hospital. Vanessa and I will be back in L&D next Saturday.....pray we can see one birth!!!

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