Post Partum Reflection

During my clinical rotation during my last semester of nursing school, I was able to work one on one with a BSN degree nurse named Judy in the ICU. Judy had three years of experience in the ICU setting. She had been a medical surgical nurse prior to her ICU transfer. The ICU at this hospital consisted of two associate degree level nurses and two BSN level nurses on my shift. I rotated three days in this particular ICU. I worked with Judy all three days of my rotation. I was excited about being placed with her for she seemed knowledgeable and skilled. We were given a male post trauma patient to work with all three days. This patient was a 30 year old male admitted for trauma related injuries and was considered unstable and was to be monitored in ICU. This patient had been involved in a motor vehicle accident and

In the hospital environment there are several resources for the nurse to partner with to address nursing sensitive indicators and ethical issues that may arise. In this scenario, to help resolve the issue with meal trays a partnership with dietary could be made to come with an appropriate solution for the correct delivery at meal time. The nurse could have brought this information forward and apologized to the patient and his daughter rather than trying to keep it quiet. The nursing supervisor

Pregnant mothers are viewed as a business made for doctors and hospitals as insurances typically cover infant birth and hospital bills. As Patricia Burkhardt, Clinical Associate Professor, NYU Midwifery Program could not speak the truth any better, she states, “Hospitals are a business. They want those beds filled and emptied. They don’t want women hanging around the labor room.”

The author is a nurse in a level two trauma facility in a community of approximately fifty thousand people in Oregon. The community is a college-town surrounded by a large agricultural area. There is a minimal ethnic diversity within the community. The diversity present occurs mainly from internationally students and faculty from the college. There is a growing population of women who desire low interventional births in the community. The author has worked on the labor and delivery unit of the hospital for the last 14 years. The hospital is the only one in the area to offer trial of labor services to women who have previously undergone a cesarean section. The unit on average experiences around 1000 deliveries annually.

When my mother woke up she needed the bandages on her face changed. She pressed the nurse call button many times. She set there for around 2 hours before she finally let me go find a nurse for her. As i went to go find the nurse station i seen multiple nurses standing around talking. I got one's attention and she was rude because I interrupted her story. The nurse finally came and changed the bandage. She did not ask my mom how she was feeling or if there was anything that she could help with. A couple hours later we realized her morphine pump was not working. When we notified someone it took over 6 hours to get someone to fix the pump.

For my third trimester service project, I provided help to my school. I went to daycare for two hours helping Mrs. Riley. I helped kindergarteners with their homework inside so that they wouldn’t have any homework to do when they got home. I also helped run a couple games and make sure everyone was making smart decisions on the playground. I then helped Ms. Maynes in the 5th grade classroom for two hours as well. I helped her with cleaning the students desks, I helped with correcting papers and putting them in numerical order, I finished coloring a Mary drawing to put on the bulletin board, and I also helped punch out some letters so she can use them in the classroom. Ms. Maynes was also kind enough to bring me down to the Kindergarten classroom

I had my first two night shift this week on Sunday 9/13 and Wednesday 9/16. I am on 7 West at Sharp Memorial Hospital and the unit is PCU unit with tele monitoring. The unit had a high census this week, but proper staffing and no codes lead to the nights being relatively calm. I was working with Laura who is not my regular preceptor. She stepped in to work with me for this week while Elle, my regular preceptor, was on vacation. I had a wide variety of patients on my two shifts. The first shift I had a patient that was suffering from an exacerbation of COPD with a history of CHF and a patient that had polycystic kidney disease, which had progressed to end stage renal failure. The second shift I had four patients; one patient had been admitted to the hospital multiple times in the past month for GI bleeds, another patient with a history of diabetes and hypertension was admitted for fever and chills and was later diagnosed with sepsis, the next patient had a history of schizophrenia and was found on the ground in her home and was expected to have been there for over 24 hours resulting in deep tissue injury, and my final patient was suspected to have a history of alcoholism and presented to the hospital with shortness of breath and an oxygen saturation of 89%. The first clinical shift I was shadowing my nurse for a majority of the shift. I was being orientated to the unit and learning where to find supplies on the unit. The second shift I took a

Throughout most of the shift, my nurse preceptor and I were in the patient’s room either evaluating her and the fetus, performing exams, taking vital signs, administering medications and fluids, charting, or reading the fetal monitoring strips. We also kept in regular contact with the physician to keep him up to date on the patient’s status and to receive new orders. We also spent a lot of time talking to the patient, her mother, and her boyfriend. They were concerned for the status of the mother and the baby. We explained to them that both the mother and the baby’s heart rate was high and their goal was to decrease them both. In addition, my nurse preceptor explained how we were administering Tylenol and amoxicillin to reduce the fever and

The nurses in this small community hospital in no way upheld the Code of Ethics for nursing at this point of time in the care of the infant in this case. Primary responsibility and code is to give respect and good quality care to every patient. When the nurse turned off the monitor on this infant, they denied him the right to quality care. The nurse took away this infant’s worth by deciding to not treat him according to the orders and policies of the doctors and the hospital. Although the nurse could have turned the monitors off because it was disturbing one of her patients, and her job is to respect the primary interests of her patients. As an infant in the hospital at that time, he was a patient as well, even if not assigned to whichever particular nurse it was

Around 9am every morning, I do my rounds of patient observations. On this particular day, I was working in Child B’s ward bay, alongside other children. I read up on Child B’s notes from the previous day and night and saw a fluctuation in Child B’s blood pressure. Mum E had also told me that Child E did not look or feel well, and she had reported to Nurse C, who did not respond to the information given. I informed Nurse C, who I was also working with, and she brushed me off, stating that I don’t know anything and that I am interrupting her.

The incident occurred during an elective caesarean section, for a woman with type one diabetes mellitus. Research has shown that maternal diabetes mellitus incurs an increased risk of neonatal hypoglycaemia (Robson et al., 2014). In response to these findings, a neonatologist is required to be present at the delivery of the fetus (Local Trust, 2015). Upon arrival of the neonatologist, a thorough handover of the client’s information, including past medical history, as well as neonatal risk factors, was performed by the student. Following delivery, the infant was placed on the resuscitaire and the initial neonatal assessment was completed by the neonatologist, as per Local Trust policy (2016). The results of the assessment were satisfactory and no neonatal abnormalities were identified; the neonatologist made the clinical decision to discharge the infant from the neonatologists’ care. Within the subsequent ten minutes the infant’s muscle tone and respiratory rate reduced which prompted the student to transfer the infant back to the resuscitaire and raise the alarm with the midwife, her mentor. The midwife proceeded to instruct the student to request a neonatal emergency crash call broadcast. Once the neonatologist team arrived, they requested a handover and glanced at the student, who at which point became flustered and unable to share the necessary information, provoking the mentoring midwife to resume control of the situation. The midwife was able to share the relevant information and subsequently aided the diagnosis of neonatal hypoglycaemia. This was quickly treated and the infant was intubated and stabilised prior to being transferred for further treatment and observation in the Special Care Baby Unit (SCBU). Subsequently, the student suffered a reduced level of

I had the baby locally, and at some point, Shabbos afternoon, nurses scurried into my room and grabbed the baby out. I tried to ask some questions and, as I got vague responses, I said “you just brought him in why are you taking him back, is everything okay?” Apparently

In addition to the Nursing Code of Ethics, the National Council of State Boards of Nursing (NCSBN) states that one of the standards related to the RN scope of practice is that nurses evaluate the patient’s response to nursing care. They do this by evaluating: the patient’s response to interventions, the need for alternative interventions, the need to consult with other team members, and the need to revise the plan of care (NCSBN, 2012). When Ms. W saw that the patient was not compliant, she should have reevaluated her plan of care. Ms. W can delegate to the LVN, who is experienced in prenatal education, and would be able to explain the importance of finishing antibiotic therapy or performing tests that are essential for a healthy pregnancy. If Ms. W is too busy to educate, then she is responsible for finding someone

So I kindly, asked the nurse if we are supposed to look under the patient to assess for any blood pooling under her. Because of this reminder, the nurse realized she forgotten this step and thanked me. We looked under the patient, and thankfully there was no blood pooled under her. Another example, of having an EVP mind, was when I watched a labor. I noticed that the residents kept putting their fingers in the patient’s vagina. In lecture, we learned that we want to limit the amount of times that we assess the patient’s cervix due to the risk for infection. Because I don’t know about deliveries, and how many times the doctor is supposed to assess the cervix; I didn’t say anything. I also didn’t feel comfortable, as this delivery team, offered for me to watch. I didn’t know these employees or patient from earlier. In the second half of the semester, I plan to speak up, if I see something that doesn’t seem right, regardless, of the employee’s title, and how long I’ve been working with

I was working night shift in a level 3 Neonatal Intensive Care Unit facility and my 10 days orientation was over. It was my first day working without my preceptor. Since I was a new staff, the charge nurse allocated two stable babies for me. One was Baby Zahra, a 33 weeks preemie, on room air, with nasogastric tube, with peripheral intravenous line to keep the vein open and feeding with expressed breast milk every 3 hours. I started my shift with a bit of nervousness knowing that I am on my own and wondering if I can remember everything that my preceptor had taught me during our orientation. I started my assessment and observed Baby Zahra to be pale, her skin was slightly mottled. I checked her vital signs. The cardiac monitor showed that she