Sunday, September 15, 2013

It has began!!!!!

 I have met my preceptor, a great nurse whom I will call M. She is so very nice. She actually had a meeting with me and my advisor on campus to meet. I have my schedule figured out to get all my hours in.  I have done two shifts and learned so much, and done so much!!! I have successfully started IV's and been  labour support, and charting and doing all kinds of great things!! 12 hour shifts go by fast, but by the time I get home I am very tired haha!! Tomorrow I will be doing my first  12 hour night shift- Oh MY that might kill me. But in labour and delivery nights might be a bit crazy- all my babies came at night!!
M is an awesome teacher, and very patient with me!!! I am still second guessing myself at some things, but for the most part I am doing alright- getting the hang of things!!!!
One of the things I'm working on is Fetal Heart Monitor Tracing(FHMT). This is a machine that reads fetal heart rate and contractions, and even though not 100% accurate it can give the nursing staff and the rest of the obstetrics team a picture of how the baby is handling the labour process. It is specially used when  when things are happening such as mom getting an epidural. Epidurals can cause baby to have bradycardia (low heart rate [HR]).  I have attached some pictures I found on the web. FHMT is complex and I could write for days. The reader's digest version is: There are two  separate strips on the pictures( below) the top is the babies heart rate, and the bottom is the moms contractions. Our Job is to watch  how the contractions are affecting the baby.  First there is a baseline this is where the baby's HR trending or averaging at. There should  accelerations( heart rate going above baseline) and decelerations( below baseline).  We want to watch changes for example decelerations that occur with the contraction are normal, specially if the heart rate bounces back up to the base line . There are a lot of things we need to take into consideration when reading the strip, and sometimes to the untrained eye it may look bad, when in fact it is not. That is what I am trying to accomplish this week!! I can now read the strips, but I am not very fast at charting the haha!! Charting- that is something that requires it's own blog!!
Wish me luck tomorrow!!

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