This week’s clinical was another fantastic day for me. I got to see 2 Cesarean sections. The nurses were very good in explaining things and let me have some hands-on experience.

The first C-section case I saw was carried out because the baby was in a breech position. There was a mistake among the caring team that the mom had twins, until C. greeted the parents saying “babies”, the father corrected the nurse that they were going to have a “baby”. I followed A. while she prepared a lot of paperwork. The mom needed to sign the consents for her surgery, any treatments (if necessary) for her baby and herself, disclosure of information, hepatitis B shot for her baby. Then A. put a gel on the mom’s abdomen, put a monitor on to monitor the baby’s heart beat. She also gave the mom medication that prevents vomiting, and something else that was put in her IV, and shaved her lower abdomen where the doctor would make an incision. Then we went to the operating room to preprare identification bands, other paperwork, and count the surgical items.
 

Then the mother was brought to the room. An anesthesiologist gave her epidural anesthetic. I was there to observe the whole process since the physician made the first cut until the incision was sutured. The baby did not cry much when she got out, but in the end, she was healthy. During and after the C-section, we counted the surgical items 3 more times.

Then the mother was brought back to her room. We checked her vital signs every 15 minutes. I was allowed to check her bleeding by pushing and cupped her fundus. There was moderate bleeding immediately after surgery, and on my second check, there was no obvious bleeding.

I have heard before about instances when a wrong patient was brought for a procedure by mistake, or surgical item was forgotten in the patient body. That’s very bad. Observing the nurses check on the patient’s name and her reason for being here several time, and the time out (when the patient’s identity was check for the last time right before the surgery), and the counting for 4 times made me feel that it’s safe for the clients here.

Then I switch with M. to care for a newborn. I was taught to bathe her, hold her like a football to shampoo her hair under the running water. Then bathed the rest of her body trying to remove as much of the vernix as possible. Then I checked her blood sugar 2 times (as far as I remember, she was preterm, so we had to check her blood sugar for 6 times every 15”, then every hour), and did other vital signs. I was so excited that I could listen to the baby’s breath sound this time. The duration of a baby’s breath sounds is extremely short compared to an adult’s breath sounds, so I hardly recognized them at first.

Around noon, I followed nurse C. who was the “baby-catcher”. In this second C-section that I saw, the baby was in transverse position. It was determined to be in breech position until the mother was on the surgical table. This time instead of following the mom, I went after the baby. So C. made sure all the items needed to take good care of the newborn were in good working condition. Right after birth, the nurse and a neonatologist wiped off and assessed the newborn. The father refused to cut the newborn’s cord, so I had the chance to do it. Then back to the patient room, beside doing vital signs, I gave the baby vitamin K and hepatitis B intramuscular injections, and applied the antibiotic eye drops.  

I had a great educational day, and I look forward to the next one.