Level 3: L&D

Labour and delivery has been my favourite Level 3 placement thus far. It was one month with a nurse who supports women through labour and birth, and it was a great month!


Introductions

I was a little weary on the first day because typically the nurses don’t know that you’re coming and that is always an awkward conversation:

“Hi, I’m with XX nurse this month.”

Everyone stares. My new nurse preceptor responds:

“Oh, I didn’t know I had a student.”

Always a weird start, but I’ve become brave in this midwifery education of mine, and have learned there is nothing like a little patient smiling and nodding until they do something about my presence. Eventually my nurse preceptor remembered me from last year working with the midwives (I got lucky and got the same community).

Getting started

My lovely preceptor showed me around, asked me what I wanted to learn most, and then put me to work! At first it was a bit disorienting, especially after not having done very much of anything hands-on during OB, but I found a groove eventually. The nurses would quiz me, answer my questions, and make opportunities for me to help them. I got to do several IVs (missed most of them), fetal heart monitoring, a bit of suturing, and of course, delivered 4 babies when the student-friendly OBs were on. I even got to go on my very first ambulance transfer, and see how that whole part of labour is managed.

Building bonds

At night, we would do all of the above but also have lovely little social chats about different life lessons. Some were about having families. Some were about delicious recipes. Some were about the “dangers” of home birth (can’t go anywhere without this one!). For those 4am chats, I would wrap myself in a warm blanket from the warmer, settle in, and take a listen. Crack a joke or two, maybe, and pretend that I worked there. It felt almost like I was a junior member of the team being newly orientated to the ward, and I found myself wondering if maybe I should’ve been an L&D nurse. Even my friend L. spent some time at the same hospital in the post-partum ward, making the long nights go by much more quickly and making this placement my favourite one yet.

Transitioning to care management

From this placement forward, I need to start shifting my brain to learn to care management decision-making, but it’s really still a long way off. I get parts of it but miss others and need gentle reminding. My nursing preceptor was excellent at telling me what I could’ve done better, or at encouraging me to go into a room, look at the heart monitoring strip, and come out with what I thought would be the best management approach. She would then agree, or disagree, and eventually I started to see patterns and decision-making points that I hadn’t been able to identify before.

I really hope my 4th year preceptor is like that; pushes me but is still friendly. I really hope for good things this year, as I start to cement certain skills and build my clinical confidence.

Wish me luck, 4th year starts in May in Ottawa!