The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Posts Tagged ‘pregnant’

No Crystal Stair

Posted by isntshelovlei on April 28, 2010

We had an exam last night in Maternity/OB (final next Tuesday!). Usually there are not a lot of meds to remember for maternity since technically the patients aren’t “sick.” Other than epidurals and such during labor most of what you’ll see is postpartum—percocet and motrin for pain, maybe a stool softener if mom had a episiotomy. But when something goes amiss—antepartum, intrapartum, or postpartum—that’s when you get hit over the head with all kinds of stuff—pitocin to start or augment labor, tocolytics to stop labor, hydralazine  for hypertension, magnesium sulfate to prevent seizures (in eclampsia), methergine for hemorrhage, and injection-only insulin for diabetics since oral agents are teratogens. It’s enough to make your head spin and this is only scratching the surface of all the meds I need to know!

So needless to say I can already tell that pharm is going to be a beast. Everyone makes it sound like such a “bird course,” and that “it’s just straight memorization”…OK, if you say so. You not only have to learn the names (trade and generic) of about a gillion drugs, but also the actions, interactions, indications, contraindications, side effects, rationale for why you are or aren’t giving it…the list goes on. You have to know all of these things to be able to challenge that brand new resident’s order for your pregnant patient to receive coumadin (which crosses the placenta), or to be able to question why he wrote an order for methergine when your patient’s blood pressure is already 160/100. You have to know all of these things because in the end YOU are giving the patient their medications—YOU are their last line of defense before a potential medication error occurs. Yes, Mr. Resident that wrote the order should have some accountability as well, but everyone will be looking at YOU because YOU should have caught it. 

So although the wonderful world of maternity is coming to a close, I now have to prepare myself for a whole new kind of headache. One of my favorite poems, “Mother to Son” by Langston Hughes, sounds just like the plight of a student nurse. Nursing school for me ain’t been no crystal stair…

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I Just Didn’t…

Posted by isntshelovlei on March 29, 2010

Clinical this past Sunday was a little more interesting than last week—but not much. I did a newborn assessment, and charted a little in the paper and computer charts. Oh, and I got to help make a couple of beds—exciting stuff for a student nurse thirsty for hands-on patient care right? I did not get to do a postpartum assessment on mom (her regular nurse completed it when I whisked the baby off to the nursery). I did not get to see a birth (vaginal nor c-section). I did not get to pass meds. I did not pass go and I did not collect $200.

It was a little strange at first handling “normal” newborns. I’m used to my NICU babies who have various catheters and such attached to them; these babies were so….free—bundled up like little burritos. Mom was still kind of out of it and preferred that I fed her daughter so I did. It just felt weird being able to scoop up the little peanut from her bassinet and stroll over to the rocking chair with no IV poles or monitors to navigate around. Sitting there with that 7lb bundle of joy made me think back to when my own children were that small (and before they learned to say words such as “no” and “mine”). My lecture instructor said in class that someone always gets pregnant during this rotation—uh, no thanks, I’m retired from that line of work. I already have three strikes, so I’m out of that game.

Sadly, most of the nurses weren’t any better (read: nicer) than the ones we had last semester. I thought (or hoped) that since these nurses cared for hormonal women and babies their demeanor would be a little more accommodating—guess not. No one was outright hostile like my dear Nurse Nasty from last semester, but they did tend to make you feel like some colossal inconvenience. I still don’t quite get that whole “nurses eat their young” thing…

No clinical next weekend since it falls on Easter. Good thing too since I could really use a solid weekend to catch up on some much-needed reading.

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