Hani Kazmi Hospital Maternity 1

Methodist

Reflective paper

The experience on the labor and delivery unit at the Methodist hospital was a successful educational experience. As an introduction to the processes and nursing practice involved with caring for pregnant patients, it was as I had expected. As we have discussed in our lectures, the care for antepartum patients is significantly more challenging as their risk for fetal complications, pregnancy induced diabetes, hypertension, depression and illness are higher. I felt the assignment was a good way to experience the challenges involved with caring for antepartum patients with pregnancy, antepartum, intrapartum, and postpartum concerns. The conversation with patients in the triage area went well, as I was able to assess their mental and physical status. Working with the triage nurse helped to further develop my assessment and therapeutic communication skills. While in the triage area, I performed history and physicals, observed IV placement and ultrasound monitoring. It was a surprise to see the antepartum triage unit only had one nurse on staff, caring for six patients. I was able to follow her through patient physicals, assessments and the antepartum triage care. I understood the challenges that the triage nurse had caring for antepartum patients, while discharging a few, moving others to the intrapartum delivery area and admitting new patients to the triage

area. I noticed the triage nurse had a friend bring her breakfast at 8:30am and she finally had a chance to eat at 12:45pm. Many times the triage area was busy; the nurse was delayed in her charting and recording of patient findings. I understand the challenges that understaffing places on nurses and necessity to provide these nurses with proper assistance ie. PCTs or PCAs. The role of the triage maternity nurse is to perform a history and physical assessment, monitor patient and fetal heart rates, contractions, cervical dilation, check labs and fluid status, and provide health teachings. Many patients were expecting to deliver vaginally that same day, while a few were scheduled for Caesarians. I followed two patients from the triage area to the intrapartum or labor and delivery unit, and I was surprised to see the difference between the room settings. The labor and delivery rooms were decorated suites, while the triage rooms were similar to outpatient clinical rooms. Besides the difference of room setting, the labor and delivery unit had all the same equipment as the triage rooms plus labor assistive devices. The labor and delivery rooms each had functional equipment for the intrapartum and newborn-postpartum delivery. By asking questions, listening and observing the labor and delivery unit nurses and physicians, I understood the role of the delivery team during the birthing process. I was thrilled to interview the antepartum mothers-to-be, asking questions related to their health history, family history, medications, feelings of anxiety, pregnancy complications and self-care behaviors. During my

patient interviews, I developed an understanding of the role of family in the labor and delivery. After my interviews, I reviewed the intrapartum procedure briefly with the staff nurse and the process of apgar scoring. The apgar score is a quick summary score of the newborns health and assessment. The apgar score is determined by observing and scoring the newborn on a scale of 0-10 on five criteria: appearance, pulse, grimace, activity and respiration. I managed my time to make patient recommendations, asking for instructor feedback to clarify standards of practice, policy and procedure. The interviewing practice, head-to-toe assessment, apgar scoring and charting I learned from the labor and delivery will guide me in future health teachings and nursing care. At the Methodist hospital I maintained hand hygiene, reviewed patient safety and proper documentation. I felt confident in my ability to provide patient education, perform a history and physical, and discuss patient concerns with the nursing staff. Although I was unable to see an actual labor and delivery, I felt connected to the families and patients before and after the births. The experience at Methodist hospital was beneficial in providing insight into the challenges of understaffing, preventing fetal complication, monitoring patients in labor, assessing newborns, and implementing nursing practice.