When I started my role as a nurse educator, I am confined in the four walls of the classroom doing lectures about nursing concepts. I did not have the chance to go with my students in the clinical area, however, in the MNE program, I experienced to be with nursing students in a hospital and community rotation. One of the recent and significant encounters in my clinical practicum happened is in the delivery and labor section, where patients are high-risk pregnant. As I recall, it was a hectic shift where four patients simultaneously in labor and delivery. It was literally demanding for those nurses-on-duty, midwives, resident doctors, nursing students, the undergraduate and us from the graduate school, and other members of the healthcare team.
One of the patients delivered via caesarean section, and one of the nursing students, who had assisted with the newborn cord dare, was delegated to accompany and continuously observed the mother and the baby to the post-operative area. The student was tasked with monitoring the vital signs.
While shadowing the clinical instructor-in-charge to supervise the other students performing significant tasks in delivery and newborn care, I took the initiative to check on that specific student and post-op patient. Upon arrival, I found the student struggling in attaching the vital signs monitor and she appeared intently concentrated on that and on the monitoring sheet. However, she failed to observe the positioning of the newborn, whose face was buried into the mother’s breast and axillary area. The baby’s skin integrity was starting to turn purple to bluish, which signals suffocation. The mother was unable to hold her baby properly during breastfeeding because she verbalized weakness and dizziness from the anesthesia and pain medication.
The student, upon realizing the situation, was visibly shaken and immediately called for help. One of the midwives and a couple of pediatric residents responded promptly, assessed the baby, and initiated warming and oxygenation. Thankfully, the newborn recovered, but the event highlighted number of critical learning points.
As a clinical instructor, this event reminded me of the relevance of attentiveness and holistic observation in maternal and newborn care. Nursing responsibilities does not focus on one skill alone, such as vital signs monitoring and documentation. High-risk situations must be seen in a full picture. The student who was concentrated on the technical task at hand but needs situational awareness. As I process the student, I emphasized that those missed responsibilities are part of the learning process. I explained how serious it is to monitor not just physiological information, but also positioning, I breathing, color, and overall responsiveness of both the mother and the child. I reassured her that calling for help was the correct action to do and that recognizing one’s limitations is a mark of a responsible nurse.
More prominently, it stressed the necessity of closely supervising students during high-risk tasks and ensuring that clinical assignments are matched with their level of readiness and confidence.