OBGYN Special Care Unit

Yesterday I was in OBGYN Special Care Unit. This has Antepartum patients (hospitalized before pregnancy due to complications) and Postpartum patients that have babies in the NICU. One of my patients had her baby the night before at 23 weeks gestation. The age of viability is typically considered 24 weeks, but even then, very few survive and all of them will have mental and physical disabilities. The baby was on a ventilator and on every medication you could dream of in the hopes to save the baby, but I don't believe it will end up surviving.

The other nurse I was working with told me that the day before, one of her patients started hemorrhaging and as the nurse was trying to lay down chux (large pads) and paging the doctor, the baby was spontaneously aborted. The baby was 12 weeks old, and everyone kind of assum ed they were going to lose the baby because the mother came in completely septic. The nurse who delivered the baby wasn't sure what to do with it, so she placed it in a specimen cup and put it in the pathology refrigerator to see if there would be tests run on the baby. Pathology hadn't come and gotten it yet, so naturally, my curiosity peaked and the CNA on the floor and I went to go check it out. We pulled out the cup, and sure enough, in my hands was a tiny 3 inch long baby. It had legs, arms, eyes....I could see the GI tract and the brain through it's thin, transparent skin. Amazing. What if this mother hadn't gotten an infection and gone septic? What would this little 3 inch baby have done in the world? Well, I guess it wasn't meant to be, but that moment is in my top ten best experiences in nursing school I think. But there are a lot of awesome experiences I've had.

The rest of my day was spent using a doppler on an antepartum patient finding fetal heart tones. It's like an ultrasound in a way, and I put this stick/transducer (?) on the mom's stomach and try to find the baby's heart beat. It's hard because the placenta makes the same sound as a heart beat and is much easier to find. But if you keep moving around, once you hear a heart that sounds like a galloping horse, you are in the right place and you count the beats. It was pretty cool, and one of my patients was very skinny/small and her baby boy was moving around a lot in there. I actually jumped back when he kicked the transducer. It was like I could see the foot protruding through the abdomen. I started giggling because I hadn't see a baby kick that much!

Tomorrow is my Labor & Delivery exam, but I haven't been in that unit yet. Next week, I'll be home for Thanksgiving break, and then the following two weeks I'll be in L&D. I look forward to seeing what it is like and finishing up this difficult semester!