Wednesday, November 2, 2011

Week 8 of Nursing School, 2nd Year

I'm finally in the long-awaited Maternity rotation. This was supposed to be the ward that would change my life.  I'm supposed to find my calling and feel tugging in my heart strings.  Ironically, I haven't really felt that yet.

Instead, I've been slightly bored.

Quiet Maternity
The maternity ward is very quiet compared to the surgical ward.  The mothers are generally in good health and I won't be assigned more complicated cases until later in this term.  My first patient was very sweet, content with her new baby, and tired.  I only had to check her vital signs once, and she was mostly sleeping, feeding the baby, or gazing contentedly at her baby most of the time.

Pain
The main concern of the new mothers is pain from childbirth.  After a woman gives birth, her insides have to stop the bleeding and start changing back to pre-baby status.  This is a normal process and it is very important. Unfortunately, it doesn't feel very good.  Also, some of the moms have wounds from the baby coming out and tearing her nether parts (ouch!) from being too big or too fast.

Here's some traumatic information for you.  The tearing can be just skin (first degree), skin and muscle (second degree), skin and muscle all the way to the anus (third degree), or all the way through the anus to the other side of your anus (fourth degree).

I find this to be very frightening.  I keep wondering whether these women knew what they were getting themselves into and why they choose to have more kids.  I watch them hunched over, walking slowly and gingerly to and from the bathrooms.  I'm still in shock-phase, but I'm sure I'll soon appreciate my mom a lot for what she went through to give birth to me.

Teaching Opportunities
There's a lot of teaching to do as a nurse in the maternity ward.  Many moms are new to this stage in life, and they don't really know what to expect.  I enjoy racking my brain for information to share, and I can see how valuable this is for the mothers.  For instance, I can teach the moms about how they will produce a special milk called Colostrum for the first few days.  She won't produce a great deal of it, but this special milk is low-fat, high in protein, and contains natural antibodies from the mom that will help the baby to fight infection.

So it's important to encourage the moms to start breastfeeding right away so that the babies can take advantage of this special milk.  Some moms don't really know how to breastfeed yet, so the nurses can teach them some tips and tricks on how to hold the baby and to get a good "latch".  I also get to teach the moms about how the milk is based on a supply-and-demand system.  The more she breastfeeds, the more milk she will produce.

Stressed Out Moms
Many moms feel stressed out for the first few days because they don't produce much milk and the baby starts to lose weight.  What they don't always realize is that a) the baby will naturally lose a little weight from extra water being lost and b) the baby's stomach is about the size of a chickpea for the first few days.  The mom doesn't really need to feed it that much milk at one time.  However, she does need to feed it a little every three hours.  As long as she does this, she'll notice her regular milk come in around 3-5 days later and everyone will be happier.

Some moms want to switch to formula as fast as possible because they think that their baby isn't getting enough food, but it's important for me to teach them that human milk is much better for the baby than formula.  Formula's main ingredient is whey from cow's milk.  My teacher has noticed that babies eating formula are more gassy, more poopy, and more irritable.  Also, if the mom starts switching to formula, or using it to supplement her milk, she'll start to produce less milk.  It becomes a cycle where the mom becomes more and more dependent on using formula, and the baby is missing out on the awesome benefits of mom's milk.

Lots of New Info
I find the maternity rotation to be very interesting in terms of all the new vocabulary that I'm learning and all the information that is so specific to childbirth.  I think that I'll enjoy it a lot more once I have more knowledge from my classes on this area of nursing.  For now, I feel a little bit useless because I can't help the moms more.  I know bits and pieces of information, but not the whole picture yet.

I'm looking forward to getting more experience in clinical this week.  Maybe I'll get to bathe a baby!  That would be cool  :)

Have a great week!
My Nursing School Diary

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