Rachael Whitney

UVA clinical- Women’s health

Special Reflection

During Clinical today, I was in the Labor and Delivery unit and was given the opportunity
to be with a patient undergoing a scheduled C-section. The RN’s job in this situation was to
prepare the patient’s room with supplies that may be needed, prep the patient including
starting an IV, monitoring her IV, monitoring her and the baby’s vital signs, assessing the
mother, getting a history from her, and providing patient education among other things.
We then went with her to her surgery, and provided her with emotional support and helped
to ensure that things ran smoothly. When the procedure was finished and the baby was
delivered, we assessed the mother’s pain, vital signs, and assessed her for nausea and
vomiting. The baby was also assessed. I also had the chance to observe the nurse assist the
mother with breastfeeding her baby for the first time.
Although this wasn’t a typical vaginal delivery, I feel that this was a very special
opportunity for me. Learning about the course of action taken and care that is given to a
mother and baby undergoing a C-section will be important for me if I choose to become a
Labor and delivery nurse. It was very exciting to be able to be in the operating room and to
watch everything that goes on. Before the operation began, my patient was somewhat
nervous and stated that she felt anxious. My nurse preceptor told me to stay with her while
she was receiving her spinal epidural. It felt like a privilege to be the person to help keep
her calm and talk to her during this time before her husband got there. I think that this is a
very important part of nursing, while I was very excited to see an actual surgery and watch
the fetus be delivered this way, I was also excited to have a chance to be supportive of a
patient who really needed it.
Going into this clinical day I expected to be assisting a nurse with a mother in labor
giving a vaginal delivery. I expected to be providing nonpharmacological techniques as well
as maybe administering pharmacological medication. Being with a mother undergoing a C-
section was something that I found to be a very interesting experience that I learned a lot
from. Something that I did not think I would see in clinical that we learned about in class
was certain types of hematomas. During the surgery, one of the surgeons turned to me and
asked me to dump out a bucket containing the placenta. She looked at me and said “Dump
it out and play with it.” She then asked my nurse preceptor to explain to me what exactly I
was looking at. While observing it, I noticed a very large clump of red, something that
resembled a blood clot. It was a Subchorionic hematoma, which occurs in about 5-25% of all
pregnancies and is associated with an increased risk of spontaneous abortion (article).
Subchorionic hematomas can also lead to different types of complications during pregnancy
so it is important to monitor the mother and baby closely throughout (article). Another
thing I learned about these hematomas from my preceptor was that they can impact the
exchange of nutrients and blood to the fetus while it is in the womb. This was something
that I will always remember when I look back on my experiences in nursing school. We had
just learned about these types of hematomas and their possible implications and the next
day I was able to see it in practice.
 The great thing about nursing is the variation of what you may see from day to day and
from specialty to specialty. I think that this experience will help to better prepare me for
what it may be like when I actually am an RN and need to prep my patient for surgery and
then care for them in post-op. I have seen what an RN does for his or her patient
throughout this process and I will strive to mirror the great example that my preceptor was
when caring for our patient when I come across this situation in the future.
 Resources

Benavides-Reyes, I. et al. (2015). Subchorionic hematoma volume in the first trimester and risk
of spontaneous abortion. Revista Latinoamericana de Hipertensión, 10 (3). Retrieved from
http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,cookie,url,cpid,uid&custid=s8
863137&db=edb&AN=121088551&site=eds-live&scope=site&authtype=ip,uid