Running head: WEEKLY JOURNAL 1

NURS 3731: Childbearing and Women’s Health Nursing Journal

Giovanni Paolo Bruno

Youngstown State University

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I had my fourth OB clinical rotation this week on Tuesday, February 4, 2020. I was on

the labor and delivery unit at St. Joseph Warren Hospital and was accompanied by my clinical

instructor and peers from 1500-2100. I worked alongside of my OB preceptor nurse, Michelle

during my shift.

The most significant learning experienced I participated in was learning about the

differences between anesthesia induction for an OB patient and pain management. Within the

discussion, important side effects and distinctions between the types of anesthesia were made.

The two anesthesia techniques discussed were between general and regional anesthesia. General

anesthesia is only done for STAT C-sections because all of the drugs given to the mom will cross

the placenta and the baby can become compromised. In these instances, the baby has to be

delivered within 3 minutes. Regional anesthesia for the OB patient can be an epidural or spinal.

The main difference between the two is what layer the needles are inserted to, size of the needle,

and chance of complications. Epidurals go into the epidural space and spinals go in the

subarachnoid space. The spinal needle is smaller than the epidural needle due to the CSF leak

that can occur. The smaller needle allows a smaller pressure gradient change. The two major

complications that were discussed were hypotension and spinal headache. Hypotension can occur

with either epidural or spinal, so it is important that the patient receive a bolus of fluid to offset

the possible drop in blood pressure. If a patient receives a spinal, they will have a ‘true dura’

spinal headache 24-48 hours after the insertion and the only ‘true’ treatment to relieve the

headache is by an epidural blood patch.

I would say my overall experience today was exciting. I had one patient in labor and

delivery that was induced electively, however she refused having my buddy and I present in the

room for her labor. However, I was able to see how blood work is done on a newborn by
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pricking the bottom of the baby’s foot after warming it. The highlight of my day was when my

father came up to educate my clinical group on anesthesia differences and how they control a

patient’s pain while in labor.