Monday March 2
I completed my online modules for clinical at Presbyterian Hospital. It has taken me a month to finally get into the system. I have spent hours upon hours on the phone and it is to the point that the helpdesk employees know me by name. Mission has finally been accomplished!
Tuesday March 3 - Clinical day
Today, I had clinicals in women's services at Presbyterian Hospital Dallas. The morning started at 0630. Dr. Arnold and I began the day at the L&D board making assignments for the students. There were four students in L&D so we gave two of the students c-sections and two of the students laboring patients. One insight that Dr. Arnold gave me was to start the guys out with a laboring patient. She explained that it is very important for them to begin this rotation facing their anxieties (seeing a live birth). We gave our male a laboring patient and she was right. He came out with his eyes wide open and I guess you could say that he had faced that fear and it has to get better from here.
Another event that happened today was a neonatal death. The patient was actually one that a student was observing so the student witnessed this event from start to finish. It was devastating for all the students and for the staff as expected. The student's walked into clinicals that day only expecting to see new life being brought into this world and were devastated when they saw the other end of the spectrum. I will get back to these thoughts in a bit.
When you have clinicals in women's services you have the entire service line to cover. This is hard for instructor's to have face value with the students. The next area we sent students to was the newborn nursery and admissions nursery (where infants spend their first couple of hours of life to ensure stability of the infant). I learned a whole different style of infant care here. I currently work at Baylor and there is a completely different routine for infant care there. I found myself learning a lot as I was trying to teach the students. I think this was really good for me to stretch my area of expertise as I was teaching the students. I was able to give them different perspectives of providing care. I shared that in the clinical world there is often more than one way to accomplish the same task.
We also had two students on postpartum and one student in high-risk OB (we never rotate through there). I was able to lead students through the postpartum assessment as well as demonstrate patient education regarding specific patient needs (breast/bottle feeding, perineal & breast care). Dr. Arnold and I had a specific post conference with the students on post partum because they left clinical at 1300. We discussed patient specific nursing diagnoses (now we are talking nursing school!). We lead the students through interventions and what outcomes we would expect in an actual work day.
Finally at the end of the clinical day each student shared from their personal experiences of the day. Then we worked through a labor and delivery case study. At the end Dr. Arnold pulled out her petite baby doll and pelvis to review fetal positions.
Whew! I forgot how long clinical days are! I went to bed at 2100 from and exciting and satisfying clinical day.
Wednesday March 4 - Lecture day
Today was enlightening all around. Remember how I was talking earlier about the neonatal death that our students experienced? Well, there was another clinical group that witnessed maternal and neonatal death. This devastating experience for the students changed our lecture focus. Dr. Arnold usually teaches about perinatal loss at the end of the intrapartum lecture series, but due to the current experiences the lecture was taught today. This was a very hard lecture for Dr. Arnold to teach and for all the students to sit through. The reality is that know one expects infants to die and everyone thinks that L&D is always a happy place. Most of the time this is true, but not always. I think this lecture was given at the appropriate time and it was very necessary. It was good for me to see the instructor's flexibility according to the students' needs.
After the lecture I had a student come to me in tears. She asked if I had time after class to talk with her so we met. She has been falling behind in clinicals due to family illness (the instructors are all aware of the situation)and wanted to know if I could share my story of how I made it through nursing school. I had the amazing opportunity to share my struggles and victories throughout my journey as a nurse and nursing student. She said that she felt comfortable coming to me because she knew that I knew what it was like as a student. Wow!! What an amazing experience! One thing that I have tried to make a point to do is to be there for the students and to help them feel comfortable with coming to me. I was intimidated by a majority of my nursing instructors in nursing school and I didn't feel like I could go to them for help. I felt like if I asked them something then they would act like I should already know the information. I only remember one nursing instructor from my nursing program that I felt like I could ask her anything and she wouldn't judge me. I am forever thankful for her encouragement to me during my education. Today, I saw the effort I have made to encourage and support the students come back to encourage me as a nursing instructor. These victories remind me of the difference I am making and will continue to make as a nursing educator.
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Wow on your clinical having to deal with a neonatal death. It is an interesting dynamic to have to deal with things like that. How the student reacts, discussing it, etc. I will be blogging this week about that type of thing as one of my student had to be switched to a different patient due to "issues"
ReplyDeleteJackie, sounds like not only a physcial week but an emotionally filled one as well. On a different note, I was really surprised when you said you could have your male students in L&D. When I was teaching in Dallas that was a real no-no. It was something that always bothered me but the hospitals expressed it that most women do not want the male nursing student in the room so they were not allowed to come. The male student rotation during OB was always in the post partum and nursery units. I also know at the hosptial I taught at in Indiana they wouldn't even interview male nurses or techs for postitions for similar reasons. I am very happy to hear there are some hospitals willing to give the male students these wonderful learning opportunities. Thank you for sharing--Amy
ReplyDeleteJackie,
ReplyDeleteGood for you to share your experience and success getting through nursing school. Students ask questions and sometimes I can see them begin to calm down just by talking with them about my experiences. Educating is much more than covering the content and performing clinical skills. Communication is key and reassurance is valuable!
Donna
Jackie,
ReplyDeleteWow, what a week for you! Neonatal and maternal death- what a heavy topic and that is great that your preceptor addressed now while the topic was fresh on their minds. That's fantastic you were able to be a mentor for the student as well. Your post was very motivational. Thanks!
Jackie-
ReplyDeleteI'm sorry that you and your students had such a sad experience. It never gets easier to have a neonatal death. I've never experienced a maternal death when I worked in women's services...I can't imagine. I think it's wonderful that Dr. Arnold was so sensitive and perceptive to what the students were going through that she rearranged her lectures. On one hand, it is better the students had experienced this in a learning environment where they could come to you and Dr. Arnold to discuss their feelings/concerns in post-conference, get support from peers, and hear the lecture so soon to the occurence. You really seem like a treasure to your students and I'm glad they have you!