Friday, January 15, 2010

... So Far So Good...

I have been at the same hospital for nearly all my placements so far. The morning of my first L&D shift, I drove there on auto-pilot, distracted by mundane every-day thoughts - irritation with other drivers, the cold, the fact that I was running late. When the smell of disinfectant and the sounds of labouring women hit me as I walked onto the floor, I felt both comforted and a familiar sense of nervous anticipation. Several of the nurses greeted me with some amount of recognition, which was nice and helped me feel slightly more at ease!

The shifts have gone well so far.  My preceptor is quite lovely - a single mother to three teenagers, she has tonnes of energy, an infectious cheerful and outgoing personality and a bit of a potty mouth, which she manages to keep mostly under wraps.  She taught me, as her mother taught her, that "shit is a woman's word" - who knew??!  She disappears to her car a few times per shift for secret cigarette breaks. She is clearly insecure about getting older, with a preoccupation with putting on lipstick and talking about grey hairs, despite the fact she is quite beautiful.  We are pretty different, but we seem to get along well.  So far I've really been enjoying our time together.  My concern is that she is often running from room to room doing things without communicating with me.  I'm never sure if I should just follow her or wait for her to invite me.  Waiting seemed to be resulting in me missing out on some learning opportunities, so I have begun to follow her... but I do feel like a puppy dog.  She doesn't seem to mind.

So far my fears of this placement have proven unfounded.  Though I still think some of the nurses can act like "mean girls", I think it tends to be a product of how much time they all spend together.  Not everyone has embraced me: many of them don't acknowledge my presence and one or two are downright rude, but many others are quite nice to me and even think of me when teaching opportunities arise.  In any case, it's not nearly as hostile as I feared it might be.  I am not really sure why I expected the worst!


It has been interesting to note how the type of care provided compares and contrasts with that of midwifery.  During my last shift we had a "patient" in labour, comfortable with an epidural and doing just fine.  In many ways it was similar to midwifery labours I had previously been to - until my nurse decided that the woman would probably like a "sniff of Pit" to help strengthen her contractions so she could have the baby sooner rather than later.  She suggested it to the OB, who openly wanted the woman to have her baby sooner than later because she was tired and wanted to go to bed - and therefore said "sure, give her a sniff of Pit".  So minutes later we were adding pitocin to her IV - I don't remember any discussions with the woman around her own feelings on being augmented.  At the same time, her epidural was being turned down so she could feel whether she had any urges to start pushing.  The woman quite quickly was in a lot of pain, crying, throwing up, etc because her contractions had become so strong and her epidural was down to nearly nothing... it all seemed kind of odd to me.  We then turned her epidural back up... it was kind of a roller coaster, both for the woman and for me to watch.  After two-three hours of guided pushing, the head appeared on the perineum and magically sat there while we called the OB.  When the OB arrived, she put on gloves, caught the baby, did a few things and walked out again.  I found the whole thing very fascinating - so much was similar to what I am used to, and so much was also different.


This weekend is my birthday.  I have been trying to hint to Rob that I want to do something fun, but I haven't taken it into my own hands and planned something as I know I should have.  I have been considering it, but I just haven't been able to decide what I want to do.  Will another one come and go largely unnoticed? Hmm.


Teegan said...

glad the placement is going well! there is so much to learn from nurses (even the ones that aren't so nice!)
So... where are you headed in May for the senior placement? Hope you got what you wanted.

Smartypants said...

I did, thanks! I am staying in Toronto... phew!

Shell said...

Ugh... the whole doing things without the birthing mama knowing is a pet peeve. Who is that know all demand all person who pressures hospital staff to try to speed things up and make them longer in the end?!!