Time: ​2:00 P.M.- 11:30 P.M.

Date: ​August 7th, 2018

Place:​ Prairie Lakes Hospital, Watertown, SD

Total Hours Spent Shadowing: ​9.5 hours

Observations:

My day started out meeting Jen along with the rest of the staff and getting a tour of the

OB floor. I got to see a supply room, which had all different types of tools they used for labors.

Tools including: forceps, scissors, fetal monitors, umbilical clamps, and a urinary catheter. There

were so many more but who’s got the time? After seeing all of them and learning about what

each do, we got to work! We went to the break room and changed into some scrubs.

After getting into our scrubs we looked at our patients today. We had one patient who was was

only two centimeters dilated, another women who was eight centimeters, one that was five

centimeters, and one that was ten and ready to deliver! After going from room to room

introducing ourselves and asking what we could do to help, I got to help ladies get through their

contracts by showing them different ways to ease the pain, things like the pushing on their

knees to relieve back pain and helping them with the peanut ball. A peanut ball is just an

exercise ball that women can sit on to help them ease the pain from their contractions. After

helping the ladies with their pain, I followed Jen around giving the women pain medication like

ibuprofen, nitrous oxide, and pethidine.

Finally, one of the patients were ready to start pushing! As I entered the room, I put

gloves on my hands along with a face mask too. The OB/GYN, along with an OB/GYN intern,

walked in and started by talking to the soon-to-be mother. He told her what was going to go on

during the labor and what he was going to do after the labor, giving her all the information and

trying to settle her nerves a little. I didn’t hear much of what he was saying with all that was
going on, but I could tell that he was doing a good job of calming her down. While the doctor

was talking, the nurses set up the room. First we got the bed ready and took off the end so the

women could put her legs in the holders. Then we put protectors around the floor and a bag

hanging from the end of the bed to catch all the water and blood that comes out. Next we got

the tray ready by putting all the instruments laid out. Some of the instruments include: one mayo

scissors, one kelly clamp curve, one kelly clamp straight, rubber suction bulb, a lot of sterile

gauze, and gloves. After that, the OB/GYN’s started to put their clothing protectors on and

sterilize their hands to put their gloves on. It was time to start pushing! The mom pushed for

almost two hours. Jen told me that usually new moms push for longer. So while not much

progress was going on, we went on another trip around the rooms helping with labor pains and

monitoring the baby. We had put one of the women into the whirlpool, one of them one the

peanut ball, and the others were ready to go on a walk.

Hours went by and around nine o’clock the women who had been pushing since seven,

was getting really close to being a mom. I went back into the room and got to see the last

couple of pushes. As one nurse was holding one of the women’s legs and the husband was

holding the other leg, she gave two more strong pushes. Soon, the baby’s head came out and

then slowly the rest of the body came out too. The Dad cut the umbilical cord, with blood

splattering everywhere, the internal clipped the end of the umbilical cord that was left on the

baby. They set the baby on the mother’s chest, waiting for it to urinate or poop. We checked the

baby for vitals, weighed her, and took her measurements. While the OB/GYN pulled out the

placenta and showed it to the intern and I, he showed us the inside where the baby was and

then started to clean out the uterus and decide what kind of tear she had on her uterine wall.

We determined it was a second degree tear. While the OB/GYN was getting close to done, we

took the baby to get cleaned up. Jen and I gave the baby a bath and took her back to her
mother. By then it was ten-thirty and it was time to chart. Jen showed me where to put things

and what they mean, but as she was putting it in the computer, I got to into the nursery and hold

the babies until it was time to go. By the time we were almost ready to leave, two women were

already ten centimeters dilated and the other one was only at four centimeters. All of that was

just one day! I was so excited for the next day!

Time: ​3:00 P.M. - 11:00 P.M.

Date: ​August 8th, 2018

Place: ​Prairie Lakes Hospital, Watertown, SD

Total Hours Spent Shadowing: ​17.5

Observations:

Today started out with getting in some scrubs. After we scrubbed in using this hard

textured soap up and down our arms, in between our fingers, and all around our hands. We did

this for about five minutes, making sure every spot is cleaned. Next, she told me today was

going to be interesting. We went into the break room to get up to speed on what was going on

today. Another nurse who had been there during the morning and day walked in to catch us up.

She told us about each mother and baby, then told us about their tests they received and the

results. She also told us what the stats of the baby and mom have been, along with what meds

they have taken and when they were taken.

After we were up to speed on what was going on, we got to work. The first thing we did

was go into the rooms and ask the women if there was anything we could get them. Since most

of the women had a lot of company, we didn’t want to take the baby away from them to do

assessments. We took the babies that were not being visited into the nursery to check their

vitals. We brought two babies into the nursery, first we checked their temperature and then we

checked their lungs and heart. We kept them in the nursery for a while after so the mom could

get some rest and something to eat. During this time, I got to hold and rock the babies while Jen

did more assessments on the other babies that were there. After all the babies went back to

their mothers, we had to do assessments on the moms. To assess the mom, Jen took her blood

pressure, checked her heart, and then checked where her uterus is. To check where her uterus

was, Jen put her hand on the mom's stomach under the belly button to push and feel if the
uterus was going back to regular size. At this point all moms and babies were healthy and doing

well. For a while after finishing assessments, Jen charted and I got to talk to her about what her

pathway for nursing was like.

It was around seven o’clock when a woman called to say that she was coming in

because was having some discomfort in her stomach. We pulled up her chart and saw that she

has had three miscarriages. To set up her room, we put sheets on the bed, a robe for her to

change into, and an ultrasound machine to find out what the baby was doing. While we waited

for her to get there, we answered bedside calls. Before she arrived we had contacted the

woman's OB/GYN to let him know that she was coming in and to see if there was anything

special he would like us to do or discuss with her. At around eight thirty she came up the

elevator and we showed her to her room to help her get into her robe and into the bed. We put

the ultrasound gel on the woman's stomach where her uterus is. We turned the ultrasound

machine on and used the transducer probe to see inside the uterus. It turns out that the woman

was undergoing a lot of stress and that was why she was having so much discomfort. Jen

helped her by telling her some ways she can deal with stress and to stay away from things that

stress her out. She was discharged and sent home after we monitored her for a while.

At nine o’clock we went around the rooms again to make sure the moms and babies

were doing okay. We took one baby boy that we were not able to get assessments on before

because of the many visitors he had. We did the regular assessments but found that the baby

had a low temperature. As I wrapped him up and sat with him under the warm lights, Jen went

to check on the room that he was staying in. She came back and told me that the mom was so

hot she turned it down because she sweats so much. Jen told me “one of the hardest things

was having to tell mothers that their babies have this or are doing this because of something
they are doing or did.” For the rest of the time I sat under the warm lights with the baby boy and

talked to Jen.
Time:​ 3:00 PM-7:00 PM

Date: ​November 13th, 2018

Place:​ Prairie Lakes Hospital, Watertown, SD

Total Hours Spent Shadowing: ​21.5

Observations:

Today was the most exciting day I had at the hospital. We got up to the floor and there

were people everywhere. Jen told me that it was going to be a really busy day and that I would

get to see things that she hasn’t ever shown anyone else. We got into our scrubs and scrubbed

in, this only took us seven minutes because we were in a rush to go help. We got out to the floor

and went into the break room to get Jen and I caught up on what was going on. We had seven

patients, with three that have given birth already. We went to check on our patients who have

not given birth yet, we had two who were eight centimeters dilated. I went with another nurse to

evaluate and give shots to a baby boy. We went into his room to grab him from his mom, then

took him to the nursery. First, we checked his temperature by putting a thermometer under his

armpit. Next, we checked his lungs and heart by listening through a stethoscope. After finishing

that, we checked his ears. We used a Otoacoustic Emissions, which is a tool that measures the

sound waves in ears. The baby had to score an eight in each ear to be good, he scored an eight

in the right but a four in the left. After charting those tests, we gave him his influenza shot. He

now was all done with his evaluation, so we took him back to his room. When on our way out

Jen called me over because a women was coming in with her baby girl, who has

hyperbilirubinemia. The mother and baby came up the elevator, she stepped off and the baby

was the color of a pumpkin. We brought her into the nursery and put an IV in her, then we put

her under bili lights. We left her under there for hours.
 Finally, one of our labor patients were at ten centimeters and ready to push. We walked

in the room, got our gloves and our face masks ready. Now, she has already been pushing for a

while before I walked in, so I didn’t see anything preceding up to the moment. The doctor told

her “one more push” and she gave one more big one. Next thing you know, there was a

beautiful baby girl in the doctor’s hands. The dad cut the umbilical cord and we set the baby on

the mom, so it could urinate or stool. We checked the baby and made sure to make her cry, so

she could clear her lungs. As all was good with the mom and the baby, the doctor stitched the

mom up while we checked the baby’s lungs and heart. We left the room to give the parents time

with their new baby girl. We came back a few minutes later so that we could clean the baby up

and take her vitals. We took her to the nursery and gave her a bath. Then we took her vitals by

checking her temperature, lungs, heart, and blood pressure. We rolled her back into the parents

and checked the mom’s vitals, we took blood pressure, checked her heart and lungs, and gave

her pills for pain.

After all the assessments on our patients were done, we had to go help a new nurse

handle a patient who was pregnant but also had a drug problem. She was so uncomfortable it

took us three to try to help her. She was ready to give birth and kept asking for drugs, but we

had to watch what we were giving her to make sure it was safe. While Jen set up the whirlpool

and the other nurse called the OB/GYN to ask a question the soon-to-be mom was insisting on

knowing, I did get to help her do some stretches and exercises that helped with the pain she

was having. Jen did tell me that “these women are harder to deal with because not only are they

going through labor, but they aren’t allowed to do drugs anytime during the labor so it’s difficult

for them.” After we got out of the room it was eleven o’clock and I was ready to go home.
 I learned a lot through these three days of shadowing.During the experience I could see

myself going into the medical field. Throughout my time, I got to see what it was like being an

OB nurse and I loved it. This was truly a great opportunity.