The Latest on Labor

I've been doing labor orientation for almost a month and I LOVE it! It was a bit intimidating at first. I felt like I was overwhelmed with the MANY things RNs have to assess and chart during labor that I was totally paralyzed to do any of the things I normally would do as far as comfort measures as a doula. But, slowly I'm finding myself more able to incorporate my doula training and experience to some extent. My hope is that as the nursing tasks become more second nature to me, that I won't have to dedicate so much time focusing on them and can slowly transform and grow into a well rounded, caring and competent labor nurse. Today I was able to help with hands on pain management - doula style - for about 1/2 an hour and not get too far behind in my charting... little steps

There is a ton of charting, as I expected....but even more so. According to what's going on in labor (early vs. active, pitocin or epidural infusions) the protocols vary. So, there are a lot of protocols to learn.

The vaginal exams are going GREAT... It only took about a week of fumbling around before I was accurately calling the dilatation/effacement/station.... I can only attribute that to the many years of visualizing the changing cervix and teaching my clients about theirs.....

The first time I was independently doing vag exams on a patient all day was a little stressful for me... I was so used to the safety net of my preceptors checking the cervix either before or after me and giving me feedback.... But, on that first day, I was so nervous.... Especially when I checked the patient and she was 9-10cm. My preceptor said, "Ok, then, I'll call the doctor." Inside I was thinking: "WHAT?? Don't you want to double check???" But, we got the patient ready and started pushing when I decided she was complete. The doctor came and I literally held my breath when he put his glove on and checked her..... All was good... She was complete.

But, my preceptors have told me stories of calling the doctor, having the patient up in stirrups only to have the dr. tell them the patient is 4cm. What a day that must've been... and they survived... and became great labor nurses... so, I've vowed to give myself time and permission to learn from my mistakes.... So far so good with the vaginal exams, though.....

Thursday I go to a fetal monitoring class. I'm looking forward to learning more about appropriately interpreting the fetal monitoring tracings. I learned some in school and am learning "on the job" during actual births, but I like classroom learning, too... having a list of scenarios or examples and knowing the right thing to do in each situation (is my accounting background showing through?). Regardless, I think Thursday will be helpful.