Running Head: REFLECTION

Reflection: First Maternal Assessment

Marissa Brown

Trent University
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Reflection: First Maternal Assessment

Look Back and Elaborate

This week in placement week 3 was technically my first day on the A6 floor. In the

previous week, I was placed in the birthing suites and mostly watched the specific procedures

being done rather than completing the maternal assessments like everyone else. Going into this

week of placement, I was a little hesitant and unconfident in my ability to perform those

assessments as I didnt exactly get the practice the other students had the previous week. When

asked to go in and perform the maternal and infant assessment, I felt nervous and did not know

how to even approach starting the assessment. To make myself feel a little more comfortable, I

asked my partner if I could watch her complete her assessment first and then she could come in

and watch me do mine afterwards. I asked to watch her so that I could use some of her

communication techniques and follow her pattern of assessment. This would make me appear

more confident in what I was doing even though I did not feel it. After watching her assessments,

I went in with my instructor to perform them for the first time on my assigned patient. Before

starting my assessment, I made sure to inform my patient that I was a student as well as

introduced my instructor. Throughout the procedure, my instructor gave me some pointers as to

how to use the best technique when assessing the infants heart rate and respirations as well as

finding the mothers fundus. Overall, I believe I performed the assessments adequately for my

first attempt and found that as I repeatedly performed them throughout the shift, I became more

confident in my hands-on skills and communication techniques.

Analysis of Experience

As soon as I arrived on the floor I was instantly nervous about having to perform

assessments on real mothers for the first time. Prior to placement, we had practiced on the
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mannequins however, an assessment on a real, breathing and squirmy newborn is a lot more

difficult. My nervousness was primarily influenced by the fact that this mother had just had her

first baby and I wanted to appear confident for her so that she would feel the most comfortable in

my care. I feel as if I was very professional about how I acted and appeared confident on the

outside, even if I was freaking out a little on the inside. This was difficult for me because of my

lack of real life practice. Since this was my first assessment, my instructor was present to watch

me to make sure that I was performing correctly but also to put the patient at ease knowing that

she was there to intervene. This made me a little more nervous at the start because I wanted to

prove to my instructor that I was competent in my skills.

I also felt a little unprepared for this situation compared to my classmates because of my

experience in the birthing suites in the previous week and the lack of realism in the lab settings.

Although I had an amazing learning experience in the birthing suites, the experience consisted

mostly of watching as my knowledge of maternal and child assessments are not applicable until

after they move to A6. I also felt unprepared since in the lab setting we perform on mannequins,

I did not get to experience how difficult it is to hear a live babys respirations as well as check

the fundus of a mother who is in pain. However, my instructor was very helpful with tips about

how not just hear but see the respirations as well.

In this situation, I believe the patient was a bit nervous about having a student perform

assessments but seemed to remain calm throughout. I believe that if I was the patient I would

also be nervous of someone who is new, holding and assessing my first child. Since my

instructor was with me the first time, she reassured the patient that everything was alright as well

as explained to her what assessments I was performing.

Evidence of New Learning

Obviously, there must be a first time for everything even maternal assessments. From

this experience, I learned that the best way to overcome the nervousness of performing

something for the first time, is to make sure you obtain the knowledge to complete the task and

then just jump right in. By watching my partner complete her assessment before me, although it

might have made her a little nervous, I gained a lot of knowledge as to how to explain the

procedure as I am completing it as well as the best order in which to gather the information

needed. Seeing as watching her complete the assessment made me feel less nervous, I know that

as a learner, it helps me to learn what I need to do by watching first off and then performing

myself. That way I can adapt the techniques of others and bring them into my own practice. This

also gives me the opportunity to ask any questions or offer alternative techniques that I might

think are helpful. After some research, I realized that I am not the only one who appeared

nervous in the placement setting. According to a study performed on undergraduate nursing

students, there was a lot of anxiety presented from the students about different aspects of the

placement (Sun, Long, Tseng, Huang, You and Chiang, 2016). Many stated that they were so

nervous that they were shaking or event that their mind went blank and that they could not

remember what to do (Sun et. al, 2016). This made me feel better knowing I am not the only one

feeling this way and that I can use what I learned form it to benefit me future situations.

Revision and New Trial

I can use this learning in future situations to help me feel more confident in my abilities as

well as overcome my nervousness. I can do this by asking colleagues or classmates to watch

them perform a procedure before I complete as well as ensure I get adequate practice prior to the

opportunity. This may mean spending extra time in lab solidifying my hands-on skills or writing

down pointers about effective communication techniques.

Later that day in placement I put some of my learning to the test and jumped right in on new

opportunities and tried to forget how nervous I was. By jumping right in, I was able to

experience more, and in turn become more confident in my skills. For example, I answered a call

bell for the first time without thinking about how nervous I was and after realizing that it is easy

to simply ask what the patient needs, I felt a little silly for being nervous in the first place.

Identification of Further Learning

I believe that the learning I have gained from this experience, can benefit me in my future

career as a nurse. I would like to be able to feel confident going into most situations in my future

practice. To do this, I want to be able to use the strategies that I have produced to help guide me

through future situations where I feel nervous. I want to remember to just take a deep breath and

trust the knowledge I have and just go for it. I can also take this experience and use it to relate to

other patients as well as coworkers or classmates to help them through their nervousness. I can

use this to relate to their feelings and offer them some of my own strategies to help them. For

example, I could allow another nursing colleague or classmate to watch me perform a skill I am

confident in before they proceed to perform it themselves.

I also believe that in the future I may face situations that continue to make me feel nervous

and unprepared for and the strategies I have will not work. In that situation, I must be able to

reflect on my actions and feelings as I did with this one - and come up with some new

solutions. It is important to always have an open-mind and welcome all new experiences as well

as be constantly reflecting to make myself the best version of me and to foster my continued

learning.
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References

Sun, F., Long, A., Tseng, Y. S., Huang, H., You, J., & Chiang, C. (2016). Undergraduate student

nurses' lived experiences of anxiety during their first clinical practicum: A phenomenological

study. Nurse Education Today, 3721-26. doi:10.1016/j.nedt.2015.11.001