Tuesday, June 1, 2010

Last Week's Clinical: The Nursery

Last week my clinical experience was in the nursery.

At first, I definitely felt out of place again, though not quite as bad as the previous week's perineum-and-episiotomy inspecting madness. The nursery was where all babies just born are taken care of, inspected, and assessed.

I love babies, so that part was cool. It's a totally different type of nursing though. It's scary to me to think that with all the education I'm cramming into my brain, when I graduate, I will basically be a blank slate that needs to be trained all over again in whatever special area I work in. I thought I'd be an all-knowledgeable RN, but as it appears, I'll only know the bare basics of nursing in general: my real training begins in the workforce.

In addition to the basic newborn care, I got to do a newborn assessment, which was really cool. Different reflexes, such as the Babinski reflex, startle reflex, etc. You also document size, shape, and location of the fontanelles (soft spots) on the head, take vital signs, monitor I&O, and other various things.

It was a mostly positive experience, however, I had a spiteful staff nurse working for me. I will say that I have never had a negative experience with any staff member until this point, but this girl's pissy attitude really got me fired up. She did three major things to piss me off:
  1. I went into the parent's room, introduced myself, and took the baby's vital signs. I returned to report them to my instructor. She asked me if the baby had voided or stooled. I did not know .so I stuck my head in the parent's room and asked. I noticed that the staff nurse was in there. I reported back to my instructor and resumed my normal clinical duties. The staff nurse waits, purposely, until I am next to my instructor and nearly my whole clinical group before coming over and saying, "Next time you go into a patient's room, you need to introduce yourself. They wanted to know who you where and what you were doing with their baby. You make them very uncomfortable." Thank god I had a student vouch for me that she heard me introduce myself. When I asked the parents they said they never said that. My instructor told me not to worry about it.

  2. I had to do a newborn assessment. I got the baby and performed my assessment. The baby's temperature dropped a little bit, so I stuck the baby under the warmer. When I told the staff nurse, she said, "You had the baby uncovered too long! Now it's on the warmer and you need to go tell his/her mother! She's going to totally freak out!" I told the mother, and, as expected, she did not freak out.

  3. Realizing that I was dealing with a possible pre-menstrual superbitch, I assumed that after I did my assessment she would be doing the exact same assessment on the neonate, hoping to find something I missed. Since the baby had thermoregulation issues and was on the warmer, I told her, "If you want to do your assessment, the baby is undressed and on the warmer." I resumed my normal clinical duties and checked the baby's temperature a half hour later to find that it had returned to well within normal limits.Then, I got the baby dressed in a new onesie, changed his diaper, bathed him, put his hat on, swaddled him, and covered/tucked him in his bassinet. On my way out of the nursery to return him to his mother, I am stopped by the staff nurse. "I need to do my assessment before you return the baby to his mother." Are you effin' kidding me? I just got this kid dressed, ready, and warm, and you are going to undress him again, knowing that he has temperature control issues? Pissing me off is one thing, but caused a baby more discomfort to achieve this is absolutely ridiculous!

We have to evaluate the friendliness of staff and the educational experience of the site itself. I expect that I will be writing quite a lengthy review. I enjoyed the clinical, however, this girl made me really uncomfortable and tried to get me in trouble for nothing. Maybe I wronged her in another life... maybe I got a little too lit at the local bar a few years ago and don't remember her. Either way, her actions were inexcusable. I can't wait for the clinical site review...

Is the word 'asshole' inappropriate for official documentation?