I love the story of Nathan Chen, a 18 year old US figure skater. He fell in the short program, overcome by pressure and expectations of the Olympics. Due to his failure, he had nothing to lose for the long program. He scored the highest of all competitors #1 in the long program, raising his combined ranking from 17th to 5th, not enough for a podium finish but enough to make history with 6 quad jumps in his long program. He would not have the audacity to take a chance on his competitive long program if he had not failed his short program. I love that he changed his perspective of failure into motivation to succeed. All of us can be so luckily to have that perspective.
I felt like a failure this week, doubting myself if I belong in this nursing program, questioning if I can pass all my exams, my classes and Boards at the end of the year. I say this – not for sympathy but to know that not every day is a success and not every week is amazing – that I need to know failure is a chance to succeed tomorrow.
This week was rough – we had ATI maternity exam (which is like a national comparison exam on all things maternity, a predictor if you will pass Boards on this section of your learning), a midterm in Pharm/Pathology, quiz in Community Health, quiz in Professional Nursing, pop quiz in maternity and an Exam #2 in maternity the previous week – which ended poorly with some problems in administration and then a fix, which leads to more pressure for #3/final to compensate for fairness.
At some point in studying, you feel like something has to give, you cannot retain all this material. Your eyes are tired. You feel all of this is not sustainable and you can’t keep up with this pace. On Monday, after our maternity final, our 6 weeks of maternity end and we transition to Pediatrics. It has been a challenging 6 weeks of enormous learning.
At our last maternity clinical, I was able to work with a lactation consultant (LC) and it was life changing – at least it felt like that to me. I could have said the same words to my patient but I would not have the success at delivery like the LC. It was her tone and experience that lead the mom to have confidence in herself and her abilities to breast feed.
I first observed the LC knock on the patient’s door and wait for a response. When the patient said, come in. She opened the door and before entering – at the doorway, she said, I’m [insert name], the lactation consultant, may I come in? Right there, that stopped me. She asked for permission to come into the room. Every time, I knock on the door, I don’t wait for a response and just say hello, I’m here for x task. It is presumed as a nurse, you will walk in to do what you need to do, where as the LC, waited for the invitation to be accepted. By waiting for permission, she gave autonomy to the patient.
When we were in the room, she talked to the patient and asked about her pain around breast feeding. The patient said her nipples felt sore, and the LC looked at her nipples and said, see this line – it shows the baby is not feeding correctly/latching and if continuing like that, it would lead to infection and the baby not getting enough feeding.
- She then demonstrated the patient how to position the baby – that it should be belly to belly with you and on the same plane as your breast – propping a pillow under each arm. She showed how to put her non dominant hand under her feeding breast like underwire and the other hand behind the baby’s back to help it feed and pull it closer to her.
- She pointed to acupressure points on the baby – under the shoulder, near the clavicle and in their hand to put pressure in these spots to re-engage the baby’s interest in feeding.
- She described the baby’s tight arm as still showing interest in feeding, but when the arm becomes floppy – it shows their “tank” is full.
- The LC shared how colostrum – the new breast milk is thick as honey and will take a few days to flow into breast milk. The mom had not understood this point with her previous baby, it lead to turning to formula to feed.
The mom failed at breastfeeding with her first baby, but now felt she could exclusively breastfeed and succeed. She had the education to feel confident in her abilities. The LC also shared a breastfeeding support group that was nearby and a phone number to call anytime she had questions. The LC said at her check up with the pediatrician, there are LCs available if she had questions. She put her phone number on the board so she could come back during the day if she had a question. It was amazing to watch the LC give this mom confidence in her abilities and the follow up with resources after the visit. It was so thorough, she walked her through every step and gave her support after her visit. The LC was patient, gentle, caring and her voice/tone was understanding.
I hope to emulate my patient care like hers, to allow for patient autonomy and help in their learning/education to make them feel empowered in their choices.