time to binge blog

sorry for the hiatus...but here's hoping my 4 consecutive blogs will make up for it. 8P

my first clinical day was quite dramatic! my shift started at 7 in the morning, and i was assigned to a nurse and a patient. my patient had been in labor since 2:50 am, but was only about 2-3 cm, and her water hadn't broken yet. she was doing a natural, normal vaginal birth, and was only taking half doses of the usual routine pain meds, but she had a history of rapid deliveries (her last delivery only took two hours of labor!) so we were expecting her to progress pretty quickly...but NO. she took my entire shift to dilate up to 9 cm! it took much longer than any of us, her included, were expecting. but then again, when you're expecting, i guess nothing really goes as expected.

she asked for an epidural around 5 cm, and she took 3 boluses after that, and we had to send for another anesthetic order because she was still complaining of pain. pretty soon after her epidural, her contractions became much less effective, and she was only dilating half a cm an hour. the doctor decided to artifically rupture her membranes, since her water hadn't broken yet. we hoped that would move her along, and it did, but she was still only dilating about a cm an hour. my whole shift was basically watching her dilate! finally, we gave her some pitocin (labor inducing hormone) and she got up to 9.5 cm around 2:40. my shift was supposed to end at 3, and then i was supposed to go to a post clinical conference, so i thought i was going to have to miss her deliver entirely. luckily, she kept telling us that she even though she was trying to control the urge to push, her body was involuntarily pushing, and the baby was coming!

we quickly prepared all the things for delivery, and it literally took her only 2 pushes (it took her longer to push out the placenta afterwards, can you believe it?) and her baby practically shot out, at exactly 2:54 pm. it was a girl, and perfect! her eyes were open, and she was 6.9 lbs, very pink and healthy. i actually got a little choked up, which i hope no one saw, but you have to understand, i had spent all day with my patient and her family, and gotten to know them, and they were so excited when they heard that this was my first day and first birth. they kept asking me to ask my professor if i could stay longer to watch her deliver, and my professor was so cool about it, she suggested i stay even before i brought it up!

so it was all very exciting and emotional, but the thing that really got me was that the patient's husband started crying when his daughter was born. anyways, mostly, i just observed the procedures, watched the fetal heart monitor, and took the patient's vital signs. but it was awesome to get to see a normal vaginal birth, since most of my classmates had been watching c-sections or stayed in postpartum or NICU. i know, how lame to be excited about having a front row seat for a vaginal delivery! probably too much information for you too (i promise, i tried my best to leave out the gory details)...but i was really glad i had a good first clinical. :)