My last class of nursing school instead of going to clinical with an instructor and a group of students- we worked with a preceptor for our senior practicum. Senior practicum consist of being assigned to work with one RN his/her full time schedule for 9 shifts- or 108 hours. My practicum was on a labor and delivery unit at a local hospital on night shift.
Some things I did while on the labor and delivery unit include:
- IV fluid/medication/push medications
- Fetal Monitoring
- Start & D/C IVs
- Insert & D/C foley catheter
- Cervical exams
- Care for baby after birth
- Assist mom with pushing
For mom, I adjusted more fetal monitors than I can count, charted on fetal monitor strips, did cervical exams, provided emotional support, helped educate, and gave IV/IM medications. For baby, I gave vitamin K injections, erythromycin ointment, did footprints, vital signs, APGAR scores, and weighed baby.
All of this was done with my preceptor at my side and under supervision- but it was great to get so much hands on experience. If you want a place to practice your IV start skills, L&D is the place to do it! Anyone who is admitted gets an IV, and they start all their own IVs and draw all their own labs. When we would be in triage- I would start multiple IVs a night.
I was able to attend multiple C-sections which I always find interesting. The nurses and CRNAs were eager to teach and walk me through what was going on during the C-section so that made for a great learning experience. The primary nurse spends the first two hours post-op in recovery with the patient – so I also was able to get some recovery room experience. During recovery you are checking vitals of mom and baby and assessing mom for bleeding and fundal height. I also attended multiple vaginal births which is a different but equally interesting and amazing experience.
While I would say most my experiences were happy on the labor and delivery unit, I think it’s important to point out that there also was sad moments as well. L&D sometimes gets the reputation that it is all sunshine and rainbows- and a lot of times it is- but unfortunately not always. I helped with postmortem care on a 19 week old fetal demise my first night. I cared for a woman who was having a miscarriage. I saw premature babies who were born from 23-28 weeks and had to be rushed to NICU. It was sad to see these things. However, I am so thankful to have seen both the good and bad- and feel blessed I was able to work with these mom and babies.
The staff on the labor and delivery unit were wonderful and I can’t thank them enough for sharing their abundance of nursing knowledge with me and all the learning opportunities they provided me with! My preceptor was extremely knowledgeable, supportive, and kind- making for a fantastic last clinical experience in nursing school! Thank you!
I think the most important piece of advice I can give to anyone before they begin their practicum is to be prepared for a lot of different emotions. At times, you will get things rights, do well with a new skill, or answer all your preceptors questions correctly, and be filled with happiness and excitement. However, there is also going to be times when you will feel overwhelmed. Being in a new environment, with new equipment, a new patient population, and new staff can result in a difficult transition even for experienced nurses. Give yourself some grace during your practicum- this is the beginning of the transition from student to nurse, and it’s not an easy one. Know that everyone has the stress and doubt that you are feeling- and it does not mean you won’t be a good nurse! I started off my experience stressed and anxious, and by the end I had gained a lot of confidence and my nights began to flow much better.
For more information on OB clinical and tips be more prepared for your own clinical experience- check out my post about my OB Clinical Rotation experience during my Mom/Baby class!