I have officially finished my OB clinical rotation! This was one of my favorite rotations.The nurses were very welcoming and accepting of students, and willing to help us learn. I also find all things OB to be so interesting and I find a lot of enjoyment in working with moms and babies. For this rotation I went to three different units in the hospital as well as an outpatient clinic, and each came with it’s own unique experience! I included a little information on my experience on each unit, as well as things to review before you go to this unit yourself. 

Do not get overwhelmed by the “things to review” list if most of it does not sound familiar! You will learn all of this in class. My instructors were awesome, in order to make sure we were prepared for clinical they took us to the simulation lab where they taught us everything we need for each unit since we didn’t have much class time before starting. If you don’t get this, it can all be easily looked up in your book. If you don’t fully understand it however, do not worry! You are a student, in a specialty at that, no one expects you to know everything! I just made a list based off questions I was asked by the nurses (a lot of them loved to quiz me!) and experiences I had.

Antepartum Unit

This unit was for woman who have to be admitted to the hospital while they are still pregnant, but are not ready to have the baby yet. Some common diagnosis you see on this unit are preterm labor or preeclampsia. I was able to do a couple non-stress tests with my nurse, discontinue an IV, and assist with a patient transfer to labor and delivery. My nurse took the time to really review fetal monitor strips with me which I think was a big plus to my experience.

You also may see a fetal demise (baby died) or a mom who has a baby is in the NICU on this unit. At the hospital I went to they put a butterfly on the door for fetal demise and footprints if the baby is in the NICU. If your patient has already had their baby, please make sure you verify why they are there and know what you are walking in to! OB can have a lot of sensitive things happen and you want to be appropriate with how you handle your patient. Also know that if it is a fetal demise or infant death, there is a possibility the baby could be in the room with the mom.

Things to review:

• Fetal monitor strips
• Preeclampsia and preterm labor (what they are, how they are treated)
• Non-stress test and Contraction Stress Test
• Medications for preterm labor
• How to start an IV

Postpartum Unit

On this unit, you will take care of both moms and babies. At the hospital I went to, there was no nursery, so the baby was in mom’s room the whole time. I was able to do assessments on both mom and baby. The nurse let me listen to mom’s heart, lungs, and bowl sounds, as well as check pedal pulses and for any major/pitting edema. I also had the opportunity to feel the fundus (top of the uterus). I observed a lactation nurse’s teaching about breastfeeding. I changed, swaddled, and checked the heart rate and temperature of a newborn. I also weighed the baby and assisted with discharge to home. When you weigh the baby, make sure you zero out the scale before you lay down the baby. Babies typically lose weight in the hospital but the baby should not lose more than ten percent of their birth weight prior to going home.

Things to review:

• How to swaddle, feed, bathe, and change infant.
• How to give IM injections to both Mom and Baby
• Normal respiration, HR, and temperature for baby.
• Normal lochia (discharge after birth) for mom and how high the fundus should be, also how to chart it (ie U/1).
• How to catheterize a female patient

OB Clinic

I spent one day shadowing the education nurse at a local OB clinic. This clinic was for low-income moms, so most of the population was self pay and medicaid. I found it so interesting and really loved it! The clinic was mostly staffed with Nurse Midwives (advanced practice nurses who can care for pregnant woman through birth) and Woman’s Health Nurse Practitioner (advanced practice nurses specially trained in the care of woman) which was awesome! It shows how much nurses do for all different populations and the amount of knowledge that we hold.

The nurses educators were RNs and they really knew their stuff! Education is such an important part of nursing and many times is overlooked. It is something we should always do and always be looking to improve on. Some topics they educated patients on were prenatal care (vitamins, diet, things to avoid), smoking cessation, and advantages to breastfeeding.

Labor and Delivery Unit

This was my favorite unit. I was able to see two cesarean sections and one vaginal birth. It is truly such an amazing experience! Even if you have no interest in being a labor and delivery nurse, I think everyone can appreciate the experience of seeing a birth. I was able to give a Vitamin K injection to two infants, as well as apply the erythromycin ointment to their eyes. I also did vital signs, fundal checks, an APGAR on a newborn, and observed an epidural placement.

Things to review:

• Fetal monitor strips (types of decels and what they mean as well as interventions needed)
• IM injection sites for baby and mom
• How to and why we apply erythromycin
• How to do an APGAR score and when
• Stages and Phases of Labor
• Drugs/Procedures: Pitocin, Epidural, Magnesium Sulfate, Episiotomy
• How to swaddle an infant (possibly feed and change)
• How to catheterize a female patient
• IV placement

I will say everyone in my class did great at clinical and had no major issues! I do know of nursing students who have found themselves feeling nauseous or faint when it comes to this area of nursing. My suggestion is if you feel this way: SIT DOWN! Seriously, it is better to sit than pass out and hit the floor hard! Take some deep breaths (through your mouth if it’s a smell issue) and look away. Whatever you do, do not grab on to or fall into anything blue because blue=sterile. I am sure you will be fine and have no issues, but this is just a helpful hint that I have been told more than once. Also, EAT BREAKFAST! I know, who wants to eat at 5 am. I usually eat a yogurt in the morning. It’s light and gives me some protein to keep me going until lunch. Hypoglycemia (low blood sugar) and an empty stomach do not make for a good clinical experience!

Good luck with your OB clinical rotation! If you have any questions, please let me know!