Babies and More
I've experienced so much in the last month, I hardly know where to begin. I just finished my rotation at Erlanger Medical Center. I experienced quite a range of things there. My first day I got to be in the newborn nursery and did a full newborn assessment on a c-section baby.
I also saw 2 circumcisions and felt quite traumatized. I just don't know that I could put my child through that. One of the UT doctors said quite callousedly--"He won't remember it." This one was particularly horrifying to me because he was teaching two residents how to do it and it took FOREVER for them to finish it. That poor child's lungs were about to come out of his chest. I was even further disturbed that available pain management was not even used because "it doesn't make a difference anyway." When I told my OB professor that, she made some amusing threats of mutilation to certain male anatomical parts, and "we'll see how HE likes it."
In Labor and Delivery, I got to see a c-section. It was so cool to see the layers of skin/fat/muscles/uterus all the way down to the baby. What was even more amazing was to watch a baby come out all blue and within minutes he was breathing and pink as he made the transition from being dependent on the mother's circulation to maintaining life on his own. Isn't God awesome to have designed that! I still haven't seen a full vaginal delivery. I got to dash into a room just after the baby had slid out. I was so disappointed not to see the whole thing. But it was still cool to see what I did. What a bloody mess!
I was also faced with some sobering situations involving intrauterine fetal death. I was the only one of my classmates to experience this, not once, but twice. The first case involved a premature rupture of membranes (water broke) and a prolapsed cord at 16 weeks. In that case, I came smack up against the abortion issue. In this situation, the baby was not going to be able to survive. The decision was made to abort. This inspired discussions with 2 different nurses about refusing to administer the drug to abort as long as the baby had a heartbeat. I was made aware of Erlanger's policy of having L&D nurses sign a document when they first started on their stance on this issue. The 3 options were "I am able to administer," "I am able to administer only in an emergency," and "I will never administer." This also instigated a conversation with some of my fellow classmates about refusing to administer the drug, having somebody else administer, but then continuing to care for that patient. Is that condoning? The second case of IUFD involved a placenta abruption (placenta tore away from the uterus) at 37 weeks, and the baby died. It was a heart-wrenching thing to see the mother's agony.
My postpartum experience was also unique. I had the joy of having a patient who couldn't speak a word of English, and, of course, I couldn't speak a word of Spanish. I managed to get through most of my postpartal exam and get her to take a spitz bath purely by halting communication of short sentences and hand motions. It really was a good challenge for me even though it compounded my nerves with it being my first postpartal exam. I finished the exam through an interpreter which Erlanger is blessed to have. It has made me even more determined to become fluent in Spanish.
My high risk cases involved a sickle cell crisis, oligohydramnios, and twins. I was able to take two of them to get ultra sounds done, another marvel of modern technology. In the one case, I was able to see all those tiny bones including ribs, fingers, toes, etc. as well as all 4 chambers of the heart, kidneys, bladder, liver, and even the diaphragm.
It has definitely been my best clinical experience to date. On the negative side, taking 5 classes and working 40 hours has forced me to survive on an average of 5 hours per night which doesn't make for a healthy state of mind at times. Of course, I'm not helping the situation by staying up and blogging either. However, I really wanted to get some of these experiences down so I could look back and reflect later.
I also saw 2 circumcisions and felt quite traumatized. I just don't know that I could put my child through that. One of the UT doctors said quite callousedly--"He won't remember it." This one was particularly horrifying to me because he was teaching two residents how to do it and it took FOREVER for them to finish it. That poor child's lungs were about to come out of his chest. I was even further disturbed that available pain management was not even used because "it doesn't make a difference anyway." When I told my OB professor that, she made some amusing threats of mutilation to certain male anatomical parts, and "we'll see how HE likes it."
In Labor and Delivery, I got to see a c-section. It was so cool to see the layers of skin/fat/muscles/uterus all the way down to the baby. What was even more amazing was to watch a baby come out all blue and within minutes he was breathing and pink as he made the transition from being dependent on the mother's circulation to maintaining life on his own. Isn't God awesome to have designed that! I still haven't seen a full vaginal delivery. I got to dash into a room just after the baby had slid out. I was so disappointed not to see the whole thing. But it was still cool to see what I did. What a bloody mess!
I was also faced with some sobering situations involving intrauterine fetal death. I was the only one of my classmates to experience this, not once, but twice. The first case involved a premature rupture of membranes (water broke) and a prolapsed cord at 16 weeks. In that case, I came smack up against the abortion issue. In this situation, the baby was not going to be able to survive. The decision was made to abort. This inspired discussions with 2 different nurses about refusing to administer the drug to abort as long as the baby had a heartbeat. I was made aware of Erlanger's policy of having L&D nurses sign a document when they first started on their stance on this issue. The 3 options were "I am able to administer," "I am able to administer only in an emergency," and "I will never administer." This also instigated a conversation with some of my fellow classmates about refusing to administer the drug, having somebody else administer, but then continuing to care for that patient. Is that condoning? The second case of IUFD involved a placenta abruption (placenta tore away from the uterus) at 37 weeks, and the baby died. It was a heart-wrenching thing to see the mother's agony.
My postpartum experience was also unique. I had the joy of having a patient who couldn't speak a word of English, and, of course, I couldn't speak a word of Spanish. I managed to get through most of my postpartal exam and get her to take a spitz bath purely by halting communication of short sentences and hand motions. It really was a good challenge for me even though it compounded my nerves with it being my first postpartal exam. I finished the exam through an interpreter which Erlanger is blessed to have. It has made me even more determined to become fluent in Spanish.
My high risk cases involved a sickle cell crisis, oligohydramnios, and twins. I was able to take two of them to get ultra sounds done, another marvel of modern technology. In the one case, I was able to see all those tiny bones including ribs, fingers, toes, etc. as well as all 4 chambers of the heart, kidneys, bladder, liver, and even the diaphragm.
It has definitely been my best clinical experience to date. On the negative side, taking 5 classes and working 40 hours has forced me to survive on an average of 5 hours per night which doesn't make for a healthy state of mind at times. Of course, I'm not helping the situation by staying up and blogging either. However, I really wanted to get some of these experiences down so I could look back and reflect later.
posted by Sara | 1:47 AM
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